Bed Sore FAQ

Former Illinois Nursing Home Resident Files Lawsuit Against Facility For Development Of Bed Sores

editor — Mon, 01 Apr 2013 15:32:50 +0000

A former resident of the Calvin Johnson Care Center in Belleville, IL is suing the facility for $100,000, according to the The Madison Record. The plaintiff, Robert McLean, claims that Calvin Johnson allowed several painful decubitus ulcers to develop during his stay.

The Record does not state the length of McLean’s stay at Calvin Johnson, or his age. Court records indicate that McLean developed the pressure ulcers sometime between February and March 2010. McLean, who is disabled and suffering from an undisclosed mental illness, claims Calvin Johnson violated the Illinois Nursing Home Care Act of 1980. The act states that patients who were admitted to nursing homes free of any skin abrasions might have the right to sue, if bed sores develop.

McLean and his lawyers, who filed their suit on June 10, are asking for a jury trial.

Family Blames Nursing Home For Mother’s Infected Pressure Ulcers & Death

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Gangrene & Osteomyelitis Cited In Wrongful Death Lawsuit Against Nursing Home

Turning & Repositioning By Nursing Home Staff Blamed For The Leg Fractures Of Patient

Woman Arrested for Elder Abuse, Including Neglect of Mother’s Severe Pressure Sores

editor — Fri, 01 Mar 2013 15:31:07 +0000

A recent story from Oklahoma City reminds me again that elder abuse is not only limited to nursing homes.

According to NewsOK.com, police found 57-year-old Deborah Ramirez trapped in her home in June 2010, surrounded by cockroaches and suffering from five bone-deep bed sores. Her main caretaker was her daughter, 28-year-old Carmella Saldanna. Saldanna was arrested on a felony charge of elder abuse, and will be tried in court on July 6.

This tragic story, along with forcing us to ask basic questions about elder care, also caught my attention because of specific laws in Oklahoma.

According to NewsOK.com, Oklahoma is one of only seven states to have passed a law authorizing an adult protective program. This seems incredible to me, considering the sheer number of cases involving elder abuse.

“Victims can speak up in some instances, but some victims cannot or will not,” Adult Protective Services Director Barbara Kidder reportedly said, adding that the number of abuse reports was the highest-ever in 2010. Kidder says her office saw more than 17,600 cases.

The Oklahoma Adult Protective Services, formed in 1977, is a division of the state Department of Human Services.

Nursing Home Injury Laws: Oklahoma

Oklahomans Continue To Have One Of The Highest Rates Of Pressure Ulcers In The Country

District Attorney Endorses Use Of Video Cameras In Nursing Homes

94-Year-Old Charged With Raping Co-Resident In Oklahoma Nursing Home

Decubitus Ulcers Remain Deadly Problem for Hospital Patients

editor — Fri, 01 Feb 2013 15:28:34 +0000

A recent article in Britain’s Daily Mail says that hospital-acquired bed sores continue to plague England’s National Health System in alarming numbers.

“Bed sores affected 412,000 NHS patients, and killed 4,708 people between 2003 and 2008,” the article states. The Daily Mail obtained its statistics from “Dr. Foster,” a part-public, part-private watchdog organization that analyses NHS data.

Bed sores, also called pressure sores or decubitus ulcers, can quickly become life-threatening if left unattended. They are common among elderly patients who are immobile, and who must be manually “turned,” or moved.

According to the Daily Mail article, bed sores are preventable, and are most often a result of inadequate nursing practices.

“[Bed sores] come down to poor nursing care, and there should be zero tolerance of them,” said Peter Walsh, Chief Executive of Action Against Medical Accidents.

Stopping [bed sores] is not rocket science. But in many hospitals they happen too easily.

Gail Adams, head of Unison, Britain’s largest nursing union, says upcoming government budget cuts could make the situation even more dire for elderly patients.

“Thousands of nurses are losing their jobs, and this could lead to a rise in the number of patients with bed sores,” Adams said.

The Daily Mail listed the worst-performing hospitals in terms of bed sore care. They include Warrington Hospital in Warrington, Halton General Hospital in Runcorn, and Medway Maritime Hospital in Gillingham.

Reducing Decubitus Ulcers In Hospitals. How One Facility Managed To Reduce Hospital-Acquired Wounds By 63%

Jury Punishes Hospital With Verdict In Medical Malpractice Lawsuit Where Patient Developed Bed Sores During Admission

Is The Lack Of Continuity In Patient Care Responsible For The Endless Bedsore Problem?

Pressure Sores Continue To Be A Vicious Sign Of Neglect At Medical Facilities

Medicaid Pulls Hospital Reimbursement for “Never Events,” Including Severe Bed Sores

editor — Wed, 02 Jan 2013 15:26:50 +0000

Medicaid has recently announced that it will no longer reimburse hospitals for “never events,” or 28 preventable conditions that should never happen in a qualified hospital. “Never events” include: falls that result in injury, catheter-related infections and severe bed sores (also called “pressure ulcers.”) The new rules, mandated by the Affordable Care Act, went into effect July 1.

“These steps will encourage health professionals and hospitals to reduce preventable infections and eliminate serious medical errors,” said CMS Administrator Donald Berwick, MD, in a press release. “As we reduce the frequency of these conditions, we will improve care for patients and bring down costs at the same time.”

Currently, 21 states already refuse to reimburse “never events.” The remaining 29 will have up until July 1, 2012 to implement the new rules. States will also have the right to identify additional “preventable” conditions, for which Medicaid can be denied.

From my experience as a medical malpractice lawyer, I know that “never events” often indicate neglect and abuse. I can only hope that the new rules give more protection to the most vulnerable members of our society.

Medicare No Longer To Pay For ‘Reasonably Preventable’ Medical Errors

New Medicare Report On Medical Errors In Hospitals Reinforces Ongoing Problems

Hospitals Fined For Preventable Medical Complications Such As Bed Sores

Gov. Weakens Nursing Home Watchdog Program, Prompting Uproar from Consumer Advocate Groups

editor — Mon, 03 Dec 2012 15:25:03 +0000

As a nursing home lawyer, it makes my day to see new elder care laws being passed. From my experience, I know that many senior citizens sorely need our help – both from a legal standpoint, and from society at large.

So I was disappointed to read about recent events in Florida, where Gov. Rick Scott is attempting to cut back on nursing home regulations. According to a recent AP article, soon after Scott took office in January, he fired the state’s long term nursing home ombudsman – a move many are now calling illegal.

Nursing home ombudsman programs exist in every state. They’re funded by the federal government, and their main goal is to investigate complaints filed about individual nursing homes. A vast majority (90 percent) of the 14,000 national ombudsman staff are volunteers.

At question in Florida is whether Gov. Scott had the right to fire upper-level ombudsman personnel, and to replace them with people who are reportedly friendly to the nursing home industry. In February, Scott ousted state ombudsman Brian Lee, putting in his place Jim Crochet – a well-established figure in the nursing home lobby.

“The state is succumbing to the demands of the nursing home industry,” said Janet Wells, director of public policy at The National Consumer Voice for Quality Long-Term Care. The National Consumer Voice is a D.C.-based nonprofit that advocates for long-term care residents.

In a June 3 editorial for The Palm Beach Post, Lee called Gov. Scott’s actions “criminal,” and encouraged nursing home residents – and their families – to speak out.

“Ombudsman now work under the same fear as the residents they are defending,” said Lee. “If the [ombudsman] program fails, residents will have nowhere to turn for help.”

Lee, along with another high-level ombudsman employee who was fired, Lynn Dos Santos, have filed whistleblower complaints with the Florida Commission on Human Relations. The federal Administration on Aging has also launched a formal investigation into Lee’s dismissal.

Florida Nursing Home Earns Spot Amongst Nations Worst

Do Nursing Home Inspectors Need To Exercise More Regulatory Muscle With Dangerous Facilities?

Yes, Good Nursing Homes Do Exist!

Nursing Home Ombudsmen Making A Difference In Patients’ Lives

Study: Black Nursing Home Patients May Be More at Risk for Pressure Sores Than White Patients

editor — Thu, 01 Nov 2012 15:23:25 +0000

A recent study from the Journal of the American Medical Association (JAMA) found that black nursing home patients might be more at risk for developing pressure sores than white patients. Pressure sores, also called decubitus ulcers, are open wounds that could become deadly if left untreated.

The study, which analyzed data from 2.1 million U.S. nursing home patients from 2003-2008, found that blacks consistently had higher rates of bed sores than whites. The highest rates of bed sores occurred in nursing homes with the highest percentage of black residents. The lowest rates occurred in nursing homes with mainly white patients, according to the study.

Researchers also found that both black and white residents were more at risk for developing bed sores when nursing homes had mainly black residents.

Yui Li, one of five authors of the study, said that nursing homes with higher concentrations of black residents tend to suffer from chronic staffing issues.

The authors of the study conceded that more research needs to be done on the issue, since differences in mattresses and disposable briefs can also affect bed sore rates.

Report Shows: Hispanic Nursing Home Patients Are Living In Inferior Facilities

Blacks Receive Inferior Care At Most Nursing Homes

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

6 Most Common Causes Of Bed Sores & How Caregivers Can Help

Outpatient Surgery— Why Even Relatively Healthy Patients are at Risk for Developing Pressure Sores During Recovery

admin — Mon, 15 Oct 2012 14:55:27 +0000

A resident of Peoria went into St. Anthony’s Medical Center in Rockford for surgery to repair bilateral fractures in the spring of 2003. A year later, he died from complications due to pressure sores after losing the lower part of his left leg as part of the effort to keep him alive. When most people discuss the topic of bedsores, they assume that bedsores only occur in elderly patients with diminishing health. Patients that are young and healthy can develop the sores too, however, and if they go untreated, they can contribute to a painful death.

How Pressure Sores Develop

When a patient is confined to a single position, such as in a hospital bed, the weight of the body on points throughout the body may cut off circulation to the surrounding area, depriving skin and muscle tissue the nutrients and oxygen needed to function. After some time, the cells begin to die and a condition known as necrosis develops, which is defined as the death of living tissue. Bedsores initially develop as a discolored and painful welt on the affected area, which can be treated by moving the patient at regular intervals so that blood and oxygen can reach the area. If the sore goes untreated, however, it can become an open wound, which is highly prone to infections by powerful bacteria.

After Everett Johnson’s surgery, he developed sores and was transferred to the Rosewood Care Center 10 days after the operation for treatment of pressure ulcers. In the lawsuit filed after Johnson’s death, his wife argued that doctors didn’t properly evaluate his sores or document their size and the complications that followed from their development. She also argued that the facility did not react quickly and failed to provide proper treatment for Everett’s pain or the sores.

Gangrene and Sepsis Resulting from Pressure Ulcers

Mr. Johnson eventually developed gangrene in his left leg and the only course of action that doctors had was to remove the lower portion of the leg. At the same time, sores began to fester on his right foot and sepsis, a widespread infection, began to present further complications. His sores had gotten so bad that they would have requires skin grafts if he ever hoped to recover from them. After an entire year of complications and pain, Everett Johnson passed away— presumably from the advanced infections that he was fighting.

What was supposed to be a routine surgery to repair bilateral fractures became a nightmare for the Johnson family, who watched Everett die a slow and painful death due to bedsores that could have been prevented. Mrs. Johnson argued that doctors never addressed the issue beforehand and the sores could have been prevented if there was a plan in place to prevent the development of pressure ulcers in Everett’s post-op recovery. The lack of a plan to prevent the sores combined with the poor care that Everett received resulted in a $120,000 settlement out of court between the healthcare system and Johnson’s family.

Pressure sores are not a problem that is limited to the elderly and more attention needs to be given to patients who are forced to remain still for long periods of time. By simply moving a patient every two hours, bedsores can be prevented from developing and in their early stages they are easily treatable. Understaffing and the lack of education among caregivers are the primary reasons that patients develop bedsores and if hospitals, care centers and nursing homes were to focus on maintaining an adequate number of staff members and educating them on how to prevent bedsores, the issue would not be as prevalent as it is today.

Sources for more information regarding the development of patients following outpatient surgery and other types of routine medical procedures:

http://www.outpatientsurgery.net/news/2012/05/16-Did-Post-Op-Pressure-Ulcers-Kill-Patient

http://www.nlm.nih.gov/medlineplus/ency/article/002266.htm

Two Families Sue Same Nursing Home, Saying Facility Caused Relatives’ Sepsis and Bed Sores

editor — Mon, 01 Oct 2012 15:21:14 +0000

Two families have recently filed separate bed sore lawsuits against the Madison Manor nursing home in Richmond, Kentucky, saying the facility provided grossly inadequate care for their relatives.

The first lawsuit, filed May 11 by Donna Anderson, says Madison Manor let a severely infected bed sore develop on her late husband’s foot. The bed sore (also called “pressure sore” or “decubitus ulcer”), according to The Richmond Register, led to the amputation of Robert Anderson’s leg, as well as his eventual death. Anderson was a patient at Madison Manor from April 4, 2009 to May 22, 2009, according to lawsuit records.

The second lawsuit, filed June 16 by David Drury, says that Madison Manor severely neglected his mother, Lena McKinney. McKinney was a patient from Dec. 24, 2008 to July 22, 2009. The lawsuit claims that Madison’s Manor’s negligence led to falls, weight loss, urinary tract infections, acute renal failure, and sepsis. Sepsis, also called “septic shock,” is a severe illness caused by a blood infection.

Both Anderson and Drury accuse Madison Manor of medical negligence, corporate negligence, and violating long-term care residents’ rights. Both plaintiffs are seeking punitive and compensatory damages, as well as a jury trial.

Wrongful Death Lawsuit Claims That Assisted Living Facility Failed To Care For Vulnerable Patient

Nursing Home Fined After Investigation Determines That Urinary Tract Infection Was Related To Poor Care

Videotape Reveals Abuse In Kentucky Nursing Home

Untreated Urinary Tract Infections In Nursing Home Patients May Result In Urosepsis

Can the Rate of Pressure Sores be Decreased? One Hospital Says Yes and Proves It

admin — Fri, 14 Sep 2012 14:45:29 +0000

A chain of hospitals based in St. Louis set out on a mission in 2007— eliminate any harm befalling patients that could be otherwise prevented. BJC HealthCare noticed that pressure sores accounted for roughly two thirds of the preventable conditions that occurred under the watch of their hospital staffs. While other healthcare companies deemed pressure ulcers to be an inevitable condition for immobilized patients, BJC set itself on a path to prove them wrong and succeeded. In the first two years, the hospitals reported a 58% decline in the number of bedsores reported among patients and continued to show improvement over the two years to follow.

The Root of the Problem

In order to correct the problem, BJC needed to understand the cause. After reviewing procedure at three of its hospitals, the company found three trends that seemed to exist among patients who developed pressure ulcers. The first was that patients were left in positions that did not distribute their weight properly, leading to loss of circulation in areas that had pressure placed on them. There was also a lack of transparency and communication, which resulted in physicians not being aware of the existence of a problem until it was too late.

The final trend that was discovered was a lack of education among the caregivers that treated patients who developed sores. BJC focused on training staff to understand the risk factors leading to bedsores, how to prevent them, notice them and how to treat them. By providing education to staff members, the first two issues could be addressed as well. Caregivers knew how to position their patients so as to reduce pressure on their bodies and they communicated openly with other staff members if a patient was at risk of developing bedsores or showing symptoms.

Preventing a Condition is More Efficient than Curing It

BJC HealthCare wanted to prevent pressure ulcers from occurring rather than to treat them after the fact. In order to accomplish this, they made sure to move all patients who were at risk of developing pressure sores every two hours to prevent long periods of poor weight distribution that cut off the circulation to joints and other areas that held the bodyweight of the individual.

Staff members were equipped with new training that informed them of conditions that put patients at a higher risk of developing sores and more attention was given to those patients in order to both prevent the sores from developing and to detect them early on while they were still treatable. The hospital developed a point system that took the patient’s history and current medical conditions into account in order to calculate a number that represented the risk of pressure sores forming on the patient’s body.

Patients that were at the greatest risk received more attention and supervision and if a patient needed to be moved on a regular basis in order to prevent sores from developing, two people would turn the patient in order to reduce the risk of other injuries. In the first three hospitals that BJC implemented these new procedures, the occurrence of bedsores dropped 58% over a period of two years. After applying the changes company wide, BJC HealthCare reduced the number of reported bedsores by 30% system wide, proving once and for all that the problem could be fixed and that it only continues to exist because health care facilities choose to ignore it.

Facilities that claim the problem is a fact of life and can’t be prevented simply don’t want to prevent it because of the time it would take to train staff members and the cost of hiring additional workers in order to be able to turn patients and attend to their needs. BJC HealthCare has provided a model that other facilities can mimic in order to prevent pressure sores from developing and to treat them early. It requires training staff members on the issue and making sure that patients are evaluated for their risk of developing the sores. It then requires providing proper care and making sure that the patient is under adequate supervision.

Source for more information regarding pressure sores in hospitals:

http://www.beckershospitalreview.com/quality/under-pressure-to-reduce-harm-how-bjc-healthcare-decreased-hospital-acquired-pressure-ulcers-by-58.html

Woman Acquitted for Murder Charges in Pressure Ulcer Death Case

editor — Mon, 03 Sep 2012 15:18:45 +0000

The horrific death of an elderly California woman raises disturbing questions about who’s ultimately responsible for the care of older relatives.

When paramedics found 91-year-old Maria “Concha” Lopez in her home in December 2009, she weighed 35 pounds and was covered in her own feces and urine. She also had numerous stage four pressure ulcers; several of which were so severe that they bared down to the bone. Her primary caretaker, 26-year-old great-niece Stephanie Hernandez, was arrested on charges of elder abuse and murder. She was later let go and re-arrested in February 2010.

In her trial, which took place this April, Hernandez was presented by her lawyers as a caring relative who never meant to let things spiral so out-of-control.

“There’s absolutely not one shred of evidence that Stephanie knew that if Concha died….she’d be accused of murder,” said defense attorney Craig Collins. “The evidence is clear. Stephanie didn’t cause Miss Lopez to die.”

Geriatrician Kathryn Locatell, who was called to the defense’s witness stand, saw things differently.

“I’ve never seen someone with this skin condition – the numerous wounds; the inflammation, the rashiness,” said Dr. Kathryn Locatell. “There’s no treatment. It’s evidence of neglect. It’s not a part of normal dying. It’s not part of dying at all.”

“These wounds,” added Locatell, “are extremely painful, as the skin is loaded with nerve endings. This is appalling.”

The jury heard five weeks of testimony before deciding to acquit Hernandez on charges of murder, involuntary manslaughter, and felony elder abuse. According to the L.A. Times, jurors said there wasn’t enough evidence that Hernandez had intended to harm her great-aunt.

The jury remained deadlocked on the lesser charge of misdemeanor elder abuse

Court Date Set In Illinois Elder Neglect Case

Home Nurse Who Failed To Get Medical Attention For Patient With Severe Bed Sore Now Faces Criminal Charges

Cook County Nursing Home Pleads Guilty To Gross Neglect Charges

New York Nursing Home Nurses Charged With Criminal Neglect