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Stage 3 Bed Sore
Pressure sores are skin injuries caused by staying in one position for too long. When a person sits or lays in bed for long periods, pressure can accumulate in body parts in constant contact with the surface, cutting off blood flow to those areas. The oxygen-starved skin then starts to die and develops wounds called pressure ulcers or bedsores.
These injuries are categorized into different stages, from least to most severe. Stage 1 and 2 sores are relatively mild and have a lower risk of infection. However, when a pressure ulcer reaches Stage 3, the risk of complications and further injury rises exponentially.
Did you or a loved one develop a stage 3 pressure sore in a nursing home? If so, you could be a victim of nursing home neglect. The attorneys at Nursing Home Law Center, LLC, can help you seek justice against negligent parties and obtain financial compensation for your losses.
Contact our nursing home abuse lawyers at (800) 926-7565 (toll-free phone number) for a free consultation to discuss your legal options.
What Are Pressure Sores?
Pressure sores, also known as bedsores or decubitus ulcers, are skin and soft tissue injuries caused by prolonged pressure. When someone stays in the same position for extended periods, blood flow is cut off in certain body parts, causing the skin and underlying tissues to die. A sore can form in as little as two to three hours after circulation has been cut off.
Who is at Risk?
Bedsores often affect nursing home residents with limited movement or those who are immobile, such as wheelchair users and bedridden patients. Other risk factors for these injuries include:
- Incontinence: Constant exposure to urine and stool can increase the skin’s vulnerability to damage.
- Malnutrition and Dehydration: Poor nutrition and hydration can diminish skin health, making it dry and more prone to injury.
- Certain Medical Conditions: Illnesses that affect blood flow, such as diabetes and vascular disease, can increase the risk of bedsores due to poor circulation.
- Lack of Sensory Perception: Conditions that reduce or eliminate sensory perception, such as spinal cord injuries, can make a person more prone to bedsores. They cannot sense pain and, therefore, may not reposition themselves when the pressure starts to build.
- Obesity: An overweight or obese person exerts more pressure on surfaces, causing an increased risk of pressure injuries.
Where Do Bedsores Form?
The location of a pressure ulcer development often depends on the position in which a person stays for most of the day. People in wheelchairs are more likely to develop bedsores on:
- Shoulder blades
- Tailbone or buttocks
- Backs of arms and legs where they rest against the wheelchair
On the other hand, patients lying in the same position in bed often develop sores on:
- Shoulder blades
- Tailbone or lower back
- Heels, ankles, back of the knees
- Back or sides of the head
Four Stages of Pressure Ulcers
Pressure sores are categorized into four stages, from least to most severe. The stages of pressure sores are:
Early-stage bedsores appear as red spots that feel warm to the touch. The discoloration may have a blue or purple tint on darker skin.
You can distinguish a bed sore from unrelated discoloration by pressing on the area. If the spot does not get lighter (blanching), less blood reaches that area, and a pressure sore has formed.
The patient may complain of slight pain, burning, or itching in the area. The site may also feel different from the surrounding skin, e.g., firmer or softer.
Relieving pressure is the best way to prevent early-stage bedsores from progressing. Washing the sores with mild soap and water can also help prevent the skin’s surface from acquiring further damage. With proper treatment, Stage 1 bedsores can heal in as little as two to three days.
Stage 2 bedsores have penetrated deeper into the skin. A stage 2 bedsore leaves a scratch, open wound, or blister and is often painful. The spot is swollen, warm, and red, indicating that the body is trying to heal itself.
Stage 2 bed sores are at risk of getting infected. To avoid this, wash the sores with water and saline solution and dry them gently with a clean paper towel. Keep the sores covered with sterile gauze or a see-through dressing to prevent infectious bacteria or debris from entering the wounds.
Stage 2 bed sores may not require professional medical treatment. However, seek medical attention immediately if you notice signs of infection (fever, pus, redness, odor).
Once stage 2 bedsores have gone through the skin’s second layer and into the adipose (fat) tissue, they become stage 3 sores. There is a moderate to severe risk of infections for stage 3 sores, especially if they go without proper wound care.
A stage 3 bedsore leaves a crater-like wound and may show signs of infection, such as redness, swelling, fluid drainage, foul odor, and heat. If the skin has died, there may be black tissue in or around the sore.
Treating stage 3 pressure ulcers as soon as possible is crucial to prevent infections and other complications. Health care providers recommend going to the hospital for wound care and a thorough assessment. Your doctor may prescribe antibiotics if you have already contracted an infection. If there is dead tissue in or around the sore, the doctor will remove it to allow the skin to heal.
With proper care, stage 3 sores will take at least one to four months to heal. Seek professional medical advice on how you can care for your sores independently.
Stage 4 sores occur when stage 3 sores extend into the muscle tissues beneath the skin. Some stage 4 ulcers can even reach the bone.
A stage 4 pressure injury is deep, large, and shows signs of infection (redness, heat, swelling, foul odor, fluid drainage). The fat tissue, muscles, tendons, and bones may be visible. The patient also experiences severe pain in the affected area.
Stage 4 pressure ulcers are the most severe and require immediate medical care. These injuries often require surgery to remove dead tissue and repair the skin. Some people undergo flap surgery wherein healthy skin is used to cover the open sores.
Treating pressure sores at this stage often includes a course of antibiotics to fight infections. The patient needs constant monitoring to ensure the pressure ulcers are healing instead of worsening. These injuries can cause death due to sepsis or gangrene if left untreated.
The healing process for stage 4 ulcers may take anywhere from a few months to a few years.
Suspected Deep Tissue Injury (SDTI)
A suspected deep tissue injury (SDTI) is a sore that affects underlying soft tissue but has no open wound. The area may appear purple or maroon, and there may be a blood-filled blister under the skin.
An unstageable bedsore has full-thickness tissue loss wherein the wound bed is covered by slough (dead tissue separated from living tissue) or eschar (scab). Due to these tissues, the doctor cannot see the bottom of the sore and, therefore, cannot determine its depth.
Removal of the slough or eschar is necessary to determine the sore’s stage.
When to See a Doctor
Seek professional medical advice when you notice discoloration, unusual pain, or open wounds. Do not wait for potential sores to progress to stage 3 or 4. Otherwise, the sores can penetrate underlying tissue and cause further damage.
If you have open wounds, it may be best to go to the hospital immediately. When stage 3 sores are not treated properly, you may suffer potentially fatal complications.
Complications of Stage 3 Bedsores and Dead Tissue
Without adequate treatment of stage 3 bedsores, there is a moderate to severe risk of the following complications:
- Cellulitis: Infectious bacteria (usually staphylococcus and streptococcus) can cause cellulitis, an infection of the skin and connected soft tissues. This condition causes redness, pain, and swelling in the affected area. When left untreated, cellulitis can lead to other complications, such as extensive tissue damage and gangrene.
- Bone and Joint Infections: Stage 3 pressure ulcers can lead to osteomyelitis, damaging the bone and increasing the risk of bone death. Bacteria entering a sore can also cause septic arthritis, potentially causing joint loosening or dislocation.
- Cancer: Long-term and non-healing sores can lead to squamous cell carcinoma. Bedsore-related cancer is rare but can occur when stage 3 bedsores go without treatment, cause bone infections, or recur.
- Gangrene: This term refers to the death of body tissue. Tissue damage caused by gangrene is irreparable and has a high risk of death. Some patients may require amputation to remove gangrenous fingers, toes, or entire limbs.
- Sepsis: Stage 3 ulcers can lead to sepsis, a condition where the body overreacts to an infectious bacteria, damaging its organs and tissues. Sepsis is life-threatening and requires immediate treatment to prevent organ failure. Stage 3 sores can also cause septic shock, wherein the body’s blood pressure drops dangerously low. It has a higher mortality rate than sepsis at about 40%.
Secondary complications for stage 3 sores may include:
- Malnutrition and Dehydration: A patient with stage 3 decubitus ulcers may have reduced appetite due to pain and discomfort. As a result, there is a significant risk of malnutrition and dehydration. These conditions may also slow down the healing process due to a lack of nutrients required for wound healing and immunity.
- Urinary Tract Infections (UTI): Stage 3 pressure ulcers often reduce mobility. Patients who cannot move freely may be more likely to hold their urine, a risk factor for UTIs. Stage 3 sores can also make it difficult to clean correctly after toileting, increasing the risk of bacteria entering the urinary tract.
Allowing these complications to occur may be considered nursing home or elder abuse.
Common Causes of Stage 3 Bedsores in Nursing Homes
Elderly and disabled nursing home residents are generally prone to pressure injuries due to physical limitations. However, these residents are less likely to develop sores if they receive proper care and attention.
Nursing home residents often develop stage 3 bedsores due to neglect or medical negligence, such as:
- Infrequent Repositioning: Nursing home staff members must reposition immobile patients frequently to prevent pressure from accumulating in their bodies. Unfortunately, not all nursing homes implement strict policies for this process. As a result, at-risk residents have a higher chance of developing bedsores, and earlier-stage bedsores may progress rapidly.
- Poor Hygiene Care and Assistance: Prolonged contact with sweat, urine, and stool increases the skin’s vulnerability to damage. When nursing home staff members neglect proper toileting, bathing, diapering, and other hygiene processes, residents have a higher risk of bedsores. If stage 3 bedsores are already present, stool and urine increase the risk of bacterial infections.
- Lack of Risk Assessments: Nursing homes must evaluate each nursing home resident to determine their bedsore risk. Otherwise, patients with a higher risk of bedsores may not receive the care and attention they need to avoid these injuries.
- Inadequate Bedsore Monitoring: Some nursing home residents cannot ask for help when they develop mild or severe bedsores, possibly due to dementia or a disability. In other cases, patients cannot feel the pain of bedsores and are therefore unaware. It’s up to nursing home staff to inspect each at-risk patient’s skin regularly to watch for signs of injury.
- Delayed Treatment: Sometimes, earlier stage bedsores progress into stage 3 or 4 sores due to lack of prompt treatment. In severe cases, delayed treatment of stage 3 or 4 sores leads to death due to life-threatening infections. Nursing homes that allow this to happen could be liable for medical malpractice.
- Poor Wound Cleaning and Dressing: Stage 3 ulcers can become infected due to poor wound cleaning and dressing. Life-threatening infections may occur due to poor hand hygiene, using non-sterile gauze, not cleaning the wound properly, etc.
Our elder abuse attorneys will help you identify the exact causes of your loved one’s injury during the discovery phase of filing a lawsuit.
Treating Pressure Sores in Nursing Homes
Stage 3 bedsores require immediate medical attention to prevent infections and other complications. Treating pressure sores in nursing home settings may involve:
- Relieving Pressure: Once a nursing home resident develops a Stage 3 pressure injury, staff must minimize pressure in the spot as much as possible. Using special pillows, booties, or foam pads can help. Using a special bed may also be necessary in severe cases.
- Repositioning: Nursing home staff members must reposition wheelchair users every 15 minutes and bedridden patients every two hours or less. If the patient can stand and walk, allowing the patient to perform light exercise can help promote proper circulation.
- Wound Cleaning: Keeping stage 3 sores clean, dry, and covered with sterile dressing is crucial in preventing the entry of infectious bacteria. Stage 3 sores may require flushing with saline solution to remove loose or dead tissues.
- Surgery: The treatment for stage 3 sores may require surgery to close or repair the skin’s surface. Plastic surgery may be necessary for severe bedsores too large to close without skin grafting.
- Skin Care: Keeping a patient’s skin moisturized can help prevent more stage 3 sores.
- Medical Nutrition Therapy: Treating and preventing bedsores often entail a proper diet rich in zinc, biotin, protein, and vitamins A, C, and E. These nutrients help the body fight infection and speed up the healing process.
- Medication: Medical care for stage 3 bedsores usually involve antibiotics to address infections. Nursing home doctors may also prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen sodium, to relieve pain.
In addition to medical care, nursing home residents with stage 3 bedsores may benefit from psychological support to help them cope with the pain.
Filing a Nursing Home Abuse Case for Stage 3 Pressure Sores
Stage 3 bedsores are severe and are unlikely to occur with proper nursing home care. Hence, Stage 3 sores are often considered signs of nursing home abuse. If you or a loved one suffers a Stage 3 sore or beyond due to a facility’s negligence, you have the legal right to pursue damages.
Elements of a Nursing Home Abuse Case
To file a nursing home or elder abuse case, you must prove that the following are true:
- The defendant owed a duty of care to you: Nursing homes and assisted living facilities are legally responsible for patients’ health and well-being, including preventing bedsores.
- The defendant breached this duty of care: This ‘breach’ can be an act or failure to act that leads to the development of a stage 3 bedsore.
- You or your loved one suffered an injury: In legal terms, ‘injury’ can be physical, emotional, or financial. To file a personal injury claim, you must prove that an injury does exist.
- The defendant’s negligence directly led to your injuries and other losses (causation): You must show that you suffered harm due to the defendant’s actions.
Who is Liable for a Stage 3 Bedsore?
Health care providers are responsible for treating and preventing bedsores. Failure to do so could hold them accountable if a nursing home resident suffers a stage 3 bedsore.
Liable parties may include doctors, nurses, orderlies, and other nursing home staff members. However, the nursing home administrator may be accountable for the nursing home abuse or neglect, regardless of who is directly responsible for the plaintiff’s stage 3 sores.
Evidence to Prove Nursing Home Abuse
The existence of stage 3 bedsores is a strong indicator of nursing home abuse. Apart from that, you can also present the following forms of proof to prove negligence:
- Medical records
- Expert testimony
- Nursing home incident reports
- Witness accounts
- Victim’s testimony
You must also show the extent of your damages in a nursing home abuse claim. The following documents can help you recover legal compensation:
- Hospital bills
- Testimonies from family members
Your nursing home abuse lawyer will tell you what documents you need to start collecting during your free legal case review.
Nursing Home Abuse Compensation for Stage 3 Bedsores
Filing a nursing home abuse claim can help you recover legal compensation for damages caused by your stage 3 bedsore. These damages may include:
- Medical Bills: Out-of-pocket expenses for treating Stage 3 sores, such as hospitalization, medication, surgery, and therapy costs.
- Disability: Compensation for disability-related expenses and damages if your loved one becomes disabled from their stage 3 bedsore. Damages may include mobility aids, physical therapy, loss of quality of life, etc.
- Loss of Quality of Life: Compensation for quality of life lost due to the effects of stage 3 bedsores.
- Pain and Suffering: Compensation for physical and emotional harm caused by stage 3 sores, including physical pain, emotional trauma, mental distress, etc.
- Lost Wages: Income, benefits, and wages family members lost while caring for your injured loved one.
- Scarring and Disfigurement: Compensation for emotional distress, reduced quality of life, and other related damages if your stage 3 bedsore becomes a permanent scar.
- Wrongful Death: Funeral, cremation, and burial costs, the grief of surviving family members, loss of consortium, and other death-related damages if your loved one dies due to stage 3 bedsore complications.
Your nursing home lawyer will help determine the potential value of your settlement during your free legal case review. Remember that settlement amounts vary from case to case, depending on several factors (e.g., the victim’s age, the severity of the injury, etc.).
Let Our Nursing Home Abuse Lawyers Seek Justice for You and Your Family
All nursing home residents deserve proper care and treatment. Bedsores are clear signs that a nursing home or assisted living facility has failed its legal duty to protect residents from preventable harm. Furthermore, the development of stage 3 bedsores indicates that a patient’s injuries have been left untreated.
Did you or a loved one suffer a stage 3 sore due to a nursing home’s actions or lack thereof? At Nursing Home Law Center, LLC, our experienced attorneys help victims and their family members recover fair legal compensation for their losses.
Contact our nursing home abuse attorneys at (800) 926-7565 or use the contact form for a free legal case review. All confidential or sensitive information you share with our legal team will remain private under an attorney-client relationship.
Our nursing home lawyers handle all accepted cases on a contingency fee basis. You don’t have to pay for our services unless we recover legal compensation for you.