Lawyer Resources for Bed Sores

pressure-sores-in-nursing-homesWhile they take a while to develop, pressure sores (also referred to as pressure ulcers, decubitus ulcers, or bedsores) are a clear sign that long-term care institutions are providing poor care to its residents or patients. Unfortunately, in recent years the number of pressure sores amongst nursing homes, assisted living facilities, and hospital patients has drastically increased. In fact, studies show patients are far more likely to develop pressure sores today than they were a decade ago.

What is the cause behind these pressure sores?

The reason that these pressure sores are associated with inadequate care is because they develop because of unrelieved pressure over an extended period on the bony parts of the body. As the pressure builds up, it restricts the blood flow. As a result, the tissue and skin that does not receive the blood it needs begins to die. This gradually leads to a wound in that area.

Where do these sores develop in nursing home and hospital patients?

Oftentimes these pressure sores will develop in parts of the body that have little tissue or muscle to mitigate the weight of the body. Especially over a longer period, these areas are far more prone to developing issues. Even though these problems may occur anywhere on the body, the most likely areas that these problems may develop include:

  • The back of the head
  • The back
  • The heels
  • The buttocks

Other factors contributing to the development of decubitus ulcers

The lack of movement and positioning are two major factors in the development of pressure sores, but personal hygiene and the patient’s overall health also play an important role. Dehydration and poor nutrition may hinder the body’s ability to heal and may negatively affect skin health. Oftentimes neglect and maltreatment can lead to a patient sitting in his or her own feces and urine or left in wet bedding and/or clothing. Again, this can deteriorate the skin and lead to the development of pressure sores.

Further complications related to open pressure sores

When the pressure is never relieved and combined with conditions such malnourishment and incontinence, chances of a developing pressure sores increase dramatically. Despite the pain that will accompany these pressure sores, it also opens the door to further serious medical complications. These may include:

  • Gangrene
  • Osteomyelitis
  • Sepsis
  • Infection
  • Amputation of affected body part
  • Death

Early detection is important to the treatment of pressure ulcers

In order to be able to deal with these pressure sores as effectively as possible, it is important to identify them at the earliest possible stage. The deeper tissue they affect, the harder it becomes for the skin to heal. Ultimately, the best thing is to never have these sores develop in the first place.

Hold the facility responsible for the negligent care of your loved one

When someone is in the care of a medical facility or nursing home, it is that facility’s responsibility to ensure that these pressure sores do not develop. Basic prevention methods include:

  • Regularly moving patients at consistent intervals
  • Preventing malnutrition and dehydration
  • Making sure the patients remain dry and clean
  • Using specialized cushions or mattresses to relieve pressure for high-risk patients

Be aware of the dangers. Bed sores can be fatal.

The majority of the time, pressure sores develop because the facility is not doing an adequate job of providing patient care. Oftentimes the underlying cause is inadequate training of staff or under-staffing. Remember that it is their responsibility to provide adequate care, but being aware of the conditions may make it possible to avoid the problem from developing altogether.

Lawyers Who Take Bed Sore Cases Seriously

There still is a feeling that amongst some in the medical-legal community that bed sore cases simply don’t have much value and aren’t worth prosecuting. To the contrary, Rosenfeld Injury Lawyers recognizes bed sores as one of the most visible signs of poor care in nursing homes and other medical facilities. Typically, bed sores are a tragic emblem of a system that is broken– where patient needs take a distant position after facilities tend to their profitability. We also are mindful of the devastating impact these wounds have on the individual and their family. Our experience litigating bed sore cases has earned us a reputation as attorneys willing to do what it takes to hold facilities fully responsible for these horrendous injuries that can contribute to complications or even death. We invite you to talk with us as soon as you become aware of the presence of a pressure sore on your loved one.

dollarWhen nursing homes take simple, preventative steps such as: turning patients, keeping them clean, and providing adequate nutrition and hydration; they can greatly decrease the incidence of pressure sores at their facilities.  However, even though the preventative steps are well known, many nursing facilities simply fail to implement the necessary care that patients require to function optimally.

I was particularly disturbed when I came across an article in the Arizona Daily Star regarding a Kindred-owned nursing home that has been repeatedly failed to provide sufficient wound care for its patients.  In fact, Villa Campana Health Care Center was most recently fined by state authorities $10,000 following a horrific chain of events involving a patient who was admitted to the facility last fall.

Within a month of entering Villa Campana, a patient developed a pressure sore on their buttocks.  Despite the staff’s documentation of the wound, little care was provided at the wound progressed to the point that bone was involved and an infection known as osteomyelitis ensued.  Eventually, the patient required multiple surgeries to treat the advanced pressure sore including a debridement surgery to remove portions of the coccyx, sacrum and surrounding tissue.

Some of my angriest clients contact me after a loved one was transferred from a nursing home to another nursing home or hospital only to learn of serious medical problems their loved one likely acquired during their original admission.  

Of course, breaking disappointing news is difficult for anyone to do.  Yet, in the case of nursing homes— this is something they simply are required to do under the law.  Similarly, nursing homes must notify the patients doctor if their condition deteriorates.

Undisclosed Complications With Nursing Home PatientsI see many cases where there is no doubt an intention on the part of the original facility to cover up change in condition– but also injuries related to situations involving improper care.

Screen-shot-2010-06-29-at-7_39_51-AMAn article published in the Las Vegas Sun, painted an unfortunately common set of circumstances; an overweight patient goes into a hospital for a medical procedure– only to acquire pressure sores during their stay.  Sure, the same scenario can (and most certainly does) occur with people of average stature, but there definitely is a disproportionate number of obese patients who enter a hospital or nursing home only to develop a lingering souvenir.

The sun article concentrates on 60-year-old Tyrone Bush, a maintenance man, who was admitted to Desert Springs Hospital for a quadruple heart bypass surgery in 2008.  It was during Bush’s recovery at the hospital, that he developed multiple bed sores (or pressure sores, pressure ulcers, decubitus ulcers) on his buttocks.

More than two years later, Mr. Bush continues to be plagued from the wounds and requires extensive medical treatment for them including doctors visits and debridement procedures– where the dead skin is removed to allow the new skin to grow over the open wounds.

Picture-1241Contractures are a medical condition where a joint is held in a fixed position due to the shortening of a muscle or tendon due to stress exerted on the muscle or spasticity (uncontrolled muscle movement). Older patients and those with limited mobility are especially prone to develop contractures. Contractures most commonly form in:

  • Hands
  • Feet

Picture-158Sad but true, many nursing home patients are suffering from malnutrition.  While we often associate malnutrition amongst the homeless or people living in a third-world country, some studies suggest that between 35% and 85% of nursing home patients are malnourished. As attorney David Terry points out in his blog post, “How Does Poor Nutrition Affect the Development of Bed Sores in Nursing Homes?” the rampant malnutrition can be associated with an increased risk of developing bed sores. Poor nutrition results in a deterioration of body functioning.  Over extended period of time, patients without adequate nutrition tend to have organs that begin to fail and critical body functions begin to deteriorate and lose effectiveness. As the largest organ of the body, your skin is one of the first places where the consequences of inadequate nutrition may be visible.  Malnutrition can result in the deminished effectiveness of the skin’s natural resiliance to pressure and other factions that contribute to the development of bed sores (similarly described as pressure sores, pressure ulcers, or decubitus ulcers). In addition to malnutritions reduction in the effectiveness in the skins natural resilancy, malnourishment of nursing home patients may also lead to other medical problems that contribute to the development of bed sores:

Reduction in Energy Levels: Malnourished people have less energy and consequently are unable to move on their own– resulting in a more time spent in one position.

Reduction in the bodies natural cushioning: A long-term consequence of malnourishment is loss of fat, muscle and tissue– that provide necessary padding particularly in bed-bound patients, the less padding the more pressure that is put directly on the body– thereby resulting in increased rate of bed sores. Inadequate Nutrition & Hinderance of The Bodies Natural Healing Properties David makes a great point regarding the important role nutrition plays in not just bed sore prevention, but also healing bed sores.  One of the most overlooked aspects of bed sore treatment is assuring that facilities provide additional calories and protiien for patients with advanced bed sores. A nutritional consultation should be brought in for patients with open wounds (stage 3 or 4 bed sores) so the specific nutritional needs can be tailored to the patient need.

Picture-321In times of need, locating necessary information regarding the legal rights and resources for nursing home patients can be difficult and imposing.  In this respect, we are proud to introduce a new resource for patients, families and practitioners looking for a concise compilation of information regarding nursing home laws.  Nursing Home Injury Laws, provides every states’:

  • Nursing Home Laws
  • Medical Malpractice Laws

A colleague forwarded me this video with Dr. Dale Bratzler of the Oklahoma Foundation for Medical Quality as he discusses the prevalence of pressure ulcers amongst patients in nursing homes and hospitals in the state.  Unfortunately, Oklahoma is one of the top five worst states in terms of frequency of development of pressure ulcers.

Oklahoma has One Of The Highest Rates Of Pressure Ulcers Dr. Bratzler suggests that the best method of prevention is to educate ‘front line workers’– those who typically provide the most hands-on patient care as to what can be done to from a prevention standpoint and how identify the wounds in their early stages before they become particularly problematic.

I couldn’t agree more.  In my experience by the time a pressure ulcer (similarly called: bed sore, decubitus ulcer or pressure sore) has developed, it is really a display of a complete breakdown in patient care at the entire facility.  In the days and weeks a stage 3 or 4 pressure ulcer develops, it literally means that shaft-after-shift of nurses or aides failed to do their job.

iStock_000003559387XSmallIn addition to monitoring food and liquid intake of nursing home patients, staff need to pay attention to the elimination of the wastes.   When urine and feces are not produced on a regular basis, nursing home staff must bring these problems to the attention of physicians.

One of the more obvious cases of nursing home neglect my office is working on involves a patient who went at least 10 days without a bowel movement.  Shift after shift of nursing home staff tended to our client– yet no one cared enough to look at his medical chart to see when the last bowel movement occurred.  It was not until the man was taken to a local hospital, was it determined that the man’s bowel had become impacted with feces.  Within 24-hours of his admission to the hospital, the man died from complications related to sepsis.

What is an impacted bowel?

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A nursing home negligence lawsuit has been filed against Highland Health Care Center and its parent company  Covenant Care Midwest for their negligent care of a patient.  The lawsuit alleges that the patient was admitted to Highland Health Care Center on November 5, 2008 for physical therapy, following a total knee replacement surgery.

During the course of the prescribed physical therapy, the patient developed decubitus ulcers on his back and heel.  The decubitus ulcers became so severe that surgery was required to help heal the wounds.

The nursing home negligence lawsuit claims Highland Health Care Center made numerous mistakes related to the patient’s care and subsequent decubitus uclers, including:

A colleague sent me this disturbing video of an advanced pressure sore.  A fair warning, this video is graphic and disturbing.  However, the reality is that pressure sores are a problem effecting individuals in nursing homes, hospitals, and long-term care facilities and can not be ignored.

Related Nursing Home Law Center LLC Blog Posts Related To Pressure Sores:

Nursing Homes With Higher Percentage Of Hispanic Residents Have Higher Rate Of Bed Sores

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