Maryland Lawyer in Nursing Home

Decubitius Ulcer Cases

 

Background

Circumstances sometimes require us to entrust the health and safety of aging family members to nursing homes and assisted living facilities.  This may be because we are not qualified to provide the necessary level of care, because our family members do not want to be a “burden,” or for any number of other reasons.  So we trust the health care professionals at nursing homes and assisted living facilities to take care of our loved ones. 

Most of the time, the doctors, nurses and staff at these facilities are caring, compassionate and competent.  Sometimes, though, they cut corners, cut budgets, and cause harm. 
Perhaps the most devastating and preventable injury is the decubitus ulcer.  A decubitus ulcer is also known as a bedsore, a pressure sore or a skin sore.  Most decubitus ulcers start off innocently enough, as a small mark on the skin, often on the lower back or buttocks. 

Unrecognized and untreated, however, those innocuous marks can grow to full stage IV holes in the skin that penetrate to the bone.  In the worst cases, the flesh becomes necrotic and dies, and surrounding tissue, organs and bone become infected.  Stage IV ulcers are often fatal.  Our nursing home lawyers work to bring understaffed and uncaring nursing home facilities to justice.

 Anatomy 101:  Decubitus Ulcers

Pressure sores are created because of a body’s weight on the skin, soft tissue, muscle and bone on a surface.  Active people don’t typically have problems with pressure sores, because constant pressure is required to make a sore.  In someone who is less mobile, however, the capillaries cannot refill adequately, and the lack of blood flow harms the skin. 

Patients who are particularly susceptible to bedsores are the immobile, people with contractures and spasticity, and people recovering from some surgeries (for example, hip fractures). 

Stages

There are four stages of decubitus ulcers. Each stage corresponds to a specific depth of sore.  Not all ulcers follow a clear progression from stage I to stage IV, however.  Most nursing home decubitus ulcer lawsuits are the result of a failure to identify developing bedsores. 

  • Stage I:  Intact skin with signs of impending ulceration.  The skin may appear white, indicating less oxygenation to the skin.
  • Stage II:  Partial-thickness loss of skin into the subcutaneous tissue (third layer of skin); looks like an abrasion or blister.
  • Stage III:  Full-thickness loss of skin into the subcutaneous tissue; looks like a crater.
  • Stage IV:  Full-thickness loss of skin and subcutaneous tissue with extension into muscle, tendon or bone. 

Ulcers may cause foul odors, wound drainage, and necrotic tissue.  If the wound is necrotic or comes into close contact with urine or feces, life-threatening infection is possible.

Treatment

Treatment of bedsores depends on the stage and severity.  In case of minor sores, the solution is usually to keep pressure off of the developing bedsoreulcer.  Sometimes, getting a patient off of a standard mattress or wheelchair and onto specialized bedding or padding, like foam devices and air-filled devices, can help the wound to heal and prevent reoccurrence.  In all cases, patients should be repositioned frequently. 

The wounds must be kept dry and clean.  Antibiotics may be necessary in case of infection.  In more severe cases, a specialized dressing should be applied to the wound.  If necessary, the wound may need debridement (removal of dead, damaged or infected tissue) to avoid sepsis, necrotizing fasciitis and gangrene.  Surgery may eventually be necessary. 

Treatment can be made more difficult with patients who are malnourished, or anemic (poor oxygenation in the blood).  It is not enough to simply treat the bedsore—the whole patient must be treated. 

Statistics
  • Two-thirds of pressure sores occur in people over 70 years old
  • 17-28% of nursing home patients develop pressure sores
  • 7-8% of all paraplegics die because of pressure sores
Nursing Home Duty to Prevent Bedsores

Nursing homes and other assisted care facilities have a duty to prevent severe bedsores.  The reality is that bedsores are not always avoidable.  Exacerbation of bedsores, however, is avoidable.  Nursing home stuff must be trained and given the time to thoroughly check their patients and residents for signs of bedsores.  At the first sign, if appropriate measures are taken, more severe medical complications can be avoided.  Failure to properly treat these ulcers, which may require physician or surgical intervention, can cause serious injury and death. 

How Our Lawyers Prove That Nursing Homes Were Negligent

Nursing homes conduct extensive intakes on their patients.  In most cases we have litigated, the patient enters the nursing home with no skin problems, and ends up with a fatal stage IV decubitus ulcer. 

The nursing home records often tell the complete story:  records frequently document regular skin checks and rotation, yet somehow an ulcer is found suddenly at stage IV with no warning signs.  Proper inspection would have revealed that wound well before it became a life-threatening problem.  The nursing home is often caught in its own lies. 

It is estimated that treatment of bedsores costs over $6 billion in the United States.  One prime area of discovery in nursing home cases in some states (particularly where punitive damages are available) is the nursing homes financial records and staffing records.  Where a nursing home is understaffed, a jury is allowed to infer a financial motive to provided very limited and inadequate care. 

Contact Us

If someone you love has a bedsore or other injury that you suspect stems from that a nursing home violating the law or providing improper care, call our Maryland nursing home attorneys at 1.800.553.8082 for a free consultation, or get a free internet consultation. There are no fees or expenses unless money damages are awarded by a judge or jury or obtained by settlement in your Maryland nursing home case.

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