Bed sores are injuries to the skin and underlying soft tissue caused by prolonged pressure on bony areas of the body. When nursing staff fails to take pressure off residents’ bodies, the affected skin can break and be an entry point for infection-causing bacteria.
Infection can be fatal, especially for frail nursing home residents. If your loved one died from a pressure ulcer, you could seek justice through a personal injury claim.
The personal injury attorneys at Nursing Home Law Center, LLC, can help you and your family hold the negligent nursing home accountable. Contact our bedsore lawyers at (800) 926-7565 (toll-free phone number) for a free consultation to determine your legal rights.
What Are Bed Sores?
Bed sores, also known as pressure or decubitus ulcers, are injuries caused by excess pressure on the skin. These injuries often occur on the skin covering bony body parts, such as the tailbone, ankles, hips, and heels.
What Causes Bed Sores?
A bed sore occurs when blood supply to the skin is cut off for more than two to three hours, causing the skin to die. A lack of blood circulation often occurs in people with limited or no movement, such as those confined to beds or wheelchairs. People who are unable to sense pain are also prone to these injuries.
When left untreated, the affected skin can break, and the bed sore can extend to the underlying tissues, muscles, tendons, and bones. Once a bed sore develops, the dead tissue can take months or even years to heal, if possible.
Risk Factors for Pressure Ulcers
An individual may be more prone to pressure injuries if the following risk factors are present:
- Immobility: Nursing home patients may suffer pressure ulcers if they cannot reposition themselves independently. Lack of mobility may be caused by poor health, a spinal cord injury, or a disability.
- Incontinence: There is a greater chance of skin breakdown if the skin is frequently exposed to urine and stool.
- Loss of Sensation: Patients with sensory perception issues (e.g., those unable to feel pain) may be unaware of developing sores and the need to reposition.
- Circulation Issues: Medical conditions that affect blood flow, such as diabetes, can increase the risk of bed sores.
- Inadequate Nutrition and Hydration: A healthy diet and proper hydration are necessary to maintain strong and healthy skin. When a patient is malnourished or dehydrated, their skin is more prone to breaking down with excessive pressure or friction.
Stages of Pressure Sores
Pressure ulcers are divided into four stages:
- Stage I: In the early stages of bedsores, the skin looks red and feels warm to the touch. The area may be more challenging to see with people with darker skin. The patient may complain of pain, burning, and itching. A Stage I pressure ulcer may heal in as little as two to three days.
- Stage II: The skin is broken, has an open wound, or looks like a blister. The area is red and swollen, and the blister may have clear fluid or pus. The patient will likely complain of significant pain in the area. Stage II bed sores require proper cleaning to prevent infection and may go away within two to three weeks with appropriate treatment.
- Stage III: A deep wound on the skin has cut down to granulation tissue and has a crater-like appearance. There may be signs of infection, such as pus, red edges, odor, and fluid drainage. There may be dead tissue in or around the sore. Immediate medical treatment is necessary for Stage III ulcers to prevent severe infection. They can take around one to four months to heal.
- Stage IV: There is a large wound on the skin. The dead tissue has turned black and shows signs of infection. The tendons, muscles, and bones beneath the skin may be visible. These sores need immediate treatment and may require surgery. Once late-stage bed sores develop, wound healing may take a few months to a few years due to large-scale tissue loss.
Diagnosing bedsores in the early stages reduces the mortality rate among affected patients. Once you notice skin changes, such as discoloration or tenderness, in your loved one, bring it to their doctor's attention immediately.
Common Sites of Pressure Ulcers
The location of the pressure sore usually depends on how and where the patient sits all day. People in wheelchairs typically develop sores on their:
- Shoulder blades and spine
- Tailbone or buttocks
- Backs of the legs or arms where they rest against the wheelchair
People confined to their beds may develop sores on the:
- Back or sides of the head
- Shoulder blades
- Hips
- Lower back or tailbone
- Heels, ankles, behind the knees
How Common Are Bed Sores in Nursing Homes?
According to the Centers for Disease Control and Prevention (CDC), one in ten residents had a bedsore (about 11% of the 159,000 nursing home residents) in 2004. The number is likely much higher today due to a larger elderly population and frequent abuse and neglect cases in nursing homes.
Regarding bedsore death, the 6-month mortality rate of residents with bedsores is over 75%. Most deaths involve people 75 years and older.
Causes of Bed Sores Among Nursing Home Residents
People with limited mobility or are otherwise immobile need frequent repositioning to prevent pressure from accumulating in their bodies and allow the blood supply to reach all body parts. Nursing staff must reposition patients in wheelchairs every 15 minutes and bedridden patients every two hours.
Nursing home residents usually develop bedsores due to neglect, involving:
- Infrequent Repositioning: Often, bed sores occur due to a lack of repositioning in patients unable to move without assistance (e.g., paralyzed patients, patients recovering from major surgery, etc.)
- Poor Nutrition and Hydration: Failure to provide residents with proper nutrition and hydration can result in a higher risk of bed sores. Furthermore, malnutrition and dehydration reduce the immune response if an infection occurs in the sore.
- Inadequate Hygiene Care: Skin is more likely to break if it is constantly exposed to waste materials, such as sweat, urine, and stool. Therefore, people who cannot clean themselves and receive inadequate hygiene assistance (e.g., changing diapers) are at an increased risk of bed sores.
- Poor Monitoring: Nursing homes must implement frequent monitoring in at-risk patients to stop sores from progressing past the early stages. Otherwise, the injuries can worsen and lead to further complications.
- Improper Bedsore Care: Once a resident develops bedsores, the nursing staff must employ proper measures to prevent the wounds from progressing. These measures may include taking pressure off the affected skin, cleaning the sores, and inspecting the skin daily to watch for signs of infection.
These issues often have underlying causes, including:
- Understaffing: Nursing homes with chronic short-staffing problems may be more prone to negligence and neglect. Insufficient employees can result in inadequate care practices, including a lack of repositioning for immobile patients.
- Poor Training and Education: Health care providers need adequate training and education on preventing bed sores, including how to recognize them and what to do once a sore occurs.
- Lack of Monitoring Policies: Bedsores are easier to treat in the earlier stages, making it necessary for nursing homes to regularly watch out for possible signs. Inadequate bedsore monitoring leads to an increased risk of pressure ulcers and serious infections when nursing staff fails to catch the symptoms on time.
- Wilful Negligence: Some cases involve intentional neglect. Deliberately allowing a patient to develop bedsores may be considered a criminal act punishable by law.
Complications of Bed Sores
Without proper treatment, bed sores can lead to significant complications, such as:
- Malnutrition: Patients may suffer malnutrition as the pain and discomfort from bedsores can prevent them from eating properly. Malnutrition can lead to further issues, such as weight loss, compromised immunity, decreased mobility, poor stamina, etc.
- Cellulitis: A decubitus ulcer can cause cellulitis, a painful infection of the skin and surrounding soft tissue. It can lead to warmth, swelling, and inflammation on the skin. When left untreated, cellulitis can lead to other complications, such as sepsis and meningitis.
- Sepsis and Septic Shock: Infectious bacteria can enter the wound and cause an infection when the skin breaks. Sepsis is the body’s extreme immune response to bacteria that enters the bloodstream. It is an “overreaction” that damages the body’s tissues and organs and may be fatal without immediate treatment.
- Joint and Bone Infections: Bed sores can cause a bone infection (e.g., osteomyelitis) or joint infection (e.g., septic arthritis) that can affect joint and limb function.
- Cancer: Non-healing wounds can develop into squamous cell carcinoma.
- Abscess: The body’s immune response to infection may involve the development of abscesses, collections of pus that form on or under the skin.
- Necrotizing Fasciitis: Bedsores can increase the risk of necrotizing fasciitis, a rare bacterial infection that eats away at tissue surrounding the affected area, ultimately leading to large-scale tissue loss. This condition can also cause death when left untreated.
- Myonecrosis (Gas Gangrene): People with progressive bed sores can contract myonecrosis, a rare but severe infection caused by Clostridium genera. The bacteria destroy muscle tissue and can lead to death when left untreated.
- Amputation: In some cases, amputation may be the only way to prevent bed sores from causing sepsis or septic shock. This problem is more common in patients with Stage 4 sores.
How Can Bed Sores Lead to Death?
Bedsore death can occur due to any of the complications listed above. However, it most often occurs when pressure ulcers lead to bacterial infections. Without immediate treatment, infections can cause death by septic shock and organ failure in hours.
The risk of bedsore death significantly increases when the sores reach Stage 4 or late Stage 3. Bacteria can enter the body through open wounds and multiply at these stages.
Nursing Home Negligence Leads to Bedsore Death
Nursing home residents rely on staff to address their needs, including proper hygiene, mobility assistance, nutrition, and hydration. Injuries like pressure ulcers can occur when the nursing staff fails to meet these needs.
The development of a bedsore is an obvious sign of neglect. Staff would be able to notice skin changes if they attend to physically limited or immobile patients frequently.
Furthermore, they would be able to ensure that sores are treated properly once they are discovered. With proper care and monitoring, there is no reason for bedsores to occur, much less progress to Stage 4 sores.
If your loved one dies due to pressure ulcers in their nursing home or assisted living facility, you could hold the negligent parties accountable by filing a legal claim.
Taking Legal Action for a Bedsore Death
Nursing homes must prevent bedsores and other forms of avoidable harm to residents. If a nursing home resident dies due to these injuries, it could mean they are a victim of nursing home abuse and neglect.
You and your family can hold the negligent nursing home accountable for their actions (or inaction) by filing a wrongful death claim. This claim is a legal action against an individual or entity that caused the death of another due to negligence.
In filing a wrongful death claim, you must prove that:
- The defendant had a duty of care to your loved one: All nursing homes and their employees are legally obligated to protect residents from preventable harm, including pressure ulcers.
- The defendant breached this duty of care: The breach may involve a caregiver failing to reposition your loved one, treating the sore on time, reporting the incident to management, and so on.
- The victim suffered an injury: You must prove that your loved one suffered a physical, emotional, or financial injury. In a bedsore death, the “injury” is death.
- The defendant’s actions caused the victim’s injuries: You must demonstrate that the defendant’s negligence directly led to your loved one’s death and other damages.
What Evidence Can You Use?
Nursing home residents almost always develop bedsores due to neglect. Hence, the injuries often serve as solid evidence of nursing home abuse.
Other forms of proof you can use in a claim may include:
- Medical records
- Photos of injuries
- Diagnosis of other complications
- Expert testimony from medical professionals
You can also present the following to show the extent of your family’s losses:
- Medical bills
- Funeral, cremation, or burial bills
- Documents showing missed workdays
- Testimony from family and friends
Compensation for Wrongful Death
Filing a wrongful death claim could help you recover financial compensation for:
- Medical Bills: Compensation for your loved one’s medical expenses before they passed, including hospitalization, medication, surgery, etc.
- Pain and Suffering: Compensation for your loved one’s physical and emotional suffering and your family’s grief.
- Lost Wages: Compensation for income, wages, and benefits lost for caring for your loved one before they passed and making funeral arrangements.
- Funeral and Burial Costs: Compensation for a funeral, burial, cremation, and other expenses related to laying your loved one to rest.
Settlement values for nursing home neglect cases vary depending on several factors, including the extent of damages and the victim’s age, and marital status. To ensure you receive a fair settlement, your wrongful death attorney will estimate the potential value of your claim during your initial consultation.
Insurance Settlement vs. Litigation
You may receive compensation for these losses through litigation or an insurance settlement.
When filing a claim against a nursing home, its insurance company may offer you a settlement according to the facility’s insurance coverage. Our attorneys advise against accepting the initial offer as it may be less than what your claim is worth. Instead, have your nursing home abuse lawyer negotiate with the insurance adjuster.
Unfortunately, not all negotiations are successful. Your lawyer can help you file a wrongful death lawsuit if:
- Negotiations have stalled
- The insurance company refuses to make a fair offer
- The defendant denies liability for your loved one’s death
If you decide to file a lawsuit, your case will go to civil court, where a judge or jury will hear evidence from both parties and determine a verdict.
How Your Lawyer Can Help
Filing a legal claim against a nursing home is often tedious and complex. You need an experienced lawyer who can help you:
- Investigate how and why your loved one developed bed sores
- Determine the nursing home’s negligence in preventing pressure ulcers, e.g., failing to reposition your loved one every two hours
- Identify specific parties responsible, e.g., nurses, doctors, aides
- Gather evidence to support your claim
- File a claim with the facility’s insurance company
- Negotiate a fair settlement
- File a lawsuit in civil court and represent your case, if necessary
Talk to an Experienced Bedsore Death Attorney Today
Disabled and elderly nursing home residents need adequate care and attention to avoid bedsores. Unfortunately, some nursing homes fail to meet their residents’ needs, leading to these painful and potentially life-threatening injuries.
If your loved one died due to a nursing home’s failure to prevent bedsores, you have the right to seek justice against all parties involved. The experienced lawyers at Nursing Home Law Center, LLC, can help you file a strong case against the negligent nursing home and obtain fair compensation for your losses.
Contact our bedsore death attorneys at (800) 926-7565 or use the contact form for a free consultation. All confidential or sensitive information you share with our legal team will remain private under an attorney-client relationship.
Our lawyers handle all accepted cases on a contingency fee basis. You don’t have to pay for our legal services unless we win your case.
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