Pressure Ulcer Legal Cases

Often, pressure ulcers—also known as bedsores or decubitus ulcers—are mentioned as though they are a normal part of aging or of the experience of living in a long-term nursing facility. In truth, pressure ulcers are often serious injuries that can result in a potentially fatal infection. They’re also often a sign of nursing home neglect.

If your loved one has experienced new or worsening bedsores since entering a nursing home, an experienced nursing home negligence lawyer can explain your legal options for obtaining compensation for the financial and quality-of-life impacts the injury has caused through a free, no-obligation case evaluation.

What Are Pressure Ulcers?

Pressure ulcers are injuries to the skin and underlying tissue resulting from prolonged pressure on the skin. Pressure limits the blood flow that is available to the skin, and blood is necessary to provide oxygen to the tissue to keep it alive and healthy.

Pressure ulcers most commonly occur in areas where the skin is covering bony parts of the body, such as the heels, ankles, hips, and tailbone. Individuals who use wheelchairs often suffer bedsores on their tailbone or buttocks, shoulder blades or spine, and the back of the arms and legs where they rest against the chair. Bedridden individuals also can develop pressure ulcers on the back or sides of the head.

Bedsores generally develop on people who have reduced mobility and cannot independently change positions at least once every two hours to prevent the pressure from injuring their skin and the structures beneath it. Incontinent individuals are at even greater risk of developing pressure ulcers, as exposure to the moisture in urine and stool causes the skin to weaken. Diabetes and vascular diseases can also make an individual more likely to develop bedsores, as these conditions already limit blood flow.

Symptoms of pressure ulcers include:

• Changes in skin color or texture in the affected area.
• Oozing or drainage of pus from an open wound.
• Swelling in the affected area.
• An area that is cooler or warmer to the touch than other areas on the skin.
• An area where there is tenderness.

The Risks of Pressure Ulcers

As previously mentioned, pressure ulcers are far from simple or common injuries.

Potentially life-altering or life-threatening complications can arise because of pressure ulcers, including:

• Cellulitis: This is an infection in the skin and connected soft tissues that presents as warmth, redness, and swelling in the affected area.
• Septic arthritis: This is an infection in the joint from a bedsore that can result in serious damage to cartilage and tissue.
• Osteomyelitis: This is an infection that burrows into the bones, reducing the function of the affected limb.
• Cancer: Sometimes pressure ulcers are slow healing or do not heal at all. These wounds can develop into a type of squamous cell carcinoma.
• Sepsis: Also known as septicemia, this condition is a severe “whole body” infection that leads to widespread inflammation that can cause organ damage. Sepsis can lead to death in severe cases.

The Stages of Pressure Ulcers

When an individual is found to have pressure ulcers, those ulcers are “staged” according to their depth and severity. The stage of the sore helps health care providers to determine the type of treatment that is necessary to promote healing of the area.

The stages of pressure ulcers are as follows:

• Stage 1: This is the mildest form of a pressure ulcer, only affecting the top layer of skin. Stage one pressure ulcers often produce feelings of burning or itching and the affected skin may be either firmer or softer, warmer or cooler than the surrounding skin. Stage one pressure ulcers generally heal within two or three days.
• Stage 2: In this stage, the pressure ulcer reaches deeper into the inner layer of the skin. The skin may be broken, resulting in an open wound, or the ulcer can present as a pus-filled blister. The skin is generally swollen and red and may ooze. Stage two pressure ulcers are usually quite painful and can take up to three weeks to heal.
• Stage 3: In stage three, the sore impacts both layers of skin and encroaches on the layer of fat and tissue beneath the skin. The sore often looks like a crater and may have a foul smell. Stage three pressure ulcers often show signs of infection, such as red edges on the wound, pus drainage, and heat. Stage three pressure ulcers can take several months to heal.
• Stage 4: This level of severity is the most serious, often affecting the muscles, ligaments, and sometimes even the bones beneath the sore. Stage four pressure ulcers present with blackened skin and signs of infection. Stage four pressure ulcers can take months or even years to heal.

How Pressure Ulcers Are Treated

Depending on the stage of the wound, the steps involved in the treatment of pressure ulcers include:

• Reducing the pressure or friction that caused the pressure ulcer through regular repositioning of the body and the use of supportive surfaces such as soft mattresses or cushions to provide additional relief from pressure.
• Cleaning and dressing the wound.
• Removing the damaged tissue by gently flushing the wound or carefully cutting away dead tissue.
• Pain medication.
• A healthy diet, which aids in wound healing.
• Surgical interventions, which can involve using a pad of muscle or skin from another part of the body to cover the wound and provide cushion to any exposed bone.

Why Pressure Ulcers in Nursing Homes Are a Sign of Neglect

Federal regulations hold Medicare/Medicaid-certified nursing homes responsible for providing services to residents designed to prevent bedsores from occurring.

Some of those services include:

• Regular repositioning of immobile patients to prevent pressure on a vulnerable area that can cause a sore to develop.
• Preventing dehydration and malnutrition, which can make the body more vulnerable to pressure ulcers and can make it harder for wounds to heal if they develop.
• Ensuring that incontinent residents are promptly cleaned and changed, as urine and feces both make the skin more vulnerable to pressure ulcers as well as infection.

Individuals often go to nursing homes because they require more care than their family can provide for them at home, including care provided by a licensed or certified medical practitioner. Because nursing home facilities are federally required to prevent bedsores from occurring or worsening, they also are required to have procedures in place to treat any bedsores their residents develop.

At the first sign of a stage 1 pressure ulcer, facility staff must take immediate measures to medically treat the condition and prevent it from becoming worse. Facility staff must note any areas of concern so that other staff members know and can ensure the condition does not worsen. They are also required to seek emergency medical services for residents who need immediate treatment.

One of the most common reasons for bedsores and other injuries caused by nursing home neglect is understaffing. Nursing homes are required to staff at a level to ensure that each resident receives an adequate amount of direct care. Failing to take measures to prevent new or worsening bedsores can result in a deficient rating during the facility’s annual inspection and can lead to fines and other consequences, in addition to making the facility and its staff liable for the expenses and quality-of-life impacts that the resident incurred because of the injury.

Obtaining Compensation for Nursing Home Neglect

While pressure ulcers should never be regarded as simply “something that happens when we age,” the condition is far from uncommon. More than one in every ten nursing home residents suffers from this condition, with stage two pressure ulcers being most common.

If your loved one suffered bedsores from negligent care at the nursing home, you or your loved one can pursue compensation to cover the expenses they incurred because of the injury, as well as the physical and psychological impacts of the injury. The legal process for pursuing compensation for injuries caused by nursing home neglect is to file a medical malpractice lawsuit. This is a legal claim in civil court that seeks to show who was responsible for the injury as well as the impacts of the injury on the injured person’s finances and life.

Proving Liability

To win a medical malpractice claim, you must prove that the nursing home or caregiver was liable for the injury.

You must prove their liability by establishing the following elements in your case:

• The at-fault party owed you a duty of care. The duty of care is a legal standard where the at-fault party’s actions are measured against what a reasonably prudent person in a similar profession would have done in similar circumstances. For example, the duty of care for nursing home facilities is to provide services aimed at preventing new or worsening bedsores, as required by federal law.
• There was a breach in this duty of care. The breach refers to the action or inaction the at-fault party took that was contrary to the duty of care they owed the injured resident. Examples include failing to reposition an immobile resident every two hours or failing to promptly clean and change an incontinent resident, leaving them at risk of developing pressure ulcers.
• This breach led to the resident’s pressure ulcers and the subsequent financial and emotional impacts resulting from the injury.

Damages

If your loved one has developed new or worsening bedsores because of nursing home neglect, you can seek both economic and non-economic damages from the at-fault party. The term damages in medical malpractice law means a payment made in compensation for harm.

Economic damages are made in compensation for the expenses directly related to the injury, including:

• Medical expenses. Even if your loved one is covered by Medicare or Medicaid, they can still seek recovery of medical expenses. Medicare or Medicaid are entitled to reimbursement if you obtain a damages settlement or verdict.
• The cost of moving to alternative living arrangements and the cost of obtaining additional services that the facility failed to provide.

Non-economic damages are a payment made in compensation for the impacts that the injury had on your loved one’s quality of life. Common impacts included in non-economic damage claims are:

• Physical pain and suffering.
• Emotional distress.

In some nursing home neglect cases, there is also the opportunity to claim punitive damages. Punitive damages are a payment that is not made for the expenses and impacts of the injury, but rather to punish a defendant for particularly reckless behavior.

An Attorney Can Help You

Nursing home abuse and neglect are widely underreported. Cognitive or physical disabilities in the population can prevent people from understanding or adequately talking about their injury. Family members often do not know that bedsores are a sign of neglect. An experienced nursing home lawyer not only understands the red flags that warn of nursing home neglect but also can help guide a neglected nursing home resident and their family through the legal process for obtaining much-needed compensation after an injury like this.

Medical malpractice attorneys generally offer a free initial case evaluation where potential clients can get expert guidance about their legal options and learn about additional services the attorney can provide, such as:

• Identifying all liable parties and all insurance resources that can be accessed to provide compensation.
• A valuation of the case based on the expenses and impacts the injured resident has suffered or likely will suffer in the future.
• Collecting evidence and witness testimony, including expert medical testimony when necessary.
• Negotiating with the at-fault party’s insurance provider in an attempt to garner a fair settlement offer.
• Managing all the steps and paperwork involved in litigation on the patient’s behalf.
• Assistance collecting your settlement or award.