Family of Disabled Man FIle Lawsuit Against Chicago Nursing Home After He Develops Pressure Sores During Admission

On July 5, 2008, a man with spina bifida was admitted to Sherman Hospital due to an elevated body temperature. While he was there, hospital staff noted his poor oral hygiene and bedsores. His colostomy bag had exploded as well, which had covered him in feces.

The staff reported the situation to the Illinois Department of Health which began an investigation of the facility where the man had been staying, Tower Hill Healthcare Center. The man passed away on July 31, 2008 due to a staph infection and pneumonia. The lawsuit is pending in Kane County, Illinois.

Widespread Problem of Bedsores

Bedsores are an epidemic in America among the vulnerable population. Studies indicate that incidences of bedsores have risen over the last decade.

Most bedsores are preventable, but this requires the diligence of caregivers. Staff at health care facilities, especially long-term care facilities, need to turn patients, or change positions several times per day. They must keep patients clean and dry and do their utmost to keep their diets healthy.

If they do not, the results can be fatal. Infections due to bedsores are directly responsible for the deaths of 60,000 Americans every year. Most are elderly, but even younger patients can develop bedsores if caregivers do not take proper care of them.

What is a Bedsore?

A bedsore, also called a pressure sore or a decubitus ulcer, is an open wound on the body frequently seen in immobile patients. When constant pressure is applied to a body part, the flow of blood is restricted which can lead to the death of the skin and tissue underneath. A wound develops and can broaden and deepen over time if steps are not taken to treat the problem.

Bedsores go through four stages of severity, which doctors can diagnose with a visual exam. If the bedsore is covered in slough, which is the dried, congealed material that can ooze from the wound, it may not be possible to categorize the bedsore. However, the slough acts as a protection for the wound and should not be removed.

The four categories of bedsore severity are:

• Stage I. In the first stage, the bedsore has not broken the skin. The skin will be red, maybe purple, and could be swollen, warm, or hard to the touch.
• Stage II. The second stage is when the skin breaks. Abrasions or blisters can form and infection is a risk.
• Stage III. The skin has degraded and revealed the underlying tissue. The bedsore is now a shallow wound in the shape of a crater and infection is an elevated risk.
• Stage IV. The tissue has degraded to reveal bone and muscle underneath. Osteomyelitis and gangrene are significant risks.

Who is at Risk for Bedsores?

Contrary to what many believe, bedsores do not afflict just one demographic. Anyone is capable of developing a bedsore, although certain groups are more at risk. The conditions that are more conducive to forming bedsores are:

1. Paralysis. A patient who cannot move him or herself, or can move only with difficulty, is at high risk of developing a bedsore.
2. Coma. A comatose patient will not move at all, unlike a sleeping patient who may roll over or turn. The risk of a bedsore in comatose patients is extremely high.
3. Weakness. Sometimes patients are too weak, or lack the energy to move and properly care for themselves. This occurs frequently in the elderly.
4. Smoking. Smokers have a known healing deficiency, so when bedsores form, they will be harder to heal.
5. Diabetes. Diabetics also have healing deficiencies as well as loss of sensation in their limbs. A diabetic may form a bedsore and not know it.
6. Atheroma. When plaque clogs an artery, blood flow is compromised.
7. Dehydration. Dehydrated skin is unhealthy and therefore more likely to develop bedsores.
8. Incontinence. Wet skin is also more likely to develop bedsores, and incontinent patients often have wet skin. Further, urine and feces have a corrosive effect on the skin.

Where do Bedsores Normally Form?

Bedsores can form on any body part. However, they are most likely to form on parts of the body that bear more weight and thus are subject to more pressure. This can depend on whether the patient is in a wheelchair, a bed or some other device, and in what position the patient remains for long periods of time.

Fat acts as a cushion against the body’s weight, so parts of the body with little fat will more readily form bedsores. Any area that protrudes is more likely to bear weight and therefore will more quickly form a bedsore.

The most common sites for bedsores are:

• Back of the head
• Ankles
• Heels
• Hips
• Lower back
• Knees
• Spine

A bedsore can be a traumatic experience for a patient and his or her family. It can also be fatal. Caregivers need to work more diligently to bring down the incidence of bedsores in America.

Sources

• Family of Disabled Man FIle Lawsuit Against Chicago Nursing Home After He Develops Pressure Sores During Admission
• Pressure Sore Facts & Statistics