Pressure ulcer (bedsores /or/decubitus ulcer) is a skin and underlying tissue injury caused by prolonged pressure, friction, or shear.
This is why immobile patients are most likely to suffer this painful condition. If this condition is left untreated, it can progress from mild skin redness and irritation to deep wounds exposing muscle/bone. These late-stage ulcers can easily get infected, causing sepsis or osteomyelitis.
The pain from the wound can be debilitating, but the incessant dressing changes, adhesives, and repositioning of the body can be exhausting. Patients often become immobile with the fear of pain, and this, in turn, can accelerate muscle atrophy and joint stiffness. This vicious cycle of constant new bed sores, constant bandage changes, and interrupted sleep, combined with fear of pain and discomfort, can lead to a decline in mood and mobility, and may cause bouts of depression and hopelessness.
While a pressure ulcer (bedsore) is a serious wound in itself, it is often a ‘red flag’ for underlying and even more dangerous health complications that families should be aware of.
In a legal context, preventable or worsening ulcers could be an indicator of breach of the duty of care in medical facilities, which supports malpractice/negligence claims.
The Wound Is Just The Tip Of The Iceberg
If an ulcer is present, the first order of business is to make sure it doesn’t get worse.
This means it must be checked, rebandaged, and dry. If it is left for even a day, or in some cases if a patient tends to sweat a lot, it can go from stage 1 to stage 4 very quickly, evolving to full-thickness over a couple of days, even if care is provided.
Early action is critical for prevention. These need to be checked daily, AT LEAST, in order to avoid undue pain and progression of infections or even worse, death.
The wound(s) have gotten really deep, there might be exposed bone, and the incredible pain is beyond words. It becomes obvious that the patient’s immobility could mean they have underlying circulatory issues, are malnourished, and aren’t getting the daily care they need, and an infection could be present.
In claims, the lack of timely escalation to appropriate therapy is scrutinized, as well as staffing and documentation.
Sepsis
What makes ulcers beyond painful – deadly – is how easily they can escalate into more serious issues (sepsis, osteomyelitis). This is because the wound is constantly open, making it a breeding ground for bacteria, many of which are harmful.
If the harmful bacteria make their way into the bloodstream, the infection can become systemic – causing sepsis – making its way into every part of the body, leading to organ shutdown and possibly death.
Allegations often go over whether staff recognized and acted upon early signs (e.g., confusion, extreme pain, fever/shivering, clammy skin, tachycardia, and shortness of breath) within accepted standards with cultures, antibiotics, and escalation.
Osteomyelitis
The very real and unpleasant truth is that your family is faced with the possibility of additional medical bills and the distress of the severity of the situation. It’s incredible how a little wound such as this can escalate into something bigger and affect every aspect of the patient’s life and that of their family.
If there’s bone exposed at the wound site, you could be looking at a deep bone infection called osteomyelitis.
This treatment can require weeks of intravenous (IV) antibiotics. In some cases, surgery might be required to remove infected/dead tissue or bone.
A bone infection like this could have been prevented with the right care and attention. In litigation, bone involvement is commonly argued as evidence of prolonged prevention or treatment failures, which supports damages for extended care and pain/suffering.
Gangrene and Amputation Risk
When there’s a lack of blood flow around an ulcer site, and the infection/ischemia is severe, it can lead to dead tissue (gangrene) and, in severe catastrophic cases, it could lead to amputation.
These outcomes materially increase economic and non-economic damages in personal-injury (or wrongful-death) claims.
Other Complications
For a somewhat severe bedsore that may have been prevented with the proper care, so many complications arise from the neglect:
- Cellulitis.
- Contractures (tightening of muscles and tendons).
- Overall decline in patient health, quality of life, and mental health.
All of these could indicate systemic issues (e.g., understaffing, missed repositioning, inadequate nutrition/hydration, neglect, abuse, mistreatment, etc.). If that is the case, there needs to be some form of accountability and compensation.
When these life-changing complications and, in some cases, fatalities happen, families (or victims) should seek counsel from experienced stage 4 bedsore attorneys – legal professionals who deal in such cases – to see whether they have a case; and if yes, how to proceed.
Conclusion
Sadly, there are numerous systematic failures (e.g., understaffing, poor adherence to prevention protocols, etc.) in the nursing home health care services.
Holding the government and facilities responsible is the only way to initiate change; we must be vigilant.
Families need to be involved in the care, monitor it regularly, and make sure the best care is being given to their family member, and if it’s not, don’t be afraid to challenge the authorities on what happened and consult counsel to get justice for the victims and change the situation so these things cannot happen in the future.