Bedsores are wounds that develop over bony parts or pressure points on the body, like the tailbone, heel, buttocks or hips. They are sometimes referred to as decubitus ulcers or pressure ulcers. They range in severity from the least severe, which is stage 1 and involves redness on the skin, through stage 4, where the wound has progressed and deteriorated to a point where it has broken down to the muscle and, in some instances, gotten down to the bone. These sores, in most instances, are preventable with appropriate care; however, they can be life-threatening if they become infected.
What Circumstances can Contribute to the Development of Bedsores?
People of advanced age may have conditions that put them at risk for developing bedsores, immobility being the biggest one. In most cases we see the bedsores are avoidable with appropriate care. The cause of the sore(s) is that the person was not being turned and repositioned at regular intervals. A lot of times, that can be the result of understaffing at the nurse or nurse’s aide level at the facility.
In a lot of the cases that we handle involving bedsores, the resident at the nursing home or the patient in the hospital cannot move themselves, whether in a chair or bed, on their own, so they rely on the staff of the nursing home or hospital to turn and position them at regular intervals and/or provide them with cushions and appropriate preventative measures, such as an air mattress or a specific type of bed. There are various other treatments for bedsores, when they do develop, in a nursing home or hospital setting, including dressings, the use of a wound vac, and debridement procedures.
How Common is it for Bedsores to Develop That Result From Negligence?
It is, and they are more common than they should be. Here in New York, each nursing home has to report how many or what percentage of residents at the facility have bedsores. On a national level, studies show that 2 to 28% of the nursing home population has bedsore(s). So for what is really a preventable injury, bedsores occur more often than they should.
How Serious can the Consequences Associated With Bedsores be?
Bedsores can get be serious; and as I mentioned before, they can be even life-threatening. The sores themselves, if they’re not appropriately treated, once they do develop, can deteriorate to a Stage 4, where these wounds get very deep and sometimes go down to the bone. If the bone becomes infected, the bone infection itself is called Osteomyelitis. So when these wounds or sores are left untreated or don’t receive the appropriate treatment, people’s lives are at risk. If the infection isn’t treated, it can lead to sepsis, which can cause the bodily organs to shut down and cause death. On certain areas of the body, including the heel, if these sores are allowed to progress and do become infected or develop gangrene, that can result in an amputation. So bedsores are a serious problem.
How Difficult is it to Prove a Bedsore Injury Case?
Any case involving medicine can be difficult to prove. That said, nursing homes are required to document that they are providing appropriate care and document that they are turning and positioning the patient at regular intervals and providing the appropriate preventative measures. So these cases become very medical record-intensive, and the records from the nursing homes or hospitals can be thousands of pages. So there is a huge focus on the records themselves, but we’re in a unique position to handle these cases as we have nurses with experience in the nursing home and hospital settings that we use to help us review the charts, develop our theory and put forth the evidence in these cases.
How Important are Evidence and Witnesses in Bedsore Cases?
Witnesses can be very important because, particularly in nursing home cases, we have seen in numerous instances that the documentation in the chart is inaccurate. Sometimes we’ll see that the chart indicates that the turning and positioning was performed on every shift by every staff member that was on duty, but then when we talk to the family members, they say, “We were there all day, five days a week, and we never saw anyone coming in to turn and position my mom or dad.” So witnesses can play a very important role, particularly when the information in the chart may not be accurate.
Witnesses are also important because, unfortunately in a lot of these cases, the injured party has passed away or has dementia, so family members are the ones that come in and describe the pain that was experienced by their mom or dad or loved ones. So for all those reasons, witnesses can be very important.