Bedsore Lawsuits: FAQs

WHEN IT COMES TO BEDSORES, PRESSURE SORES, DECUBITUS ULCERS IT’S OFTEN HELPFUL TO READ WHAT OTHERS HAVE ASKED. YOU MAY BE ABLE TO BENEFIT FROM SOME OF OUR FREQUENTLY ASKED QUESTIONS BELOW.

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Pressure Ulcers: What You Should Do If You See Them on Your Loved One In A Hospital

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The National Pressure Ulcer Advisory Panel (NPUAP) defines a pressure ulcer as a “localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure, or pressure in combination with shear.” Illustrations of common locations of pressure ulcers are shown below:
LOCATIONS PRESSURE SORES ENGLISH

These injuries can lead to further medical problems, infections, sepsis, amputation and even death. Whether malpractice, abuse or neglect it is simply unjust and unnecessary for it to happen to an innocent patient.

Call today for a free consultation to find out the value of a lawsuit or for more information: 212-268-8200, or 800-278-2960

Read more at http://www.BedsoreHotline.com

Stages of Bedsores:

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Bedsores Reference Guide: Lawsuit, Medical, and Treatment information

Have bedsores reached epidemic proportions yet? To many it seems so — especially in elders that are in hospitals and nursing homes — and they do not have to be incapacitated or totally immobile to be at risk.

Whether or not you or an elder in your family has unfortunately become a victim of a bedsore, pressure ulcer, or decubitus ulcer keep this handy reference guide available. Download it to you computer, cell phone or bookmark it. Because bedsores can happen extremely fast and catch you off guard. They can progress rapidly, even within hours if proper care and medical attention are not given.

Anyone with an elder family member entering a hospital, nursing home or even a skilled nursing facility for a short term stay should read and help prevent these potential life treating wounds from happening to a loved one. They can occur at even the best hospitals with the best doctors. You may not expect malpractice, but it happens. You may not expect neglect but it happens. It happens to tens of thousands of innocent patients.

Lawsuits can yield millions of dollars to the victim and their family.

Understaffing, inadequate training, changes in shifts, or simply a scenario where your loved one in a nursing home may need care but that care is given to others with a more acute immediate need. It’s at these times that the elder is at extreme risk.

You can read more about risk factors, treatment, and lawsuits to be compensated for pain, suffering or loss of life here. Reference Guide>

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Additional information on bedsores from Medical News Today>

More Facts About Your Legal Rights>

Pressure sores: Causes, treatment, and prevention

Informative medical information: 

Via MEDICAL NEWS TODAY, By Christian Nordqvist

Pressure sores can affect people who spend a long time in one position, for example, because of paralysis, illness, old age, or frailty.

Also known as pressure ulcers and bedsores, pressure sores can happen when there is friction or unrelieved pressure on one part of the body.

People who cannot make even small movements are at risk of pressure sores.

The sores can affect any part of the body, but the bony areas around the elbows, knees, heels, coccyx, and ankles are more susceptible.

Bedsores are treatable, but, if treatment comes too late, they can lead to fatal complications.

The prevalence of pressure sores in intensive care units in the United States (U.S.) is estimated to range from 16.6 percent to 20.7 percent.

Fast facts on pressure soresHere are some key points about pressure sores. More detail and supporting information is in the main article.

  • Pressure sores, pressure ulcers, or bedsores commonly affect people who cannot move easily.
  • They are more likely to affect the bony parts of the body.
  • The sores develop in stages. Identifying them in the early stage enables treatment and reduces the risk of complications.
  • Moving patients frequently is key to preventing pressure sores.

Symptoms

[Pressure sores]There are varying stages of severity of pressure sore.

Pressure ulcers can affect patients who are unable to move because of paralysis, illness, or old age.

Bed-bound patients are most at risk of developing bedsores on the bony parts of their body, such as the ankles, heels, shoulders, coccyx or tailbone, elbows, and the back of the head.

Patients who use a wheelchair have a higher risk of developing pressure sores on their:

  • buttocks and tailbone
  • spine
  • shoulder blades
  • back of arms or legs

Pressure sores develop in four stages.

  1. The skin will look red and feel warm to the touch. It may be itchy.
  2. There may be a painful open sore or a blister, with discolored skin around it.
  3. A crater-like appearance develops, due to tissue damage below the skin’s surface.
  4. Severe damage to skin and tissue, possibly with infection. Muscles, bones, and tendons may be visible.

An infected sore takes longer to heal, and the infection can spread elsewhere in the body.

Causes and risk factors

Anyone who stays in one place for a long time and who cannot change position without help is at risk of developing pressure sores. The ulcers can develop and progress rapidly, and they can be difficult to heal.

Sustained pressure can cut off circulation to vulnerable parts of the body. Without an adequate supply of blood, body tissues can die.

According to Johns Hopkins Medicine, a sore can develop if blood supply is cut off for more than 2 to 3 hours.

Pressure ulcers are usually caused by:

Continuous pressure: if there is pressure on the skin on one side, and bone on the other, the skin and underlying tissue may not receive an adequate blood supply.

Friction: For some patients, especially those with thin, frail skin and poor circulation, turning and moving may damage the skin, raising the risk of bedsores.

Shear: If the skin moves one way while the underlying bone moves in the opposite direction, there is a risk of shearing. Cell walls and minute blood vessels may stretch and tear.

This can happen if a patient slides down a bed or a chair, or if the top half of the bed is raised too high.

Injured tissue can develop an infection. This can spread, leading to serious illness.

Risk factors

[Pressure sores immobility]Pressure sores mainly affect those who are less mobile, or restricted to one position, such as older people or those with mobility impairments.

Pressure ulcers are more common among those who:

  • are immobilized because of injury, illness, or sedation
  • have long-term spinal cord injuries

Patients with long-term spinal cord injuries or neuropathic conditions, including diabetes, have reduced sensation.

They may not feel a bedsore developing, so they continue to lie on it, making it worse.

Patients who cannot move specific parts of their body unaided have a greater risk of developing pressure ulcers.

Factors that increase the risk include:

  • Older age as skin gets thinner and more vulnerable with age
  • Reduced pain perception, due, for example, to a spinal cord or other injury, as they may not notice the sore
  • Poor blood circulation, due to diabetes, vascular diseases, smoking, and compression
  • Poor diet, especially with a lack of protein, vitamin C, and zinc
  • Reduced mental awareness, due to a disease, injury, or medication, can reduce the patient’s ability to take preventive action
  • Incontinence of urine or feces can cause areas of permanently moist skin, increasing the risk of skin breakdown and damage

A low or high body mass index (BMI) increases the risk.

A person with a low body weight will have less padding around their bones, while those with obesity can develop sores in unusual places. Studies show that people with a BMI of 30 to 39.9 have a 1.5 times higher rate of developing pressure ulcers.

Diagnosis, treatment, and management

[Pressure sores relief]Placing a pillow under the affected area can help to alleviate pressure and symptoms.

A doctor will diagnose a pressure ulcer through a visual examination.

The physician will ask about recent medical history and they will check the size and shape of the sore, and if there is any oozing or weeping.

If the patient is not in residential care, a doctor may teach them how to carry out regular daily checks on themselves.

People should report any sign of a pressure sore to the doctor.

Treatment

Treating pressure ulcers is not easy.

An open wound is unlikely to heal rapidly. Even when healing does take place, it may be inconsistent, because of the damage to skin and other tissues.

Less severe pressure ulcers often heal within a few weeks with proper treatment, but serious wounds may need surgery.

The following steps should be taken:

  • Remove the pressure from the sore by moving the patient or using foam pads or pillows to prop up parts of the body.
  • Clean the wound: Minor wounds may be gently washed with water and a mild soap. Open sores need to be cleaned with a saline solution each time the dressing is changed.
  • Control incontinence as far as possible.
  • Remove dead tissue: A wound does not heal well if dead or infected tissue is present, so debridement is necessary.
  • Apply dressings: These protect the wound and accelerate healing. Some dressings help prevent infection by dissolving dead tissue.
  • Use oral antibiotics or antibiotic cream: These will can help treat an infection.

In the early stages, people may treat ulcers at home, but more severe ulcers will need dressing by a health care professional.

Negative pressure wound therapy

Also known as vacuum-assisted therapy, this procedure involves the attachment of a suction tube to the bedsore. The tube draws moisture from the ulcer, drastically improving the healing time and reducing the risk of infection.

Wounds heal within around 6 weeks at half the cost of surgery.

Surgery

Some bedsores may become so severe that surgical intervention is necessary.

Surgery aims to clean the sore, treat or prevent infection, reduce fluid loss, and lower the risk of further complications.

A pad of muscle, skin, or other tissue from the patient’s body is used to cover the wound and cushion the affected bone. This is known as flap reconstruction.

Prevention

Even with excellent medical and nursing care, bedsores can be hard to prevent, especially among vulnerable patients.

Preventing bedsores is easier than treating them, but this too can be challenging.

Tips to reduce the risk of a bed sore developing include:

  • moving the patient at least every 15 minutes for wheelchair users and at every 2 hours for people in bed
  • daily skin inspections
  • keeping the skin healthy and dry
  • maintaining good nutrition, to enhance overall health and wound healing
  • quitting smoking
  • exercises, even if they must be carried out in bed, with assistance, as they improve circulation.

Patients should mention any possible bed sores to their health care worker or doctor.

A physical therapist can advise on the most appropriate positions to avoid pressure sores.

Complications

[Pressure sores cellulitis]Cellulitis is a possible complication of bed sores.

Without treatment, bed sores can lead to serious complications.

Cellulitis is a potentially life-threatening bacterial infection of the skin, from the surface to the deepest layer of skin. Cellulitis can result in septicemia, or blood poisoning, and the infection can spread to other parts of the body.

Bone and joint infections can arise if a pressure ulcer spreads to the joints or bones. This can result in damage to cartilage and tissue, and a reduction in limb and joint function.

Sepsis, in which bacteria can enter through sores, especially advanced ones, and infect the bloodstream. This can lead to shock and organ failure, a life-threatening condition.

There is a higher risk of developing an aggressive Cancer in the skin’s squamous cells if the patient has bedsores.

Outlook

Stage 2 bedsores can heal within 1 to 6 weeks, but ulcers that reach stage 3 or 4 may take several months, or they may never heal, especially in people with ongoing health problems.

With the appropriate measures, patients and medical staff can significantly reduce the risk of developing pressure ulcers.

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Download: Bedsore Legal and Medical Facts Booklet>

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“My mom is in a nursing home and I noticed some bruises and sores. I think they are bedsores—what should I do?”

Bedsores are often a sign of neglect and sometimes a sign of abuse. The first thing you should do is speak to a nurse on duty and begin to remedy the situation. Be aware that the nurse may not have a full understanding of these injuries and you will likely need the attention of a wound care specialist and medical doctor. If you have a cell phone take some pictures of the wound for documentation. Bedsores and Pressure Sores, also known as Decubitus Ulcers can progress quickly and can be deadly. They occur when someone is immobile and there is not adequate blood flow. Then the affected tissue dies and an ulcerated sore develops. In a nursing home, hospital or other care facility it is their responsibility to check and turn the patient regularly. There are laws in place that protect patients and you should know that these injuries are not the fault of the patient. The patient is the victim. If a loved one you know is suffering they may have a significant, financially rewarding lawsuit. Read more about this on our website, http://www.RaphanLaw.com.

As an Elder Law firm we see these cases often. Whether malpractice, abuse or neglect it is simply unjust for it to happen to an innocent victim. Do not put off addressing the issue. Call me for a free consultation (212-268-8200, 800-278-2960) or even to just guide you through the process of getting the proper medical and legal attention.

Visual Stages of Bedsores:

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Read our Frequently Asked Bedsore Lawsuit Questions here>

By Brian A. Raphan, Esq.

Bed and/or Chair Rest + Neglect = Bedsores

Article by Brian A. Raphan. Published 3/17/15 in ‘THE DOCTOR WEIGHS IN’

When a patient develops pressure ulcers, it is often a sign of neglect and can even be the result of hospital malpractice, nurse malpractice or nursing home negligence.

Any time a patient is confined to a bed or chair for a period of time and not provided proper and adequate care, the risk of pressure ulcers increases.

The National Pressure Ulcer Advisory Panel (NPUAP) defines a pressure ulcer as a “localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure, or pressure in combination with shear.” Illustrations of the stages of pressure ulcers are shown below:

stages of bedsores

Sadly, pressure ulcers are the underlying cause of mortality and morbidity for several thousand patients across the country each year. Researchers analyzing the national Medicare Patient Safety Monitoring System (MPSMS) database found that the nationwide incidence rate for hospital-acquired pressure ulcers was 4.5 percent. The five states with the highest incidence rates are New York (5.2%), Missouri (5.3%), New Jersey (5.3%), Massachusetts (5.5%) and Pennsylvania (5.9%).

The federal government, in its first year of a federal initiative to improve patient safety, recently imposed penalties aimed at reducing preventable harm. Five states saw a significant percentage of hospitals being penalized: New York, where 26% of hospitals were penalized by having their Medicare reimbursements cut by 1%; Missouri, 25%; New Jersey, 37%; Massachusetts, 22%; and Pennsylvania, 25%.

In New York State, penalized hospitals included some well-known healthcare facilities, such as Beth Israel Medical Center and New York University Langone Medical Center.

All sedentary patients are vulnerable, but the elderly and patients whose skin condition has been compromised are especially at risk. Pressure ulcers are most common on bony prominences with little protective fat or muscle (such as heels, hips, shoulders, and tail bones), and they develop when patients stay in one position for too long without shifting their weight. The constant pressure against the skin reduces blood flow to contact areas. The skin begins to break down and the tissue dies, possibly in a matter of hours. Friction and shear caused by sliding down in the bed, or being moved improperly from a stretcher to a bed can exacerbate the problem. Pressure ulcers slow a patient’s recovery, can lead to other issues and infection and prolong hospital stays. The total annual cost for treating pressure ulcers in the U.S. is estimated at $11 billion. However, pressure ulcers (also known as bedsores and decubitis ulcers) are preventable.

To prevent pressure ulcers and damage to the skin, recent NPUAP recommendations can be summarized in seven steps:

prevent bedsores

Because these seven steps are so easy to follow, when a patient develops pressure ulcers, it is often a sign of neglect and can even be the result of hospital malpractice, nurse malpractice or nursing home negligence.

Upon admission to a hospital for another health concern the issues can go unnoticed, allowing further damage to take place in a relatively short time. This also creates liability on the part of the hospital.

In many lawsuits that we handle, the hospital is dealt a bad hand by receiving a patient from a nursing home where a skin breakdown or pressure ulcer has already begun. At times, due to dementia for example, a patient may not be able to express or know how to communicate pain upon entering the hospital. However, this is no excuse for not identifying a high-risk patient and making regular daily assessments.

To be clear, pressure ulcers are not the fault of the patient. The patient is a victim. Medical negligence by a hospital, doctor, nurse, aide or medical technician is unacceptable and may be the cause of pain and suffering, or even result in death. It is simply not acceptable for patients to develop bedsores or pressure ulcers while they are in the care of medical professionals and receiving medical care and treatment at a facility.

There is no doubt that hospitals and staff, from talented skilled doctors, nurses and medical professionals to support staff and administration, do their best to help and treat patients. However, protocols exist in every facility, and perhaps, it is just a matter of every individual being a bit more aware, and caring just a little more, when dealing with the elderly and at-risk patients.

By Brian A. Raphan (Principal Attorney, Law Offices of Brian A. Raphan, P.C.

Download a Free Bedsore Legal, Medical & Treatment Guide