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Pressure Sores and Medical Negligence

Pressure Sores and Medical Negligence

All too often, substandard medical care will result in a patient developing a pressure sore. If this has happened to you or your loved one, you could be entitled to pursue a claim for compensation. To find out more, you need to speak to a solicitor who specialises in medical negligence claims.

What is a pressure sore?

A pressure sore is when the skin breaks down due to unrelieved pressure on the underlying tissue.

When pressure is placed upon an area of tissue, the blood supply to that area will be disrupted. The blood supply provides oxygen and nutrients to the tissue and also carries away waste products.

When the blood supply is restricted due to compression, the area will become deficient in oxygen (called tissue ischaemia) and waste products will build up. All this will damage the tissue, slowly causing it to break down.

If the pressure is not alleviated, the tissue will continue to break down until an open wound develops. This is a pressure sore.

A pressure sore is also known as a bed sore or pressure ulcer.

Pressure sore grades

There are varying degrees of pressure sore ranging from grade one to grade four. Grade one is when the tissue initially begins to break down, while a grade four pressure sore is when there is a large open wound on the surface of the skin that is surrounded by dead tissue.

The different grades of pressure sore can be described as follows:

Grade 1

A grade one pressure sore is the first stage of a pressure sore and can be difficult to spot. Early signs include red skin which will remain red when pressed. This is opposed to healthy tissue which goes white when pressed (known as blanching).

Grade 2

If pressure is not alleviated, the tissue will continue to break down. The skin will become slightly thicker and a small injury will appear on the skin. This may take the form of a blister, abrasion or a shallow crater.

Grade 3

As the tissue deteriorates, the skin will feel very thick and will begin to fall away. This will only extend to the subcutaneous tissue, rather than the underlying fascia. The sore upon the skin will have opened, presenting as a deep crater.

Grade 4

In the final stage, the skin loss will be significant, involving both the underlying tissue and muscle. The tissue will die (called tissue necrosis) and damage may extend to the bone. A grade four pressure sore is life-threatening and can lead to infection and blood poisoning.

Who gets pressure sores?

A pressure sore can affect anyone whose tissue becomes distorted because of unrelieved compression. There are factors that increase the risk of a pressure sore occurring, including:

  • Poor blood circulation
  • Fragile skin
  • Moisture on the skin
  • Diabetes
  • Smoking
  • Reduced mobility
  • Old age

Most commonly, pressure sores affect patients in hospital, or in another healthcare environment such as a care home. This is because many patients will suffer one or more of the aforementioned risk factors.

In particular, reduced mobility is a key factor in the development of a pressure sore and is something that regularly affects hospital patients – whether due to ill health or a surgical procedure. Consequently a patient is left lying or sitting in the same position for prolonged periods of time, and is unable to move without assistance from nursing staff.

Depending upon their position, certain areas of tissue will be compressed by their own body weight, restricting the blood supply. For example, if lying down, the patient's heels, buttocks, shoulders, elbows and head will be compressed. If this is not alleviated, the tissue will begin to break down.

Preventing pressure sores in hospital

Because hospital patients are known to be at risk of developing a pressure sore, steps should be taken to protect the tissue, so far as is reasonably possible.

Within six hours of being admitted to hospital, a patient should be risk assessed for pressure sores. If the patient is thought to be vulnerable – perhaps due to limited mobility, old age or poor circulation – preventative measures should be taken.

This must include placing a patient on a pressure relieving mattress. Nursing staff must regularly check a patient's pressure spots, looking for signs of tissue damage. A patient must also be encouraged to change position regularly. If he/she cannot achieve this on their own, nursing staff must turn the patient at frequent intervals, usually once every two hours.

If these steps are taken, it is possible to prevent a pressure sore.

Treating a pressure sore

If a patient does begin to suffer tissue damage due to prolonged pressure, immediate action must be taken to prevent the problem deteriorating any further.

If caught in the early stages, a pressure sore can be effectively treated. The wound should be regularly dressed, the skin kept dry and clean, and further pressure relieving measures implemented. It may also be necessary to consult a tissue viability nurse.

However, if a pressure sore is only diagnosed in the later stages, more extensive treatment will be required. For example, debridement surgery may be needed to remove the dead tissue. In severe cases, the damage must be so widespread that a skin graft is required to help the wound close.

Pressure sore complications

A pressure sore can result in long-term complications. The healing process will be slow and painful, and may result in permanent scarring and fragile tissue.

If a grade three or four pressure sore develops, the consequences can be life-threatening. This is because the tissue will become necrotic (dead), and this may extend to the bone. All necrotic matter must be surgically removed, and this can in turn lead to an amputation.

A pressure sore also make a patient extremely susceptible to infection and the open wound provides the perfect opportunity for bacteria to enter the body. When a pressure sore becomes infected, the bacteria can quickly spread to the bloodstream, resulting in sepsis. This is very serious and may end in septic shock, organ failure and even death.

Pressure sore never event

If a patient develops serious complications as a result of a pressure sore, questions must be raised as to whether or not medical care is to blame. This is because a pressure sore is considered to be a never event.

The National Patient Safety Agency defines a never event as: “serious, largely preventable patient safety incidents that should not occur if the available preventative measures have been implemented.”

This means that a pressure sore should not happen in a healthcare environment and should be readily avoided with preventative measures. Therefore if a patient develops a pressure sore while staying in hospital or in another healthcare environment, the standard of care must be called into question.

Is a pressure sore negligent?

If a pressure sore arises because of substandard medical care, there will be a case of medical negligence. The level of care will be deemed unacceptable if medical professionals failed to:

  • Identify a patient at risk of developing a pressure sore
  • Implement preventative measures to stop an at risk patient developing a pressure sore
  • Regularly check a patient's pressure areas
  • Turn a patient at regular intervals, if they are not able to do so themselves
  • Spot the early signs of tissue damage and provide immediate treatment
  • Prevent the progression of a minor pressure sore to a serious pressure sore
  • Diagnose a pressure sore and/or an infected pressure sore

Because a substandard level of medical care has caused a patient to suffer unnecessary injury – namely, a pressure sore – there will be grounds for a medical negligence compensation claim.

Pressure sore claims

To find out if you are able to make a pressure sore claim, you need to speak to a solicitor who specialises in these cases. Or if your loved one suffered a pressure sore but has since died, you may be able to make a claim on their behalf.

A medical negligence solicitor will listen to the details of the care provided before suggesting what options are available. If there is a case to be answered, your solicitor will begin the claims process, fighting to get the compensation you deserve.

Pressure sore negligence settled claims

At Glynns Solicitors, we have extensive experience in pressure sore claims. We have successfully settled a number of cases in which patients wrongfully suffered a hospital-acquired pressure sore, making us well placed to help you.

In one case, a disabled patient developed a grade four pressure sore after an operation because nursing staff failed to turn her for two days. She was awarded £42,500. In another case, an elderly hospital patient was left sitting in a chair for days on end. She developed a pressure sore on her sacrum which became infected. Tragically she died of sepsis. Her family was awarded £90,000 compensation.

Pressure sore compensation

If your pressure sore claim is successful, you will also be awarded a sum of compensation. The amount will depend upon the circumstances of the case. As with all medical negligence claims, your settlement will be broken down in to general damages and special damages.

General damages reflect the physical/emotional pain and suffering you have experienced because of medical negligence.

Special damages reflect the actual financial loss you have incurred because of the negligence. To help your solicitor calculate this figure, it is useful to keep a record of any costs incurred, along with receipts and invoices.

Time limits for pressure sore claims

If you are thinking about claiming for a pressure sore, it is best not to delay when seeking expert legal advice. This is because medical negligence claims are subject to a three year time limit, starting from the date the negligence occurred. If you exceed the date of limitation, you will be unable to make a claim, even if you have a very strong case.

There are some exceptions to the three year rule. If a Claimant lacks capacity, there will be no time limit whatsoever. If the Claimant was under the age of 18 when the negligence occurred, he/she will have until their 21st birthday to bring a claim. Lastly, you may be able to rely upon a later date of knowledge, meaning you only discovered there had been a case of negligence at a later date.

Claiming for a pressure sore

To talk to a solicitor about claiming compensation for a pressure sore, please get in touch with us today. We will put you through to a solicitor who deals exclusively with medical negligence claims.

The solicitor will then ask you about the care you or your loved one received while in hospital/a care home. After all the information has been obtained, we will consider your case before advising you upon the options available.

If we suspect that there is a case of medical negligence, we will ask if you would like to proceed with a claim. Before making a decision, you can ask the solicitor any questions you might have, helping you to make a choice. For example, you may like to know whether there are any costs involved and what the process involves.

If you decide that you would like to continue with a pressure sore claim, we will handle the entire process on your behalf, providing expert legal advice at every stage. The first step will be to obtain your medical records (or those of your loved one), and to take a witness statement. Thereafter will we explain what happens next, guiding you through each phase.

Pressure sore medical negligence solicitors

To find out if you can claim for a pressure sore, do not hesitate to get in touch with us at Glynns Solicitors.

We have a wealth of knowledge in this area of the law and can help you obtain the compensation you deserve. Although this will not undo the damage you have wrongfully endured, it will provide some form of recompense for the physical, emotional and financial injuries you and your family have experienced.

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