Court of Appeals of Texas, Seventh District, Amarillo
INTEGRATED OF AMARILLO, INC. D/B/A PLUM CREEK HEALTHCARE CENTER, APPELLANT
CLEO KIRKLAND, APPELLEE
On Appeal from the 181st District Court, Potter County, Texas. Trial Court No. 98,326-B, Honorable John B. Board, Presiding.
Before QUINN, C.J., and CAMPBELL and PIRTLE, JJ.
James T. Campbell, Justice.
Appellant Integrated of Amarillo, Inc. d/b/a Plum Creek Healthcare Center ("Plum Creek" ) appeals from the trial court's judgment in favor of appellee Cleo Kirkland. We will affirm the judgment of the trial court.
On December 24, 2007, Kirkland was injured when he stepped out of his pickup truck. The pickup's transmission apparently was in reverse instead of the park position, because as Kirkland stepped out, the vehicle moved backward. Kirkland was knocked down, and the pickup's front tire ran over and broke both of his legs.
The fracture of Kirkland's left leg did not require surgery. The right leg injury was more severe, with fractures of both the tibia and the fibula. Dr. Brendan Albracht performed surgery on December 25, described as an open reduction internal fixation that included the placement of screws and plates in the right leg. Albracht testified that when he saw Kirkland he also had abrasions to both legs and swelling. Albracht described Kirkland's postoperative course as " benign with the exception of the administration of pain medication. He explained that by benign, he meant " [t]here were no complications that arose during that time period that he was seen at the hospital at BSA."
Two days after the surgery, on December 27, Kirkland was transferred from the hospital to Plum Creek for rehabilitation. Nursing notes from Plum Creek show the presence of " fracture blisters"  on his right shin and along the back of his right calf. Five days after surgery, a Plum Creek nurse applied Silvadene, a prescription antibiotic cream, to the fracture blisters, despite the absence of a doctor's order prescribing the cream.
On December 31, Kirkland was transferred back to the hospital for treatment of a deep venous thrombosis in his right leg. Beginning on January 2, 2008, he was seen by Dr. Taylor Carlisle, an infectious disease specialist. On January 4, 2008, Kirkland was transferred to another facility. The condition of his right leg worsened over time. On January 16, a dermatologist performed a debridement of dead skin from his leg. Albracht was notified that during debridement, the end of the plate in Kirkland's leg was exposed. After consultation, the decision was made to amputate
the right leg above the knee, a procedure Albracht performed on March 5, 2008.
Kirkland was 74 at the time of his accident. Plum Creek's records contained a notation that Kirkland is allergic to sulfa, an ingredient of Silvadene. Kirkland complained of an extreme burning sensation after application of the cream. Medical records also show Kirkland has ...