Decubitus Ulcers

Major Bedsores Under Managed Care


Decubitus ulcers, also called bedsores or pressure ulcers, are one of the most prevalent forms of nursing home neglect. Decubitus ulcers are usually caused from lack of turning the patient by the staff on a regular basis. Unsanitary conditions, such as not changing the patient’s diapers on a regular basis may also cause decubitus ulcers. Federal and state law requires the nursing staff to turn the patient on a regularly to ensure proper blood flow to the body parts.

Some nursing homes have a “don’t care” attitude and do not care for their patients properly while others may be severely understaffed which leads to poor patient care. A patient that lies in one position for too long will lose blood circulation to the portions of the body which support the body. This causes a lack of blood flow to the area. Because of the lack of blood flow, the tissue begins to die and will eventually “rot” away unless treated properly. A common example to help you understand is if you were sitting in a chair for a long time, you will shift around in the chair to restore blood flow to your bottom. Imagine sitting in a chair for several days not being able to shift or move. Eventually your bottom would become numb decubitus ulcers to lack of blood and the tissue would begin to die. That what some nursing home patients endure as they lay in bed, resulting in these decubitus ulcer’s, because they are not turned regularly by the staff.

Decubitus ulcers are usually formed on the bony prominences of the body. They are usually located in the sacral area (on the lower back near the tail bone), the buttocks, back of the heels, knees, elbows, and sometimes the upper back.

There are generally four stages of bedsores.

Their descriptions are as follows:

Stage I – A stage one decubitus ulcers usually appears as a red spot on the skin that fails to disappear once the pressure from the area is relieved. It may appear as a small rash. Stage I decubitus ulcer’s can usually be eliminated with proper treatment and turning by the nursing staff and are sometimes common with nursing home patients. Usually, the nursing home is not negligent with a stage I decubitus ulcer.

Stage II – A stage II decubitus ulcer usually begins as a stage I decubitus ulcer that progresses to a stage II. Stage II decubitus ulcer may appear as a small blister with maybe slightly broken skin. The skin is usually red, but may appear as bruise. A stage II should be carefully monitored by the nursing staff and medical treatment should begin and the patient’s doctor notified. Nurses can begin therapy and skin conditioning. Also things such as air mattresses and special padding, along with regular two hour turning of the patient, should be considered by the staff. The staff is not necessarily negligent if the patient has several stage II decubitus ulcers. Some stage II decubitus ulcers may be unavoidable.

Stage III – A stage III decubitus ulcer usually appears as an open wound on the patient. Many times the wound are bloody or oozing bodily fluids. They range in size from the size of a dime to the size of a dinner plate? The skin is open usually to a depth of a quarter of an inch or more. Immediate medical attention and treatment should be provided to the patient. The treating doctor of the patient should be aggressively treating this wound and hospitalization should be considered? Infection that could kill the patient is possible. Usually, unless unforeseen and unavoidable circumstances are involved, the nursing staff is negligent if they let a decubitus ulcer progress to a stage III.

Stage IV or unstageable – A stage IV decubitus ulcer is considered the worst type of decubitus ulcer. The wounds are open and usually bloody. There is usually a strong stench or odor that is usually caused by infection and unsanitary conditions in the wound itself. When you see a stage IV you will know it, and it will usually gag and repulse you. They range in size from about a quarter coin in size up to the size of a large dinner plate. They usually have a depth down to the bone and tendon, with bone and tendon visible, which could be several inches in depth. Usually hospitalization, with a surgeon cutting out the dead rotting flesh (debridement) is required. Many patients never recover from stage IV decubitus ulcer decubitus ulcer to infection, shock, and other complications. One of the major complications of Stage IV decubitus ulcers is sepsis, or septicemia, which is commonly known as a whole body infection that attacks all the organs of the body. Many times sepsis will kill the patient. Usually the nursing staff is negligent for allowing a patient to progress to this deplorable, terrible condition and most juries at trial return high monetary verdicts based upon this condition.

In the event you have a loved one that has a stage III or stage IV decubitus ulcer, be sure and take several close-up color photographs with a good camera of the wound without bandages on the wound. The nursing home will always object to you taking pictures, so you will have to take the pictures while the nursing staff is not in the patient’s room. (Of course you must be an immediate family member or have the patient’s permission to take the photograph). At trial, no one will believe you as to the terrible condition your loved one was in until you show the jury the pictures. Remember that a picture is worth a thousand words. Once the picture is shown, the nursing home and their insurance company will usually be willing to compensate the patient, or their estate, for the terrible way the patient has been treated.

What is the compensation by a jury for a stage III or IV decubitus ulcers?

Depending upon your case and the degree of negligence by the nursing home, settlements or jury verdicts ranging from $25,000.00 to over $1,000,000.00 are not uncommon. These are estimates only! No dollar amount is guaranteed.

Please contact our offices immediately if you loved one has suffered from a stage III or IV decubitus ulcer (bedsore) for a free consultation.