Bedsores and Healthcare Negligence in Nursing Homes

Bedsores, also known as pressure sores, decubitus ulcers, or pressure ulcers, are caused by unrelieved pressure on the skin. Bedsores can cause infections and other life threatening conditions like cancer, sepsis, gas gangrene, and bone and joint infections.

Bedsores are injuries to the skin and tissue beneath the skin (epidermis and dermis) and occur as a result of pressure on the skin, usually from a bed or wheelchair. This pressure decreases blood flow that delivers oxygen and other nutrients to tissues. If the nutrients are not delivered properly, the skin cells and tissue may become damaged and die. Sustained pressure is caused by immobility, which is associated with conditions such as general poor health, sedation, surgery recovery, paralysis, and comatose.

Bedsores often occur on skin protecting bony parts of the body, since the skin faces more pressure due to the friction between the bone and outside surface. As bedridden people or those in wheelchairs are most susceptible to bedsores, they frequently occur on the tailbone, buttocks, shoulder blades, spine, backs of arms and legs, back or sides of head, rims of the ears, hips, lower back, heels, ankles, and the skin behind knees.

Since bedsores are caused by immobility, they often occur as a result of negligence on the part of a healthcare provider who fails to attend to the wellbeing of the patient. According to the Centers for Disease Control and Prevention (CDC), approximately 10% of residents in nursing homes currently suffer from bedsores. Bedsores are painful and in some cases life-threatening, yet they are easily avoided if a healthcare provider takes the proper precautions.

Bedsore Classification

Bedsores are categorized based on their severity, as follows:

Stage 1 is the least severe. At this stage the sores are not open wounds. The skin may be painful but there are no breaks or tears. However, the person will experience persistent redness of skin.

At stage 2 the skin breaks open and forms an ulcer that might appear as a blister. There may be a loss of partial thickness of the skin as the sore extends into deeper layers of the skin. At this stage, the skin becomes tender and painful.

During stage 3 the sore gets worse and the ulcer exhibits a loss of full thickness of the skin, with the sore extending into the tissue beneath the skin until a deep crater is visible.

Stage 4 is the most severe sore causing extensive damage. At this stage, the sore is very deep, causing a loss of full thickness of the skin and reaching into muscle and bone. 

Bedsores may also be considered “unstageable,” in that the surface is covered with dark tissue so that the depth of the wound is not visible.

Bedsores can lead to extremely serious, potentially life-threatening conditions. The most common consequence of stage III and IV bedsores is sepsis, which occurs when bacteria enter the bloodstream through the sore. The bacteria rapidly spread throughout the body and infect it. If left untreated, sepsis can lead to organ failure. Bedsores can also lead to cellulitis, an infection of the skin and soft tissues, and bone and joint infections, which are all life-threatening illnesses. In rare cases, bedsores may lead to the development of a cancerous cell that grows specifically in non-healing wounds.

Stage I and II bedsores may be healed within several weeks with effective treatment through the use of pain management medication and antibiotics. Stage III and IV bedsores are much more difficult to treat. If a person experiences signs of a bedsore, the best treatment is to move, if possible. If there are no signs of improvement within 24-48 hours, the wound may be infected, and a doctor must be called. The signs of an infected bedsore include: fever, drainage from the sore, increased heat, and/or redness surrounding the sore. If you are experiencing any of these symptoms, seek immediate medical attention.

Bedsores are extremely painful and are considered to be serious medical conditions. In fact, the presence or lack of bedsores is one of the main ways that quality of care in a nursing home can be assessed. Bedsores are caused by immobility; when a person cannot move on their own, it is the responsibility of their caretaker to make sure that they are moved, turned, and bathed regularly. For this reason, bedsores frequently occur as a result of negligence, typically in rehab facilities, hospitals, long term care facilities, or nursing homes. Bedsores are preventable if nursing home staff members follow proper medical care and daily patient monitoring procedures.

Nursing homes and other assisted-living facilities are supposed to provide their patients with high-quality care. There are specific standards that care facilities must follow to ensure that they provide the necessary quality care and services. When a new patient enters a facility, the facility must provide the “necessary treatment and services to promote healing, prevent infection and prevent new sores from developing.” These standards can be found in the Code of Federal Regulation (CFR) 483.25(c), created by the Department of Health and Human Services, as well as other agencies.

Bedsores Legal Help

Bedsores often develop through neglect, when the patient does not receive adequate care, including the failure to regularly reposition immobilized residents. A nursing home may be held liable or legally responsible for any bedsores that an individual subsequently suffers.

If your loved one is suffering from bedsores due to the inattention or inadequate care of a nursing home or long-term care facility, contact Hach & Rose, LLP, today by calling (212) 779-0057 to speak with a qualified New York nursing home abuse attorney.