“Overall the Braden Scale is user-friendly, and each {section} has a detailed explanation,” the study says. “Fewer severe ulcers were documented…during the time the Braden Scale was used.”

The study took a look at two groups of patients – those admitted to a Level I Trauma Center between March 1, 2007 and March 17, 2008, and those admitted between March 18, 2008 and March 31, 2009. Age didn’t factor into the study, though most patients admitted were around 60 years old. Along with the Braden Scale, an assessment technique called the Skin Scoring Tool was frequently used.

“The Skin Scoring Tool includes the following domains: sensory, mobility, continence, skin integrity, activity and function,” the study says.  “Studies comparing the effects of {both} risk assessment instruments are needed.”

Of approximately 42,000 patients, about 350 developed advanced-stage pressure sores. Sores were frequently located on the sacral area, heel, hip, and buttocks. More than half of the ulcers in each population were stage II pressure ulcers. The study claims that bed sores are often best diagnosed by a team of doctors and nurses.

“Clinician judgment alone has shown inconsistent implementation of pressure ulcer prevention interventions,” the study says.

Related:

Study Finds High Incidence of Pressure Sores in Elderly Patients with Hip Injuries

Why is it common for nursing home and hospital patients to develop bed sores on their back?

Lack Of Cleanliness & Incontinence Contributes To Development Of Bed Sores In Nursing Home Patients

Under-staffing At Nursing Home Blamed For Pressure Ulcer, Infection & Subsequent Death

Particularly in patients who may be recovering from a surgery or illness that leaves them with compromised mobility, hospital staff must take efforts to move the patients on regular intervals and retain the blood circulation.

Extended periods in a hospital bed can put pressure on areas of the body that have little tissue or muscle to disperse the pressure.  Even relatively short periods of extended immobilization can result in unrelieved pressure that impairs blood flow and eventually causes the skin and tissue covering the pressure point to die.  As the tissue dies, the underlying tissues and bone may be exposed resulting in a condition known as a bed sore.

Hospital bed sores: a widespread problem

Far from being an isolated complication, hospital acquired bed sores impact thousands of patients every year leaving them with a complication that may be more complex and painful to heal than their underlying illness that they were originally admitted for.

Even at some of the most prestigious medical facilities across the country, hospital acquired bed sores remain a real threat to the well being of patients.  Recognizing the significant threat to patient health, the federal government (Medicare) has added hospital acquired bed sores (also referred to as: pressure sores, pressure ulcers or decubitus ulcers) to its list of ‘Never Events’.  As part of the list of never events, hospitals can no longer seek reimbursement for care they provide to patients who have developed a stage 3 or stage 4 bed sore during their hospitalization.

Hospital bed sores: Medical Malpractice?

When a person does develop a bed sore at a hospital, they may be entitled to pursue a claim or lawsuit against the medical center based upon the applicable medical malpractice laws.  Under the medical malpractice laws in most jurisdictions, a lawsuit based upon the development of a bed sore during a hospitalization may entitle the patient to recover damages for their medical bills, disability and pain.

Because the medical malpractice laws in each jurisdiction may impose procedural requirements prior to filing a lawsuit, such as having a physician review a patient’s medical chart, it is important to consult with a medical malpractice lawyer as soon as feasible when a hospital acquired bed sore has been identified.

Related:

• Bed Sores Are Amongst Most Common Hospital Errors
• Medical Errors, Such As Pressure Ulcers, Costing U.S. $20 Billion Per Year
• New Medicare Report On Medical Errors In Hospitals Reinforces Ongoing Problems
• Hospitals Fined For Preventable Medical Complications Such As Bed Sores
• Jury Punishes Hospital With Verdict In Medical Malpractice Lawsuit Where Patient Developed Bed Sores During Admission

To the contrary, the majority of circumstances when a patient develops a bed sore during an admission to a nursing home is an indication of inadequate care or neglect.

At the very least, bed sores are a source of embarrassment and pain for the patient.  In other cases, bed sores can progress to the point that an open wound results and greatly increases the chances of the patient developing serious complications such as: sepsis, osteomyelitis or gangrene.  Yet, in other situations bed sores may be fatal.

Pursuant to federal law, any nursing home accepting federal funds must evaluate new patients for the presence of bed sores on admission and develop a plan of care to ensure that bed sores do not develop at in the future.  Most nursing home care plans entail:

• ‘turning’ patients at regular intervals
• ensuring proper hydration and nutrition
• keeping patients clean and dry

Studies continue to demonstrate that with the proper care, bed sores (also referred to as pressure sores, pressure ulcers or decubitus ulcers) are an unnecessary medical complication that can be prevented when staff are attentive to patient needs.

Unfortunately, many nursing homes have jeopardized the safety of their patients— and have increased their risk for developing bed sores— by deliberately reducing the staffing levels at facilities to the point where patients’ needs go unattended— in order to drive profits at the facility.

When the nursing home’s inattention results in a patient developing bed sores, the individual or their family may be entitled to pursue a legal claim or lawsuit against the facility for their negligence.  Depending on the laws of the jurisdiction, a bed sore lawsuit may allow for recovery of medical expenses, pain and suffering, lost wages or even death benefits when a nexus between the bed sore and death can be established.

A lawyer experienced in prosecuting nursing home bed sore cases, should be able to evaluate your claim and advise you of your legal rights pursuant to the applicable law.  In most states, bed sore lawsuits must be filed within a specific period of time known as the statute of limitations.  While an applicable statute of limitation may allow for a lawsuit to be filed years after the poor care, it may take months to obtain copies of the medical charts so many attorneys suggest conducting an investigation as soon as feasible.

Related:

• Family Sues Illinois Nursing Home Over Relative’s Death Related To Bed Sores & Infection
• Bed Sore Prevention Is An Ongoing Process For All Nursing Home Patients
• Lawsuit Blames Nursing Home, Management Company & Staff Doctor For Patients Decubitus Ulcers
• Mounting Evidence Suggests That Bed Sore Prevention Is Cost Effective

“Elderly patients who have had strokes or spinal injury don’t have good [sensory abilities], so their bed sore ‘hot spot’  often goes unattended, ” says Dr. Eliot N. Mostow, a dermatologist and professor at Ohio’s Case Western Reserve University. “We need to look first at preventing bed sores, and then caring for them when they occur. ”

Mostow, a former president of the Cleveland Dermatological Society, says that dermatologists should be involved at all levels of bed sore care, from identification to healing.

“Sometimes, a dermatologist is the only one who can distinguish a pressure ulcer from something else,” Mostow says. “It’s the dermatologist who would look at the pressure spot and know whether or not it’s a decubitus ulcer, a squamous cell cercinoma, or a deep fungal infection. Clinicians might see it as just a red area, but a dermatologist might diagnose it as a stage I ulcer.”

Mostow noted that many pressure sores often form in the sacral area, an area highly vulnerable to prolonged redness and irritation.

According to Mostow, proper bed sore treatment should involve either a multidisciplinary team at a hospital, or specialists at an outside wound care clinic. Mostow advises fellow doctors to visit www.woundsource.com, a site where they can learn about the most up-to-date wound care technology.

“Too often, dermatologists forget what they already know about wound care,” says Mostow. “If there’s pressure, work with pressure release. If there are problems, we need to provide the appropriate moist wound healing and prevention, and then correct the (original) factor.”

Related:

Why is a colostomy needed for patients with severe bed sores?

What is a wound vac and how does it work?

How many calories does a patient with advanced bed sores need to consume?

Study Gives Suggestions for Treating and Preventing Bed Sores

What makes younger people even more susceptible to develop bed sores during an admission to a hospital or nursing home is the fact that many staff at the facility fail to appreciate the risks given their age.  Consequently, many of the well-known preventative measures may never get implemented in younger patients as their may be a wrongful assumption that younger patients are not at risk or may be capable of caring for themselves.

In situations where a younger people has developed an advanced bed sore, they may require many of the same medical procedures used for treating pressure sores in patients of all ages.  Many doctors and medical facilities may employ the following techniques to heal bed sores in younger patients:

• Debridement
• Wound Vacs
• Flap Reconstruction Surgery
• Amputation of limbs
• Colostomy

In certain circumstances, a patients youthful vigor may indeed allow them to survive some of the medical complications and rehabilitation associated with advanced bed sores.  However, many younger patients who survive the recovery process may require future medical care to monitor complications or a lifetime faced with disability.

Legal Rights Of Young Bed Sore Patients

Like all cases involving the negligence of a hospital, doctor or nursing home– the injured party has the burden of establishing that the individual or entity they are pursuing failed to meet the standard of care in the community.  Demonstrating the negligence of a party may be accomplished through a variety of methods such as with the use of expert medical testimony from physicians or nurses with a particular type of knowledge about wound care.

Once the negligence of the facility has been established, the damages associated with the injury can be addressed.  In the case of a bed sore lawsuit, damages may include:

• Past and future medical expenses
• Past and future pain and suffering
• Disability
• Disfigurement
• Lost wages

Damages for younger patients must be carefully addressed as many will face a lifetime of medical care due to a bed sore.  Lawyers representing younger people with bed sores may further use the services of a: life-care planner– a doctor or specially trained professional who can assess what type of medical care and supplies an injured person may require in the future and an economist– to help calculate a present value for the future care or lost wages.  Certainly, in cases where a younger person has developed a bed sore at a medical facility it is imperative to evaluate the case based upon the both the immediate harm and future needs of the individual.

Related:

The Less-Wrinkled Faces May Be Younger In The Nursing Home, But Still Require Care

What Brings You To The Nursing Home? The Answers May Surprise You?

Hospital Acquired Pressure Sores Are Devastating Source Of Patient Injury & Death

Nursing Home Abuse: The Deaths Of 13 Children Linked To Poor Care At Chicago Nursing Home

Despite having multiple medical conditions such as: prior strokes, hypertension, diabetes and dementia that put the man at an increased risk for falling, the facility allegedly failed to implement the necessary safeguards and he subsequently fell and fractured his hip which necessitated a surgery.

In addition to the fall and resulting injury, the lawsuit further alleges that the facility failed to prevent the development of a diabetic ulcer on the patient’s ankle that ultimately resulted in severe medical complications such as gangrene and osteomyelitis.

Related Bed Sore FAQ’s:

Can bed sores cause osteomyelitis?

If bed sores are not timely treated, can gangrene develop?

Can bed sores be fatal?

Bed Sore FAQ: Bed Sore Lawsuits

Nursing Home Injury Laws: Illinois

Most pressure sores are preventable and are caused by faulty care where the nursing home or hospital does provide adequate care to prevent and treat bed sores.  Patients vulnerable to developing pressure sores are the elderly, people who are bedridden, and people with diabetes.

Pressure sores in nursing homes can be prevented by taking simple preventative measures including:

• Turning patients
• Using pressure reducing mattresses and pads (pressure relieving devices)
• Keeping residents clean and dry
• Providing adequate nutrition and hydration
• Performing skin checks

Related:

Can dehydration contribute to the development of bed sores?

Can malnutrition cause bed sores?

What is ‘turning’ and why is it important to prevention of bed sores?

Are pressure relieving mattresses required to be used in nursing homes?

The trial commenced by the family of Emilo Gonzalez, a patient with motile medical complications including: partial paralysis, anemia, seizure disorder, decreased appetite, dementia and Parkinson’s disease, alleges that despite a medical chart that seems to substantiate regular care—including crucial bed sore preventative measures such as turning and re-positioning, the care was never actually provided.

Lawyers for the nursing home, assert that the facility actually performed all of the care that the records demonstrate and the development of Mr. Gonzalez’s bed sore (similarly referred to as: pressure sores, pressure ulcers or decubitus ulcers) was simply an unavoidable medical condition that developed due to the fact the Mr. Gonzalez’s body was shutting down.

Inevitability is a common defense asserted by nursing homes and hospitals in litigation involving the development of a bedsore during an admission to the facility.  Despite these arguments, it usually is readily from the testimony of staff at the facility that the care indicated in the patient’s chart was not, nor could have been provided.

Related:

What are some common defenses used by nursing homes and hospitals in lawsuits involving pressure sores?

Why are mentally disabled patients at risk for developing bed sores?

What steps can be taken to minimize the risk of developing bed sores?

What are nursing homes required to do to prevent bed sores?

Nursing Home Injury Laws: Texas

The subject of the lawsuit, Nellie Wilks, was an elderly woman who was admitted to Parkwood Skilled Nursing and Rehabilitation Center on July 7, 2008.  At the time of her admission, Ms. Wilks suffered from various medical conditions and was very much dependent on the staff at Parkwood for providing care for her daily living needs.  Despite her maladies, Ms. Wilks did not have any type of pressure sore on her body.

Also at the time of her admission, the staff at Parkwood conducted an assessment of Ms. Wilks needs and determined her to be at risk for developing bed sores, due to her limited mobility, incontinence of bowel and bladder and need for staff assistance with all of her daily living needs.

The failure on the part of the staff at Parkwood (as well as the owners’ failure to provide staff with the means to do their job) to properly implement Ms. Wilks’ plan of care is alleged to be responsible for the development of a stage IV pressure sore on Ms. Wilks’ sacrum. The wound’s advanced nature, necessitated a medical procedure known as a diverting colostomy and extensive medical care until her death on October 26, 2008.

Related:

Are incontinent patients at an increased risk for developing bed sores?

Nursing Home Injury Laws: Missouri

Are there any federal regulations that apply to the prevention of bed sores?

How does the use of the Braden Scale help in the prevention of bed sores?

If a lawsuit or claim is filed against a facility where a person developed bed sores, what type of damages is the person entitled to?

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.

Not surprisingly, the hospital where the wounds developed blames the wounds on Mr. Bush himself, implying that the wounds were unpreventable given his size.

Related:

What is surgical debridement of bed sores?

Simple preventative techniques can drastically reduce the rate of hospital-acquired decubitus ulcers

Why is it important to differentiate the type of facility where a bed sore developed?

Nursing Home Injury Laws: Nevada