Bedsores

Bedsores sometimes occur to patients at hospitals, nursing homes and rehabilitation facilities due to the failure of medical care providers to follow standard protocol. A bedsore is also referred to as a pressure ulcer or a decubitus ulcer, and it is a painful injury to the skin and underlying tissue that is often the result of immobile patients not being properly repositioned with sufficient frequency, along with a variety of other factors that may cause a bedsore to develop.

Bedsores are caused when there is pressure against the skin limiting blood flow to the skin and nearby tissue. This will occur when the skin is trapped between a wheelchair or bed and the bone with sustained pressure over a period time. This may also occur as a result of shearing, a process that occurs when the skin of a person stays in one place as the skeletal muscle slides down. The skin is most vulnerable to bedsores where there is not a significant amount of fat or muscle between the bone and the skin so they most commonly occur near the hips, spine, pelvis, heels, knees, ankles and elbows. When someone is not moved frequently enough, there is an increased likelihood that this sustained pressure or shearing on the skin will occur in one of these areas, causing a bedsore.

The facility that treats patients must have a procedure in place to evaluate a patient's risk of developing a bedsore, and the most commonly accepted method to perform such an evaluation is know as the "Braden Scale", wherein a patent's risk factors are analyzed on a numerical scale. Once a patient is determined to be at high risk of developing a bedsore, the treating medical care provider should implement protocol to prevent the formation of a bedsore, which should consist of the following:

  • Systematic skin assessments with special attention to bony prominences
  • Turning and repositioning the patient on a frequent basis
  • Avoid vigorous massage over bony prominences
  • Ensuring that the skin in the vulnerable area is kept dry, and that proper care is implemented when a patient is incontinent
  • Use of support pillows or orthotic devices for pressure redistribution
  • Ensuring means of transportation for the patient which do not add further irritation to the area at risk

Once a bedsore has developed it is very difficult to treat, but if detected early they can be managed and even prevented. There are four stages of bedsores with each later stage being both more painful and more difficult to heal and treat. A stage one bedsore consists mostly of a change in color of the skin with some possible pain. At stage two, there is a loss of skin thickness and there may also be a blister. These first two stages have significantly better prognoses than stages three and four. At stage three, the bedsore will consist of a deep wound with the possibility of fat being exposed, and yellowish dead tissue at the bottom of the ulcer. Lastly, at stage four, the bedsore may expose muscle, bone, or tendon, and the damage is likely to extend beyond nearby healthy areas of skin. Once a bedsore is at stage four, treatment is extremely difficult and it may never heal.

When a hospital, nursing home or rehabilitation facility fails to put a program in place to avoid the development of a bedsore, and prevent the deterioration of bedsores that have developed, they may be liable to the patient due to their failure to follow accepted medical procedures.

At Law Offices of Louis Grandelli, P.C., we have significant experience in evaluating and litigating a bedsore case. If you or a loved one has suffered a bedsore as a result of the negligence of a medical care provider, it is important to speak with an attorney as soon as possible in order to preserve your rights. If you are interested in legal assistance, please don't hesitate to call us for a free legal consultation.