## Facts

- Edna Stovall, an elderly patient with serious medical conditions, was admitted to a nursing home on February 8, 1985; no bedsores were documented at admission.
- Within days, Stovall developed pressure sores, which worsened during her residency and later required hospital treatment and surgical debridement of multiple ulcers.
- Stovall was rehospitalized in February 1986 for additional debridement; multiple ulcers were noted on several parts of her body.
- Stovall died on March 4, 1986; the death certificate listed cardiopulmonary arrest due to multiple decubitus ulcers with sepsis (with disputed evidence regarding a “chronic vegetative state”).
- The estate sued the nursing home and its parent corporation, alleging negligent and wanton care that caused infected bedsores leading to death.
- The plaintiff introduced state health department survey and deficiency reports citing recurring facility problems (including staffing and care deficiencies) to show notice and a pattern of substandard care.
- A jury found for the estate against the facility and parent corporation, awarding $2 million in punitive damages; the treating physician received a defense verdict.
- The trial court denied defendants’ post-trial motions (including JNOV, new trial, mistrial requests, and remittitur).

## Issues

1. Whether state health department survey reports and deficiency citations were admissible to show notice, pattern of conduct, and care deficiencies relevant to causation and wantonness.
2. Whether the trial court abused its discretion by denying mistrial motions based on alleged prejudicial remarks or conduct by plaintiff’s counsel.
3. Whether evidence supported imposing liability on the parent corporation based on its control over the nursing home’s operations.
4. Whether the $2 million punitive damages award in a wrongful death action was improper or excessive, including in light of the defendants’ asserted financial distress and bankruptcy status.

## Decision

- The Supreme Court of Alabama affirmed the judgment.
- The survey and deficiency reports were properly admitted as relevant evidence, and the trial court acted within its discretion.
- The denial of mistrial motions was affirmed under an abuse-of-discretion standard.
- The evidence permitted the jury to hold the parent corporation liable based on substantial operational control affecting patient care.
- The punitive damages award was upheld; the Court rejected arguments for remittitur based on financial condition or bankruptcy.

## Legal Principles

- Regulatory survey and deficiency materials concerning a facility’s care practices may be admissible when relevant to notice, recurring deficiencies, and whether conduct met the applicable standard of care; admission lies largely within the trial court’s discretion, subject to limits on unfair prejudice.
- A trial court’s ruling on mistrial based on attorney conduct is reviewed for abuse of discretion, with deference to the judge’s first-hand assessment of the trial’s effect on the jury.
- A parent corporation may be held liable for a subsidiary health-care facility’s torts when evidence shows substantial control over policies and operational decisions (including staffing and budgeting) tied to resident care.
- In Alabama wrongful death actions, damages are punitive and may be sustained to punish and deter egregious neglect; financial distress or bankruptcy does not, by itself, require reduction where the award remains supported by the evidence and deterrence rationale.

## Conclusion

The court upheld a $2 million punitive wrongful-death verdict against a nursing home and its parent corporation, holding that regulatory deficiency reports were properly admitted to show notice and recurring care failures, that mistrial relief was unwarranted, that parent-company control could support liability, and that the punitive award was not excessive despite claimed financial hardship.


Montgomery Health Care Facility, Inc. v. Ballard, 565 So. 2d 221 (Ala. 1990)