Bedsores

Bedsores Point To Negligent Care

Experts tell us that when an elderly person or disabled person is being properly cared for, bedsores in nursing homes should not occur. If the person is turned regularly and skin is kept clean, his or her skin should remain free of bedsores.

Furthermore, if the beginnings of a bedsore are evident on the skin of a hospital patient, nursing home resident or assisted living home resident, alert and competent care professionals should take action immediately to treat and correct the condition. Failure to diagnose and treat skin ulcers is negligence. Serious infections can develop as a result.

Bedsores Can Complicate A Recovery

If you or your loved one developed bedsores that caused a more serious infection, you may have grounds to file an injury claim against the care facility where this took place. Perhaps you were briefly hospitalized for what was supposed to be quick and uneventful surgery, only to have your hospitalization prolonged after you developed a bedsore and/or a serious infection. You may be entitled to financial compensation for ensuing medical expenses as well as your pain and suffering.

Seeking Compensation Or Assurances

If your loved one became very ill or died of an infection after developing bedsores in a nursing home, you should explore the possibility of filing a lawsuit alleging nursing home neglect. Personal injury lawyers at Caesar & Napoli, can evaluate your case and develop a promising strategy for getting compensation for you to cover your losses.

Many clients who bring nursing home neglect cases say at first that they are not interested in money so much as answers and assurance that the facility will not continue the neglectful practices. A nursing home neglect lawsuit can include demands that a facility revise and amend its procedures for the safety of other residents. In addition, an elderly or disabled person and/or his or her family may be able to recover compensation for medical care costs as well as pain and suffering and/or loss of companionship in bedsore cases.

How Bedsores Are Staged

Clinicians describe pressure injuries by stage, and the stage recorded in the chart tells you a great deal about what happened in the weeks before it was written down.

• Stage 1. Intact skin with redness that does not fade when pressed. At this point the injury is still reversible with repositioning and pressure relief.
• Stage 2. Partial thickness loss of skin, often looking like a shallow open sore or a blister.
• Stage 3. Full thickness loss of skin, with fat visible in the wound bed.
• Stage 4. Full thickness loss exposing muscle, tendon or bone. These wounds can lead to infection of the underlying bone.
• Unstageable. The base of the wound is covered by dead tissue, so the depth cannot be determined until it is cleaned away.
• Deep tissue injury. Persistent discoloration under intact skin, signaling damage that started below the surface.

An advanced pressure injury generally develops over a period of days rather than in a single shift. When a resident who was admitted with healthy skin is later found with a Stage 3 or Stage 4 wound, the question is what the chart shows about the time in between.

The Rules Nursing Homes Are Required To Follow

Pressure injuries are one of the few areas of nursing home care where the standard is written down in plain terms. Federal regulation 42 CFR 483.25(b) requires a facility to ensure that a resident who enters without pressure ulcers does not develop them unless the individual’s clinical condition demonstrates that they were unavoidable, and that a resident who has one receives the treatment and services necessary to promote healing and prevent infection.

New York adds its own protections. Public Health Law 2803-c sets out a residents’ bill of rights, and Public Health Law 2801-d gives a resident a direct right of action against a facility that deprives them of a right or benefit established by law or regulation. A claim under 2801-d is separate from an ordinary negligence claim, it can carry statutory damages, and it allows a court to award attorneys’ fees. Facilities in this state are also regulated under Title 10 of the New York Codes, Rules and Regulations.

Complaints about a licensed facility can also be reported to the New York State Department of Health, which investigates them independently of any lawsuit.

The Records That Decide A Bedsore Case

Bedsore claims are won and lost in the chart. The documents that matter most include:

• Skin assessments performed on admission and at intervals afterward
• Braden Scale scores, which record the facility’s own assessment of pressure injury risk
• Turning and repositioning logs
• Wound care notes, measurements and photographs
• The care plan, and whether it was revised as the resident’s condition changed
• Weight, intake and hydration records, since poor nutrition slows healing
• Staffing records for the unit on the relevant dates
• Minimum Data Set assessments submitted for the resident

Gaps in these records matter as much as their contents. A repositioning log with entries missing for a shift, or a care plan that was never updated after a risk score climbed, tends to say more than any single note.

If a relative is still in the facility, photographs taken with a date stamp are valuable, and so is a written request for a copy of the complete medical record. Families have a right to those records, and requesting them early prevents arguments later about what existed and when.

What A Bedsore Claim Can Recover

• Medical expenses for wound care, surgery, hospitalization and treatment of infection
• Pain and suffering
• Statutory damages and attorneys’ fees where Public Health Law 2801-d applies
• In a case involving a death, the family’s pecuniary loss along with a survival claim for the conscious pain and suffering the resident endured

Some families want changes at the facility more than they want money. A claim can press for both. Prior results do not guarantee a similar outcome.

Deadlines That Apply To A New York Bedsore Claim

• Claims under Public Health Law 2801-d are generally treated as claims upon a liability created by statute, which carry a three year period
• Claims pleaded as medical malpractice carry two years and six months (CPLR 214-a)
• Ordinary negligence claims carry three years (CPLR 214)
• Wrongful death actions carry two years from the date of death (EPTL 5-4.1)
• Care at a public hospital or a facility operated by a municipality requires a notice of claim within 90 days and suit within one year and 90 days (General Municipal Law 50-e and 50-i)

Which period governs depends on how the claim is framed and on the facts behind it. Because the shortest of these runs two and a half years, waiting to have a case reviewed can quietly remove options.

Questions Families Ask About Bedsores

Are bedsores always a sign of neglect?

Not in every case. Federal regulation recognizes that a pressure injury is sometimes unavoidable given a resident’s clinical condition, and a facility is entitled to make that showing. What it cannot do is assert it without the assessments, the repositioning records and the care plan revisions that would support it.

The facility says the wound was present on admission. What then?

Then the admission skin assessment becomes the central document, along with the records from wherever the resident was before. Disputes over the origin of a wound are common, and they are resolved with paperwork rather than argument.

My relative signed an arbitration agreement in the admission packet. Does that end it?

Not necessarily. Whether an arbitration clause binds a particular claim depends on who signed it, what authority that person held, and what the agreement actually says. It is worth having reviewed rather than assumed.

Can I bring a claim if my relative has already passed away?

Yes. A representative of the estate can pursue the claim. In that situation the two year wrongful death period becomes the governing deadline for part of the case, so these matters should be reviewed promptly.

Do you handle bedsore cases outside Manhattan?

Yes. The facilities involved in these claims are licensed by the New York State Department of Health wherever they sit, and the same federal and state standards apply to all of them. A claim against a facility operated by a municipality is the one exception worth checking early, because it carries the shorter notice deadline described above.

What does it cost to have a case reviewed?

Nothing. The initial consultation is free, and these cases are handled on a contingency fee basis.

Related Nursing Home And Malpractice Pages

• Nursing home abuse
• Malnutrition and dehydration
• Injuries from wandering off
• Medication errors
• Failure to diagnose
• Medical malpractice
• Wrongful death

Contact A Committed, Compassionate Elder Neglect Attorney

At Caesar & Napoli, we do not charge for initial consultations regarding bedsores, malnourishment, dehydration, falls, abuse and other forms of nursing home neglect. To schedule a meeting with one of our trial lawyers, please contact us at (888) 235-6766. Most bedsore cases are handled on a contingency fee basis. We do not charge attorneys’ fees until we win compensation for you.