We think of bedsores as something that typically happen from poor care in Nursing Homes. But they can occur in hospitals and acute care facilities as well. It is not just the elderly who are at risk. Any person who lacks mobility due to illness or injury, such as paralysis, is keenly at risk for developing bedsores.
Furthermore, the proper term for “bedsore” is pressure injury as they can just as easily be caused from sitting too long in a chair as lying in a bed. Bedsores or pressure injuries are a growing issue for immobile patients in hospitals. It is also a sign of neglect; although, a detail review of medical records is necessary to determine if a potential case exists. In certain situations, while a pressure injury is preventable, given the nature of someone’s underlying illness or injury, a hospital may not be legally liable.
When a patient has limited mobility and is confined to a bed, chair, or other object for an extended period, the body is placed under significant pressure. The areas with the greatest continued pressure cannot adequately disperse that pressure, affecting a person’s blood flow. If the person is left unattended, in the same position for long periods, the skin and tissue are damaged due to the lack of blood flow. As the underlying tissue dies, the affected area is exposed and can result in a pressure wound, also known as a pressure ulcer, which many commonly call “bedsore.”
Usually, these painful sores appear on a patient’s tailbone, buttocks, hips, or heels. Essentially, sores are prone to appear over bony areas of the body. The cause, however, is simple. Pressure sores only occur when the patient has remained in the same position for an extended amount of time, making most of them preventable with limited exceptions.
Since bedsores occur when a part of the body receives prolonged pressure, patients who are not mobile are most susceptible.
Generally, patients who cannot move on their own accord are the most at risk. This includes patients in the Intensive Care Unit (ICU) and those admitted with severe spine or brain injuries. Since the ICU cares for seriously ill patients, many are not mobile and cannot move their own bodies. The same applies to those admitted with severe injury and a lack of control over their extremities.
Patients with heightened risk factors are also at an increased risk for bedsores. Those with poor dietary habits, such as dehydration, malnourishment, are more susceptible to bedsores. Also, conditions like diabetes make some patients more prone to bedsores.
Patients who suffer from Alzheimer’s and Parkinson’s disease are also at a greater risk because they may forget how long they have been in one position.
When we go into a hospital, we expect to get better, not worse. Generally, this falls in line with the standard of care that a hospital owes its patients. All staff working at a hospital, including medical staff, are responsible for treatment and care provided to each patient. That means if bedsores occurred, it was most likely due to hospital personnel breaking that responsibility of care to their patients.
Typically, standard of care and hospital regulations require that immobile patients be turned at least every two hours to prevent pressure sores. There also exists a variety of pressure relief devices that hospitals and acute care facilities can use to prevent pressure injuries. These devices typically include cushions, mattresses, pillows, and heel devices.
A hospital may be liable for the actions or inactions of all those acting on behalf of the hospital. This includes physicians, staff members, and other employees. When a hospital employee, be it a nurse or doctor, fails to care for and treat a patient, there is a break in the standard of care. That makes the hospital legally liable for injuries.
Initially, a stage 1 bedsore may appear. It emerges as a red spot on the patient’s skin. The area may be swollen, warm, or hard. At this early stage, if pressure is removed from the area, then the signs will clear up within a few days. If properly treated early on, no further medical treatment is typically needed.
When a caregiver ignores the initial signs of a stage 1 bedsore, then it has the potential to develop to stage 2. At this stage, the patient is likely to develop other medical issues besides redness and swelling. These include blistering or abrasions. Bedsores must be cleaned and dry to avoid infection. The bedsore will also have to remain covered. If a caregiver catches the bedsores at this stage, it can usually take a few days to several weeks to heal.
Stage 3 bedsores are much more severe and painful. The patient’s skin may be damaged, including underlying tissues. It may appear like a crater and may excrete blood or pus. At stage 3, a physician or wound care specialist will need to evaluate the bedsore and treat it properly. In some instances, treating the wound may require antibiotics and removing pressure from the site. Depending on the severity of the bedsore, healing may take four to six months.
Stage 4 pressure sores can be fatal due to the significant risk of infection that can quickly spread. Injuries include significant damage to the underlying muscles, nerves, and tendons. The sores usually travel deep into the skin and tissue. At this stage, the wound has probably become infected, is hot to the touch, and drains fluids and pus. The muscle, nerves, and tendons can even be exposed. Surgery is usually needed. If left untreated, bedsores that have reached stage 4 can be deadly.
Additionally, some sores may be unstageable as dead skin, or necrosis, will cover the sore impeding the ability to detect just how severe it is. Debridement (or removal) of the dead skin is necessary in these situations.
If you experienced bedsores, you could hold a provider and hospital responsible for their inactions. As the victim brings a suit, you carry the burden of proving that negligent behavior led to bedsores. However, you do not have to do this alone. We encourage you to contact our office at The Baer Law Firm. Or call us at 404.THE.BAER (404.843.2237) for honest advice about your potential case.