While we often do not consider the risk of receiving inadequate care when we are stuck in the hospital, such care is a real concern. Bedsores are one possible outcome of inadequate care. Hospitals face a significant challenge when fighting against a patient lawsuit stemming from bedsores—they are preventable medical incidents. This almost always makes them liable when a patient gets bedsores.
What Are Bedsores?
Bedsores are also known as pressure ulcers. They are very painful sores that may appear on a patient’s tailbone, buttocks, hips, heels or over other bony areas of the body. Bedsores develop for one simple reason: a patient has remained in the same position for an extended time.
When a patient is confined in bed for an extended time, it puts pressure on certain parts of the body. When the areas with the greatest pressure lack muscle or have thin tissue coverings, the body cannot evenly disperse pressure, which can affect blood flow. Left unattended for an extended time, this can cause the skin and tissue that covers the pressure point to sustain damage and die due to lack of blood flow. As more tissue dies, underlying tissue also dies and, in some cases, both bone and tissue may face exposure from the resulting pressure wound, which is called a bedsore or decubitus ulcer.
What Patients Are Most Prone to Bedsores?
Immobile patients who are bed-ridden or cannot move without assistance are most prone to developing bedsores.
In general, this will include:
- Patients in the ICU – Patients who are seriously ill and receiving care in an ICU are generally not mobile enough to turn themselves.
- Hospital patients of severe injuries – Anytime a person has been hospitalized due to a severe injury and has no control over their extremities, they are at risk of bedsores. When a patient with a significant injury is under medical care in the hospital and develops hospital-acquired bedsores, the patient may file a lawsuit.
- Patients with poor dietary habits – If a patient is admitted to a hospital due to malnourishment, dehydration or other medical conditions that indicate poor diet or reduce their appetite, hospital staff should monitor the patient to ensure that he or she is changing position regularly.
- Patients with certain risk factors – Patients who have poor circulation, or suffer from incontinence are more prone to bedsores. Hospital staff should ensure that these patients are turned and positioned and do not remain in the same position for more than two hours at a time to minimize the risk of developing bedsores.
- Patients with certain medical conditions – Diabetic patients often lose or have diminished sensation in certain body parts. This is a warning sign since many will not be aware of pain or pressure problems and may not think about remaining in the same position for several hours. Alzheimer’s patients, those with Parkinson’s disease, and patients suffering from rheumatoid arthritis are also at a higher risk of developing bedsores.
For some patients, surgical procedures can result in the development of bedsores. Someone who is undergoing extensive surgery may lay still on the operating table for several hours, which can increase the likelihood of developing a bedsore. The key to ensuring a patient’s full recovery from a bedsore is to identify it immediately and take steps to minimize the damage.
Hospitals Owe Patients a Duty of Care
Most of us simply assume that when we are admitted to a hospital, we will get the best possible care. We believe that hospitals always focus on the well-being of every patient in their care. However, regardless of whether you go to a prestigious facility or a rural hospital, bedsores pose a constant threat and can be deadly if not treated quickly.
Many people don’t know that the Centers for Medicare & Medicaid Services (CMS) has a list of never events. Never events are errors in medical care that are clearly identifiable, preventable and serious in their consequences for patients, and that indicate a real problem in the safety and credibility of a healthcare facility.
Medicare will not reimburse facilities for never events — such as hospital-acquired bedsores —, regardless of how much time or expense is associated with a patient’s care. Medicare calls stage 3 and 4 bedsores never events.
What Are the Different Stages of Bedsores?
At some time or another, a hospital patient may develop a stage 1 bedsore or pressure sore from not moving enough, or simply from sitting too long in one position, in bed or in a chair. You may see a red spot on the patient’s skin, and the area may feel swollen, warm or hard. In most cases, if pressure is removed from the area, the signs will clear up within a few days without needing additional medical care and treatment, outside of keeping the area clean and dry and maintaining a healthy diet. This is of course assuming that you do not repeat the behavior that caused the pressure sore to develop.
If a patient’s caregivers ignore the initial signs of a bedsore, if they fail to regularly turn and position a patient with limited mobility, this may lead to the development of a stage 2 bedsore. Stage 2 bedsores are characterized by blistering or abrasions on the skin where the original sore appeared.
In a hospital, if a caregiver fails to recognize the signs of this stage of a bedsore and fails to take action, the patient will likely develop other medical issues at this stage, and the wound will likely require additional medical care and treatment. Bedsores must remain clean and dry to avoid infection, and the wound may need to remain covered to avoid further irritation. Typically, the recovery for stage 2 bedsores varies from a few days to several weeks if adequately assessed and treated appropriately.
Stage 3 pressure sores cause significant damage to the full thickness of the patient’s skin. In some cases, signs may exist indicating that underlying tissue is also damaged. During stage 3, a bedsore may resemble a crater and may ooze blood or pus. A physician or wound care specialist should evaluate this type of injury and may prescribe antibiotics to prevent infection. At this stage, the wound can take as long as four to six months to heal and may take significantly longer depending on its location, size, depth and the care that the patient receives.
Stage 4 pressure sores may prove life-threatening. Victims who sustain this severe of a bedsore often suffer significant damage to the underlying muscles, nerves and tendons. These wounds are often deep, tunnel beneath the skin surface and in many cases, the skin and tissue surrounding the wound may die or become necrotic. Necrosis is defined as the death of body tissue, which is clear if the wound or surrounding skin has turned black.
Once a pressure sore has reached stage 4, it is common for the wound to emit a pungent odor from underlying infection; it may be hot to the touch and it is likely to drain pus or fluids. Patients with stage 4 bedsores may have exposed muscle, tendon and bone. These wounds are very serious, they may be life threatening and often require painful surgery, known as debridement, to remove all dead necrotic tissue. Stage 4 bedsores are deadly and recovery time for this serious injury can range from three months, on the short end, to years on the longer end.
Remember, all hospitals have a duty of care to their patients. This means taking care of the whole patient, including the patient’s skin. Ignoring skincare during a hospital admission can quickly lead to the development of avoidable bedsores. Generally, hospitals are liable for patient bed sores which begin in their facilities and owe patients and their families money damages for any resulting pain, suffering and the expense of any medical and nursing care needed to treat and heal these avoidable injuries.
Hospital Liability and Bedsores
You may wonder how to sue hospitals for bedsores. After all, a hospital is a corporation and not a person. The medical staff is responsible for the neglect after all. Hospitals face liability for the actions and inaction of their employees, staff members and physicians by a legal theory called vicarious liability. If a hospital employee, a nurse or doctor fails to properly care for and treat a patient, and that patient develops a bedsore, the hospital is responsible and legally liable. If the sore worsens and causes other health issues or leads to the patient’s death, the hospital can also face liability for wrongful death.
Hospitals also make decisions about staffing. For several years, hospital staff and nurses have been waiving a red warning flag and speaking out about their concerns about understaffing. When hospitals are understaffed, its nurses and nursing assistants may not have adequate time to pay attention to patients who are immobile or unable to communicate or call for assistance, which may lead to less care and result in bedsores.
Filing a Bedsore Lawsuit
Victims who have suffered serious bedsores can hold providers and hospitals accountable for their inaction that led to the initial bedsore, as well as for lack of attention once the bedsore developed. As with all types of medical malpractice cases, these cases require proof of negligent behavior.
When attempting to prove negligence, injured individuals must establish:
- The hospital owed the patient a duty of care. – The answer is simple: yes. Hospitals owe every patient a duty of care. Patients who are admitted for one condition and develop a secondary condition due to a lack of proper care while in the hospital have the right to hold the hospital accountable.
- The hospital breached its duty of care. – If the primary reason a patient develops a bedsore is that the hospital was understaffed, the staff was inadequately trained, or the staff simply ignored the warning signs of a bedsore, or simply failed to provide regular daily skin care, then yes, the hospital has breached its duty of care.
- A link between the breach and the injury. – When the bedsore develops while a patient is hospitalized for another condition, it creates the link between inaction (breach of duty) and the bedsores (injury).
- The victim suffered compensable losses. – Any patient receiving treatment for additional complications due to bedsores is paying a higher medical bill than they would otherwise have paid but for the bedsore treatment. Therefore, these losses are compensable and fulfill the final requirement for a bedsore lawsuit.
Assuming that you can demonstrate all of the above elements, your lawyer will discuss your available options with you, so you know what to expect. It is possible to hold a hospital corporation, no matter how large the institution, accountable for any resulting damages. The patient or their family members can file a personal injury lawsuit, known as a medical malpractice action, against the hospital corporation and any health care providers if they were negligent and failed to provide adequate skin care.
If a Hospital is Clearly Responsible, Do I Need a Lawyer?
Yes. Given the complex nature of Florida’s Medical Malpractice Act, you will need to have an experienced personal injury attorney when investigating and filing a medical malpractice lawsuit. Before filing a claim, the Florida Statutes requires you to conduct a presuit investigation of the claim, provide a written notice of intent to bring an action along with a sworn affidavit of a medical expert which corroborates reasonable grounds to support the claim of medical negligence. Remember, the hospital is not going to sit idly by after you claim they were negligent. Instead, the facility will immediately put together a team of its risk managers and corporate lawyers to work to minimize your claimed injury.
In some cases, the hospital’s risk manager or insurance company may offer you a quick settlement to keep the information confidential, and to pay out as little as possible. When you work with an experienced attorney, with years of expertise in this field and a proven record of success, you stand a much better chance of making a recovery for your family. Remember, the attorney you hire is there to protect your legal interests.
Working With a Bedsore Lawsuit Lawyer Near You
Bedsores often prove to be serious debilitating injuries. When bedsore victims do not receive proper daily skin care and treatment, they can develop sepsis, gangrene and other blood infections. Any of these conditions can prove deadly to the victim. Victims have a right to hold the responsible individuals accountable for the harm their actions (or lack of action) caused. According to Florida law, victims injured by a health care worker’s medical negligence may file a lawsuit against the responsible parties for up to two years following the incident that led to the injury.
Two years may seem like a long time. For an attorney to work on your case, he or she will have to request and review all your medical records to establish the timeline between the onset of your bedsores and the time they became more serious and resulted in further harm.
Many hospitals routinely refuse to produce records or, if they do, produce incomplete records to delay a patient’s ability to investigate their medical negligence claim. Sometimes it takes numerous written requests, threat of suit and years to obtain the information necessary to evaluate the claim.
There are other considerations as well—the severity of your bedsores, the outcome from the lack of treatment, how long you may suffer the repercussions of the lack of attention to the initial wounds, for example. All of these factors will play a role in your ability to bring a medical malpractice lawsuit and how much of a settlement, if any, you can recover from the hospital and the parties responsible for the pain and anguish you suffered.
We understand that you may have concerns about the costs associated with a bedsore lawsuit against a hospital. After all, while you are recovering, you may not work or earn any income, you may have to make multiple trips to the doctor for wound care, and you may face additional out-of-pocket medical expenses.
There is good news on that front as well: Experienced medical malpractice law firms, front all the costs and expenses to obtain the relevant medical records, investigate the claim and bring the lawsuit on your behalf. In fact, your lawyers do not collect any legal fees until their firm settles the case on your behalf. Your attorney won’t get paid unless you receive compensation for your injuries.
If you or a loved one suffered bedsores while in a hospital for an unrelated condition, contact an experienced medical malpractice lawyer today and learn what options you have for holding those responsible for the harm caused.