Table of Contents
When you hear the word pressure ulcers, or see the bedsores images, you will be startled as they are ghastly and make you look away.
Every year, approximately 2.5 million Americans encounter mild to severe pressure ulcers.
These recurrent skin lesions can sneak up on patients even before they understand what’s going on.
We need to arm ourselves with knowledge to prevent and manage these annoying and sometimes life-threatening wounds as caretakers, healthcare professionals, or even just caring family members.
In this blog we unravel the causes of pressure ulcers, learn how to keep our loved ones and patients comfortable, healthy, and ulcer-free and if someone else’s negligence caused it, how to handle that legally.
What is Pressure Ulcer?
Pressure sore or decubitus ulcer is commonly known as bed sore. It develops from an injury to the skin and the tissue under it caused by the prolonged pressure on the skin. It is a detrimental medical condition that can lead to pain, infection, amputation or even death.
Who are more prone to pressure ulcers? Usually people who are bedridden, with limited mobility, use wheel chairs or with chronic illnesses encounter such a serious medical issue.
Pressure sores can develop on ankles, heels, hips, shoulders, tailbone and buttocks, especially over bony prominences.
Causes of Pressure Ulcer
Pressure ulcers mostly come under hospital acquired infection when analyzed in a healthcare setting.
Stages of Development
There are 4 stages of pressure sores or bed sores. Depending on the length of the pressure to the area and the care given to the victim, the stages may differ.
- Stage 1 – In the first stage, the area under pressure will have a red or bluish purple tint. It may be warm to the touch with or without swelling. In this stage, the area will not be painful. In some cases, the person may also complain that it burns, hurts, or itches. Once the pressure is reduced, the swelling and redness will disappear.
- Stage 2 – At this stage, the skin breaks open, creating the ulcer itself. The ulcer may be red, yellow, or black. It will likely be painful, and there may be some discharge. These sores will heal within a few weeks.
- Stage 3 – Stage three ulcers penetrate the second layer of skin and start to damage the underlying tissue. The ulcer will be deep and crater-like. There may be a great deal of swelling and pain. It may take months to heal.
- Stage 4 – Stage four is the most severe stage of bedsore classification. The ulcer begins to affect muscle, tendons, or bone. There may be significant tissue damage and infection. These wounds are excruciating and can take months or years to heal.
In rare cases, a pressure wound may be classified as unstageable.
Risks and Complications
Decubitus ulcers have several risks and complications associated with.
When the open ulcers become infected with bacteria, it can spread to the surrounding tissues or enter the blood stream, causing detrimental infections like sepsis and gangrene. People with weak immune systems may encounter life-threatening complications due to these infections.
Formation of Abscess:
The bacterial infections could cause abscess, a sack of pus forming around the pressure sores. The formation of abscess makes the wound more painful and it would lengthen the healing process.
Cellulitis is also a kind of infection related to pressure ulcers, which can be painful. It can lead to expansion of the tissue damage.
Bed sores near the joints may spread to the joints and cause pain, swelling and reduce the patient’s mobility.
When the pressure sores expands and reaches the bones, it can cause Osteomyelitis. It will cause chronic pain and disability. Sometimes it may lead to surgeries or amputations.
This is a pernicious bacterial infection that can damage the skin, fat and the muscles around the pressure sores. This condition can turn out to be life-threatening if left untreated.
Longer Healing Time:
Pressure ulcers can take a long time to heal, especially in people with impaired immune systems or poor blood circulation. This extended healing phase can result in further issues and may necessitate specialized wound care.
Because of the increased protein and calorie requirements for wound healing, as well as potential difficulties with eating and digestion, people with pressure ulcers are at a higher risk of malnutrition.
Pressure ulcers can cause substantial pain and discomfort, negatively compromising a person’s quality of life and mental well-being.
Pressure ulcers can make it difficult for a person to move or change positions, increasing the risk of developing more decubitus ulcers.
Pain, limited movement, and physical disfigurement caused by pressure ulcers have a psychological impact.
How to treat pressure sores on buttocks, shoulders, knees, etc.? The treatment for pressure sores include prompt identification and preventive measures, which should go hand in hand for an effective result.
- Repositioning: Since being in the same position for more time applies more pressure to the skin, pressure ulcer can form. It is recommended to change positions of bedridden patients at least once every two hours. Patients in wheelchairs should be adjusted every 30 minutes.
- Support surfaces: Cushions, pads, heel boots, or special air or water-based mattresses can help disperse weight uniformly and alleviate strain in a particular region.
- Wound care: The most basic wound care is to clean the wound on a regular basis with saline or soap and water to avert infection and hasten the healing process.
- Antibiotics: It is strongly encouraged to use antibiotics to cure the ulcer or to prevent infection of the blood, tissues beneath the skin, or bone. Antibiotics like cream for bed sore, topical mupirocin or other oral antibiotics are used to treat the infection.
- Debridement: Removing dead tissue from the pressure sore is a crucial phase in the healing process. Specially developed dressings are sufficient for removing a smaller amount of dead tissue. Ultrasound, water jets, scalpels, and forceps are required to remove larger amounts of dead tissue.
- Pain management: Decubitus ulcers can cause unendurable pain for the patients. Over the counter medications and prescription medicines will be beneficial in helping the patient manage the pain.
- Infection control: Regular monitoring of the bedridden patients for signs of redness, warmth, pus or increased pain in particular regions can help preventing the infection on time. Early detection of the sore and infection can help you nip the enlargement of the infection in the bud.
- Nutritional support: A proper diet plan is essential to assist in wound healing. A diet rich in protein, vitamins and minerals is a must in promoting the healing process.
- Address underlying conditions: Underlying issues like diabetes, peripheral vascular disease, or malnutrition can be the root cause of bed sores. Identifying the cause and addressing it with proper treatment can prevent the bed sore.
- Physical therapy and exercise: Physical therapy and mild exercises can improve the mobility, strength and function of the patients. This will reduce their time being immobile.
- Clean environment: The bedridden or immobile patients should be always kept in a neat and tidy environment to avert the chances of infection. Personal hygiene of the patient as well the hygiene of their bed, covers and the room plays a significant role in bed sore prevention and management.
- Surgical intervention: Patients with deep wounds and infections may require surgical intervention like removing the damaged tissue, closing the wound or skin graft procedures.
Bedsores or decubitus ulcers are common indicators of recklessness in hospitals, nursing homes, and other facilities that provide long-term care. Only in rare cases, patients will have some underlying issues where pressure sores cannot be prevented.
The Federal Nursing Home Regulation §483.25(c) insists certain rules to ensure that the residents do not ensue pressure sores while being under the care of nursing homes.
Though these regulations are made to ensure good health of the nursing home residents, many of the facilities are found to be compromising patient health to profit.
Understaffing is a main reason behind the development of bed sores in patients in nursing homes or long-term care facilities. The available staff will be under pressure and may not be able to provide adequate care for the residents.
Facilities overlook the patient care by not ensuring the appointment of licensed staff or fail to provide adequate training to their existing staff. When the staff fail to notice the early signs of bedsores and take proper preventive measures, it would be detrimental in the pressure sore management.
The hospital or nursing home that provides the long-term care to a resident becomes liable when the patient develops bedsores due to the negligence of its staff. This liability is known as vicarious liability.
The potential avenues for liability includes:
- Negligence: If a healthcare provider or their staff deviates from the accepted standard of care in preventing, identifying or managing the decubitus ulcer, they can be held reprehensible for negligence.
- Medical malpractice: When the negligence of the healthcare provider leads directly to the development of pressure or the worsening of it, it can be considered a medical malpractice. The victim’s family can pursue a medical malpractice lawsuit against the facility or the provider.
- Breach of contract: The long-term care facility or a nursing home has some contractual obligations to provide standard care to the patient. When they fail to uphold these duties leading to the development of pressure ulcer to a resident, they are culpable for breach of contract.
- Violations of regulations: As we have seen, the healthcare facilities are obliged to follow the federal and state regulations for protecting an inmate from pressure sores. When they compromise on the well-being of the patient over money, they can be accountable for regulation violation.
What to do to File a Bedsore Lawsuit?
If you or your loved one developed bedsore due to the negligence of a facility, you can proceed with a bedsore lawsuit.
However, fighting the healthcare giants legally on your own will be the greatest blunder you make in your step towards getting a deserving reparation. The moment you move with the claim, the facility will be ready with their team of legal experts to tackle your allegations.
They may try to devalue your injuries or pressurize you to settle for a less compensation. Their medical experts may prove that your injuries are not developed due to their negligence.
The best decision to get a reasonable indemnity is to get the counsel of an experienced bedsore lawyer near you.
The bedsore attorney will then collate all the evidence including medical records, photos of pressure ulcers and the testimony of witnesses. With the expertise of a medical record review partner, he will churn out the evidence of malpractice to build a strong claim.
LezDo TechMed has wide exposure in handling nursing home negligence claims. Having them shoulder your claim assures you of a justifiable reparation.
Pressure Ulcer Settlements- Case Study
According to the nursing home abuse guide, an 88-year-old Delaware woman developed bedsores while in a nursing home. Her pressure ulcers spread deep into her tissue and bone.
Her family pursued a bedsore lawsuit on her behalf against the nursing home. As the nursing home’s negligence was proved, her family received $2.3 million as bedsore lawsuit settlement.
In the case of a Florida woman, Carol Reed, who had developed a stage 4 pressure ulcer, the jurors gave a plaintiff favored verdict. She received $12,353,604 in total damages including $1,728,604 for medical expenses and $10, 625,000 as pain and suffering damages.
Carol Reed had a specific spine condition from birth called spina bifida. She was admitted at Life Care Center of Orlando’s rehabilitation facility in 2017 as part of her broken leg rehabilitation process. A day after her discharge, she was again admitted for a stage 4 pressure ulcer that reached her bones.
Morgan & Morgan took up her case and fought for her. Due to her congenital spinal condition, she was unable to move enough on her own, which raised the risk of her pressure sore.
The staff who looked after Reed, did not initiate a proper wound care even after noticing the initial symptoms of pressure ulcers. Her attorney Keith Mitnik proved that and bagged her a deserving compensation.
Pressure ulcer or bedsore lawsuits can be complex and intriguing, involving the intersection of medical as well as legal issues. Understanding the intricacies of these claims can help patients and their families make informed decisions about whether to pursue bedsore lawsuits.
Better pressure ulcer management can rescue the patients from undergoing more agony and the facilities from facing medical malpractice lawsuits.
Follow us on Twitter for more updates.
1/7 Hidden Danger in Hospitals & Nursing Homes
The prevalence of pressure ulcers & bedsores in medical facilities and the negligence that can lead to severe complications is a shocking reality. @LevinInjuryFirm #BedSoreLawsuits #PressureUlcers #MedLegal360 #pressuresores pic.twitter.com/UwfwlAIg6f
— MedLegal360.com (@medlegal360) May 4, 2023