Pressure Sores and Bedsores
Bedsores are usually a sign of neglect. The areas of the body at greatest risk for developing bedsores are the coccyx, heels, hips and elbows. The most common cause is when an immobile resident is not moved or turned on a regular basis. The sore is actually tissue decay that results from the compression of blood vessels and underlying tissues. Bedsores (also called decubitus ulcers or pressure sores) are a serious injury. Residents can develop bacteremia, sepsis, cellulitis, and/or osteomyelitis, which may result in death. One of our wrongful death cases involved a Warren, Rhode Island nursing home that failed to prevent a man's bedsores which became infected and resulted in sepsis and his death. The resident went to the nursing home for short-term rehabilitation following surgery. Because the nursing staff did not take adequate safety precautions, the man fell and fractured his hip. The bedsores developed on his heels because the nursing staff failed to reposition and turn him as required. He died from a massive infection. The funeral director advised the family to talk to an attorney.
A Preventable Injury
Decubitus ulcers are almost always preventable. Prevention consists of changing the person's position every two hours or more often, if needed. Research has shown that a significant number of pressure ulcers develop within the first four weeks after an immobilized patient has been admitted to a nursing home. There are four stages of bedsore injuries:
- Stage 1 - A defined area of persistent redness in lightly pigmented skin, or may appear as persistent red, blue, or purple hues in darker skinned individuals.
- Stage 2 - The ulcer is superficial and presents clinically as an abrasion, blister, or shallow crater.
- Stage 3 - The ulcer presents clinically as a deep crater with or without undermining of adjacent tissue.
- Stage 4 - Extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures.
Treatment and Care
Treatment of decubitus ulcers involves removing pressure from the affected tissue, keeping the area clean, promoting tissue regeneration, and removing necrotic (dead) tissue which can form a breeding ground for infection. The use of antibiotics when appropriate is also part of the treatment plan.
Liability for Bedsore Injuries
The development of bedsores is oftentimes evidence of neglect in the areas of nutrition, hydration, hygiene, positioning, and/or infection control. Due to understaffing, many nursing home residents are not cleaned or turned, in accordance with the standard of care. As a result, these individuals develop pressure sores. When substandard care continues, some of these residents die from uncontrolled infections.