The daughter of a former LaFayette, Ga., nursing home resident is suing the company because mites burrowed into her mother's scalp, face, chest, breasts, shoulders, back, arms and hands.
Rebecca Estelle Zeni, 92, died in June 2015 after living in the Shepherd Hills nursing home for five years. She was there through three crusted scabies outbreaks, according to Department of Public Health records and facility infection logs.
Attorneys for Zeni's daughter, Pamela Puryear, argue in the lawsuit the center's staff was negligent, failing to properly isolate residents with the infection, treat those who fell victim or rush Zeni to a hospital in time to save her.
Attorneys filed a lawsuit against PruittHealth, a for-profit company that runs Shepherd Hills and dozens of other nursing homes, in Gwinnett County in April 2016.
A lawyer for the company, Jeffrey Braintwain, argues that, among other defenses, injuries may have been caused by people PruittHealth cannot control. This includes Puryear and Zeni herself.
Braintwain did not return a call or email seeking comment on the case last week. A Pruitt-Health spokesperson did not return a message left at the company's main number.
According to the lawsuit, Zeni began living at Shepherd Hills in 2010 when she was 87 years old. She suffered from dementia. During her stay there, the nursing home at 800 Patterson Road in LaFayette experienced at least three scabies outbreaks.
In August 2013, according to the Georgia Department of Public Health, 10 residents and 10 staff members were affected by scabies. In October 2014, the home's internal infection log shows, at least six patients were affected. In May 2015, according to the Department of Public Health, 20 residents and another 15 staff members were affected.
Zeni died 10 days after that third outbreak began. According to an autopsy report, requested by her daughter, she had crusted scabies throughout her body. Inside her skin, mites' eggs were still present. A layer of skin had been stripped off her right hand, which suffered from gangrenous changes that caused a loss of blood supply.
The medical examiner wrote that this condition left her vulnerable, allowing bacteria to infect her bloodstream. This led to a staph infection, her cause of death.
In a February 2008 paper in "Drugs and Aging," Milan Tjioe wrote that nursing homes are vulnerable to scabies infections. The mites dig small tunnels into the outer layers of a victim's skin. After having sex, the female mite lays about 40 eggs; the male dies. A female mite can live in your skin for a month or two.
On average, Tjioe wrote, an infected person will have 10-15 mites at a time. The condition can be treated with topical cream and Ivermectin pills.
But older patients are more vulnerable to the parasite, especially when it comes in the form of crusted scabies. An elderly person's immune system is weaker and won't attack the mite as vigorously. If not treated, the mites will multiply indefinitely. A patient can have thousands of mites in his or her body. They form crust on the skin. The crust sheds, carrying mites and eggs with it. The outbreak spreads.
In the lawsuit, Puryear's attorneys argue that the staff at Shepherd Hills did not properly isolate patients with scabies. For example, they allegedly washed all the bed sheets together. While the staff prescribed Zeni some topical cream, the lawyers argue they did not thoroughly follow the treatment.
The lawyers also argue that the staff did not monitor Zeni enough and should have sent her to an acute care center.
PruittHealth receives federal funding for its work with patients. But according to The Washington Post, the Centers for Medicare and Medicaid Services gave the company a one-star rating, the lowest it could get. The centers based the rating on health inspections, staffing and quality of care.
According to the Post, the company paid $337,000 in penalties the past two years. In one incident, the staff mistakenly gave morphine to a patient twice within a half hour. Staff continued to give the patient morphine every two hours throughout the day. The patient overdosed and was rushed to the intensive care unit.
Contact staff writer Tyler Jett at 423-757-6476 or tjett@timesfreepress.com. Follow him on Twitter @LetsJett.