CHARLESTON – The estate of a Kanawha County woman alleges a doctor failed to properly treat a severe pressure ulcer and resulting infection that led to her death.
Carmen D. Jones, administrator of the estate of Anna Elizabeth Jones, filed the complaint July 2 in Kanawha Circuit Court against Dr. James R. Toothman, a doctor of osteopathy who lives in Putnam County.
diTrapano
“The care that Ms. Jones received from the defendant doctor was inexcusable,” attorney L. Dante diTrapano told The West Virginia Record. “Her death was needless, preventable and was the direct result of negligent care by her provider.”
According to the complaint, Anna Jones was pronounced dead at 4:20 a.m. July 4, 2025, at HospiceCare at Charleston Area Medical Center’s Memorial Hospital in Charleston. The filing alleges her death was “a direct and proximate result of defendant’s negligent acts and omissions” in connection with care provided while she was a resident of Genesis Dunbar Center, a Kanawha County nursing facility.
Jones was admitted to Genesis Dunbar Center on June 10, 2025, where she came under Toothman’s care. An admission assessment noted that she “has a history of dementia and requires full assistance with care,” but was alert and oriented at the time of admission. The complaint states she was briefly sent to CAMC on June 11 for evaluation of a possible stroke, medically cleared and transferred back to the nursing home the same day. Charting that day at the facility documented “coccyx with moisture-associated skin damage (MASD) and care provided. No open wounds or pressure ulcers elsewhere.”
Toothman allegedly saw Jones for her admission history and physical two days later. On June 18, Jones experienced an acute episode of altered mental status and severe hypotension, with blood pressures noted in the 60s over 30s.
The complaint quotes an encounter note stating Toothman ordered bloodwork – including a complete blood count, comprehensive metabolic panel and thyroid-stimulating hormone – but determined “[n]o transfer to hospital at this time due to stabilization and improvement.” An interdisciplinary team note from the same day documented “worsening of existing MASD located on the resident’s coccyx.”
Lab work ordered June 19 showed multiple abnormalities, including hyperchloremia, hyperglycemia, hypocalcemia, hypoproteinemia and hypoalbuminemia. The complaint further claims there is no indication a complete blood count with differential was performed that day or that Toothman followed up on the lab results.
Conditions allegedly deteriorated sharply on June 20. A progress note quoted in the complaint says nursing staff requested a reevaluation “due to worsening appearance and odor of the coccyx pressure ulcer, which is a known Stage 4 wound,” and that the wound “appeared malodorous, raising concern for local infection with possible systemic involvement.”
A physical exam confirmed a “Stage 4 pressure ulcer to coccyx with increased malodor,” and a nurse practitioner ordered a routine culture of the sacral wound, noting “↑ wound change, Elevated WBC.”
Culture results available that afternoon identified multiple organisms – including Escherichia coli, Proteus mirabilis, methicillin-resistant Staphylococcus aureus and Enterococcus faecalis – along with rare white blood cells and numerous gram-negative rods and gram-positive cocci. Despite those findings, the complaint alleges, “Anna Jones was not transferred to a higher skilled care facility to treat and/or otherwise manage her infection.”
Later on June 20, Toothman ordered a stat urine culture, which showed elevated white blood cells consistent with a urinary tract infection, and a complete blood count revealed a white blood cell count of 13.1, indicating infection, according to the filing. Jones was started on empiric antibiotics Rocephin (ceftriaxone) and Flagyl (metronidazole), but the suit claims Toothman still failed to arrange a transfer “despite having the stain results from the sacrum culture, the results of the urine culture, and Anna’s deteriorating clinical picture.”
A nurse practitioner’s assessment and plan that day described a “Stage 4 coccyx pressure ulcer, worsening, suspected superinfection” and “Leukocytosis concerning for infection, likely wound-related; possible urinary tract infection.” The complaint says Toothman was notified June 22 that the prescribed ceftriaxone and metronidazole were awaiting arrival from the pharmacy.
New labs drawn the morning of June 23 showed Jones’ white blood cell count had risen to 21.7 and she was exhibiting signs of kidney dysfunction, the filing states. She was emergently transferred back to CAMC that day, arriving with abnormal labs, altered mentation and hemodynamic instability, including hypotension and tachycardia. Hospital physicians ultimately diagnosed septic shock and a decubitus ulcer of the sacral region. Jones underwent surgical debridement on June 27 and June 30, but she died July 4.
The estate accuses Toothman of negligence and violating the West Virginia Medical Professional Liability Act. The complaint argues Toothman had a duty to provide care consistent with the “reasonable and ordinary care, skill, and ability” exercised by other health care providers in similar circumstances and that his treatment “deviated from the standard of care” in several ways, including failing to reassess changes in Jones’ condition, failing to timely obtain repeat labs, failing to ensure timely administration of antibiotics and failing to ensure timely transfer to a higher-level facility.
The estate seeks compensatory damages for medical expenses, lost wages and earning capacity, lost benefits and household services, pain and suffering, emotional distress, funeral and burial costs as well as punitive damages, court costs, attorney fees, pre- and post-judgment interest and other relief.
The estate is being represented by L. Dante diTrapano, Timothy D. Houston and David H. Carriger of Calwell Luce diTrapano in Charleston and by Charles M. “Sonny” Johnstone II of Johnstone & Gabhart in Charleston. The case has been assigned to Circuit Judge Stephanie Abraham.
Kanawha Circuit Court case number 26-C-783
