A Kentucky woman, admitted to a nursing home for what was supposed to be brief rehabilitation after fracturing her ankle, ended up having her left leg amputated below the knee. This drastic outcome resulted from the facility’s failure to adhere to the orders given by her orthopedic surgeon, as detailed in a lawsuit.

The Coldspring Transitional Care Center in Campbell County is accused of negligence for not removing Brenda Roberts’ immobilizing ankle boot while she was resting in bed and sitting in chairs during her recovery. The 75-year-old from Williamstown suffered as her left heel was continually pressed against the boot’s hard plastic, according to her legal complaint.

This oversight led to skin exposure and excessive pressure on her heel, culminating in a stage 4 ulcer and a significant decline in her health, the complaint asserts. As a consequence, Roberts had to undergo an amputation of the lower portion of her leg, says her attorney, Matt Mooney.

“A routine rehabilitation should not end in such severe injury and an amputation,” Mooney expressed to Law&Crime. “Unfortunately, we often encounter preventable harm that stems from understaffing and poor care.”

Mooney explained that during her stay at Coldspring, Roberts endured the distressing experience of watching the complete thickness of skin and tissue over her heel bone deteriorate due to persistent pressure that restricted blood flow to the area. This was attributed to her continuous wearing of the medical boot, as per the complaint.

“Defendants’ failure to remove the immobilizing ankle boot from her left foot while Brenda Roberts was laying in bed and/or seated in a chair was not just a failure to follow her doctor’s orders but also a failure to follow ordinary care and minimum safety practices expected of the defendants,” the complaint charges. “[Roberts] suffered unnecessary loss of personal dignity, extreme pain and suffering, degradation, mental anguish, disability, disfigurement, all of which were caused by the wrongful conduct of defendants.”

Mooney tells Law&Crime that families are supposed to be able to “trust short-term rehab facilities to help their loved ones recover and go home,” not get worse.

“Defendants owed a duty to Brenda Roberts to have in place procedures and protocols to properly care for residents,” the complaint concludes.

“I felt neglected there,” Roberts told local ABC affiliate WCPO. “I didn’t have anyone really coming to look at my foot.”

Coldspring did not respond to Law&Crime’s requests for comment Sunday.