Pressure sores, or bedsores, are injuries to the skin and tissue that result from sustained periods of pressure on the skin. Typically, they develop on skin that covers bones; such as the heel, ankle, hips, or tailbone. A pressure sore is technically a tissue injury that develops when a person’s movement is restricted for a significant period of time. This means that pressure sores are a common injury for those who are bedridden. Pressure sores can also pop up from other conditions; such as incontinence, malnutrition, diminishing mental faculties, and other circumstances. Sustained friction and shearing of the skin have also been commonly known to result in pressure sores.How can I identify pressure sores?
Pressure sores vary wildly in severity. Although, bed sores typically develop below the waist, they can really be found on any area of the body. The affected area may appear red and will likely feel warm to touch. A pressure sore is very sensitive and painful when touched. There are four different stages of pressure sores which helps care providers assess the severity of the sore. However, pressure sores should never really develop past stage II. If pressure sores develop past stage III and IV; the pressure sores are often indicative of negligence.
- Stage I – In the first stage, the skin is not broken around the sore, but may appear red. The site will likely feel tender or painful compared to the surrounding skin.
- Stage II – When a sore progresses to the second stage, the outermost layer of the skin on the sore will be damaged or even lost. A shallow wound may also start to develop, which will look like a blister.
- Stage III – A stage III pressure sore is a fairly deep wound. The affected area will look crater-like and will usually have dead tissue at the bottom of the wound. The damage may even extend beyond the primary wound to layers of healthy skin.
- Stage IV – At stage IV, the wound will expose muscle, bone, or tendons. The bottom of the wound will contain dead tissue that will appear darkened.
- Unstageable – Pressure sores that are covered with dead and darkened tissue are considered “unstageable” because it is impossible to judge how deep the wound is.
In terms of potential lawsuits, our law firm is looking at Stage IV and unstagable bed sore cases. We take Stage III claims under some unique circumstances.Who is at risk for pressure sores?
People who have restricted or limited movement are at the greatest risk of developing pressure sores. For example, those who use a wheelchair or are confined to a bed are at greater risk. For those who use wheelchairs, pressure sores can develop on the tailbone, buttocks, shoulders, spine, arms, or legs.
The overwhelming majority our law firm’s bed sore cases are nursing home cases. In nursing homes, around 12.5% of individuals with mobility impairments, malnourishment, or who are in a coma experience pressures sores. Luckily, that number goes down to 2.5% for those who do not suffer from those conditions. But the reality is that no one should be getting a Stage III or beyond pressure sore. When patients and nursing home residents do, it is likely that the cause is negligence by a health care or nursing home care provider.How are pressure sores avoided and treated?
The best way to treat a pressure sore is to avoid one in the first place. One can do this by taking care of their body. Good nutrition and hydration ensure healthy skin and good blood flow, decreasing the risk of bed sores. Certainly, quitting smoking can be huge here considering that smokers often develop more severe wounds as a result of decreased blood flow.
In the event that a pressure sore does begin to develop, it is important to reposition the body, preventing sustained pressure on vulnerable areas. Placing a pillow between the legs is an easy way to prevent sores around the knees. In addition, keeping the skin clean and moisturized also cuts down on risk in general. In the event that a sore progresses past the initial stage, caretakers need to ensure that the wound is kept clean and re-dress the wound often to avoid the spread of infection. If the condition worsens, one might have to undergo a debridement, which is a procedure to remove dead skin.
It is definitely not rocket science. All you need is health care professionals who are diligent and are actively caring for the patient.What are the responsibilities of health care providers when it comes to pressure sores?
Pressure sores present a huge problem in the medical community considering how quickly a wound and infection can spread throughout the body. In fact, Federal law exists setting forth the policies and procedures to minimize the risk of pressure sores in long term care facilities. Further, there are clinical guidelines, which provide recommendations on how patients should be treated once pressure sores are present. The biggest factor is assessment, meaning care providers need to determine the size, location, and severity of the sore before developing a plan of action for treatment. Once sores have been identified, treatment involves more than just giving attention to the site. A patient’s diet and body condition are factors throughout the healing process. It is also vital that all care providers are kept in the loop to make sure a patient is repositioned and monitored accordingly.What should someone do if they develop pressure sores because of health care negligence?
In the event that a patient develops a pressure sore as a result of negligence on behalf of someone else; they should first contact a representative of the health care facility. They should also consider talking to an attorney. As discussed above, health care providers have a duty to minimize the risks of bedsores. So when they fail to do so, they need to be held accountable. An attorney will be able to gather the information necessary to bring a claim against a negligent care provider. Failure to prevent or treat pressure sores can be considered a form of medical malpractice. Therefore, it is important to discuss potential courses of action with an attorney before it is too late.In the event that a claim is filed, how much money do patients typically receive in settlements or verdicts?
The only remedy that the civil justice system provides for in these types of cases is money. So justice in these cases means compensation. The value of a case depends on the particular facts and circumstances behind each victim.
So while the sample verdicts and settlements we provide below (and in Maryland here) are useful and important information, they are also very limited. It is hard to gauge the value of an individual case based solely on looking at similar cases because there are so many different variables involved that have very different weights to them in terms of the settlement or trial value of the claim.
There is one thing you have to keep in mind. The overwhelming majority of these cases settle long before trial, with confidentiality clauses that do not let lawyers like us educate victims and other lawyers about our settlements. So the picking – particularly in Maryland where we practice – are very slim.
Reported settlements in nursing home cases are so rare because nursing homes are smart about covering up their mistakes. They demand confidentiality when cases settle. This has happened in every single nursing home case we have settled. Incredibly, you cannot find a reported nursing home settlement in Maryland in the last few years.
It is tough on nursing home lawyers. We want to get the word out about settlements but our clients are not focused on that. So we can’t hold up a settlement based our desire to get the word out.
With all of that said, here are some recent verdicts and settlements in nursing home cases:
- 2015, New York: $500,000 Verdict – An 86 year-old man undergoes surgery to resolve an aneurysm in his aorta. Although the surgery is successful, the recovery involves several complications, including bed sores developing on the man’s buttocks. Even though the man undergoes treatment for the sores, they continue to worsen and spread. After the man is transferred to a new facility nearly a year after surgery, he dies of kidney failure and septic shock. The man’s estate sues the hospital where the man was initially treated. Specifically, he alleges that the staff could have prevented the bed sores, which may have led to the man’s death. Further, his estate alleges that diligent repositioning could have avoided the problem to begin with. After a five day trial, a jury finds for the man’s estate, making an award of $500,000 for the patient’s pain and suffering.
- 2015, Pennsylvania: $110,000 Settlement – After an elderly man falls in his home, he is admitted to a hospital. He is discharged to a nursing facility, who notes that he has a high risk of skin breakdown. Over the next few months, he develops several pressure sores throughout his body in addition to MRSA and a serious urinary infection. He is transferred to a hospital multiple times, but dies from the injuries sustained at the nursing facility. His estate sues the facility, claiming that they were negligent in his care by failing to re-position the man to prevent his injuries. The defendants suggest that all of the injuries were pre-existing. Before trial, the parties settle for $110,000. It is easy to see why the nursing home let this one get published, right? They want you to think that a wrongful death case is worth only $110,000.
- 2014, Pennsylvania: $3,500,000 Verdict - A patient receives surgery for cauda equina syndrome. The surgery proceeds without any complications but during the rehabilitative process nurses begin to note various bed sores on the patient’s body. One of the bed sores eventually turns into a deep tissue injury of the tailbone. Over the next few months, the patient requires nearly 18 surgeries, including amputation of his right leg below the knee. He also develops a MRSA infection. He sues the hospital, alleging that they were deficient in treating him. Specifically, he claims that the hospital workers were not adequately trained. He claims that other aspects of the patient’s treatment, including malnutrition contributed to the sores. A jury awards the man $3,500,000.
- 2014, Massachusetts: $14,447,906 Verdict – A 90 year-old woman is admitted to a nursing home. For a period of around one month, staff leaves various infections and bed sores untreated. Because of the infections that resulted from the untreated bed sores, the woman’s cognitive abilities begin to deteriorate, causing her to fall out of her wheelchair. Her infections became so severe that doctors consider surgery, but given her age it is considered too risky. The woman eventually passes away from various complications that are traced to her bed sores. Her estate sues the nursing home, who admits various breaches of the applicable standard of care. They dispute that their neglect caused the injuries. In the end, the jury awards for the woman’s estate, with over $12,000,000 of the verdict comprised of punitive damages.
The Maryland medical malpractice and nursing home attorneys at Miller & Zois handle many cases involving pressure sores that could have easily been prevented. Medical records can only tell you so much.
Our attorneys dig deep and turn over every stone to figure out the most minute details of each pressure sore case – to find out what happened to you or someone you love (or loved). If you or a family member has developed pressure sores as a result of medical negligence, call us at 800-553-8082 or get a free online consultation.