If you or your relative go into hospital or a care/nursing home without a pressure sore/ulcer, and one (or more) develop, you may well have a claim for negligence. Read on…

Pressure ulcers don’t just develop on their own, but usually arise as a result of neglect. Poor risk assessment, poor management of the patient, or lack of staff resources – are some contributing factors.

A pressure ulcer (sometimes also referred to as a pressure, bed or skin sore) occurs when pressure or friction is being applied to an area of the skin over a period of time, due to a lack of mobility.

Poor circulation cuts off the blood supply, causing damage to the skin and the deeper layers of tissue under the skin, resulting in infection.

Sitting or lying down too long, eg being bed-ridden or confined to a wheelchair – are potential risk factors that could lead to pressure ulcers. Equally, there are some medical conditions that are known to directly impact on mobility eg heart conditions, lung conditions, diabetes, deteriorating mental health and dementia, to name just a few conditions that place people at an increased risk of developing pressure ulcers.

Failure to diagnose early on, inspect, manage, monitor and treat, can cause lengthy and painful suffering and infection, which can take a long time to heal, and can sometimes lead to major complications and even be fatal. Patients with pressure ulcers have an increased rate of mortality.

It is not just the elderly or infirm who may lack mobility, have thinner skin, or are necessarily at most at risk of developing pressure ulcers in hospital or a care home. For example, patients in hospital, who have to remain still or be less mobile whilst recuperating after major head, spine, hip or leg surgery, or who are under heavy sedation (or induced coma) – are also at highest risk of developing pressure ulcers.

Measuring the risk of pressure ulcers is done using the Waterlow scale – a simple scoring system in the form of a chart used by healthcare professionals to assess risk of developing pressure ulcers. The higher the score, the greater the risk.

Therefore regular risk assessments should be carried out to review the patient’s skin condition and integrity, as a lack of movement and mobility can cause pressure ulcers.

Patients who may be vulnerable should be turned or repositioned regularly to minimise the risk of developing a pressure ulcer.

Diligent and regular risk assessments and inspection should identify any pressure ulcer developing. Applying immediate and effective treatment and care should successfully resolve the problem if spotted early on, and before it develops into something more problematical, sinister and difficult to treat.

Left untreated, some pressure ulcers can go on to can cause deep infection in the wound, which can spread quickly and lead to serious and severe complications.

Pressure ulcers are graded in order of severity:

Grade 1 is at the bottom end of the scale and is the least severe. The grades increase in severity, through to Grade 2, and with Grades 3 and 4 usually being the cause of litigation against the NHS or care homes for negligence. A Grade 1 pressure ulcer is the easiest to treat and has the quickest recovery time; whereas conversely, Grade 4 is the most severe, and takes the longest time to heal, if in fact it can be healed at all.  Sometimes, infection is so bad, that intervention by surgery is needed to deal with the condition which may include amputation.

Early diagnosis, treatment and good care management are the keys to success.

In a hospital setting all pressure ulcers Grade 2 and above should be reported on admission.

For more information about pressure ulcers, pressure sores and bed sores, read [link to Farley Dwek website page].

You may be entitled to compensation if you have sustained a pressure ulcer that could have been avoided with proper care. Why not call us on 0800 011 4136 or 0161 272 5222 or enquiries@farleydwek.com for a FREE consultation.

It is a sad but common fact that unfortunately, as people become more elderly and frail, they tend to be less steady on their feet and fall more frequently. If unlucky, they can sustain nasty injuries – usually to their hip, shoulder or arm, which necessitates hospital admission sometimes followed by surgery.

Whilst helping families with their elderly relative’s claim for NHS Continuing Healthcare Funding, we have also come across a number of such unfortunate incidents with patients falling out of hospital beds – particularly following such surgical procedures.  Read more below.

The sides of the beds should be put up to prevent patients from falling out of bed whilst they are still recovering from the anaesthetic post-surgery.

We recently acted for an elderly lady who was admitted to A&E and then subsequently transferred to an acute medical unit and from there to a private side room.  The staff got her out of bed at some stage in the night to change the sheets but then forgot to put the side rails up again after she returned to bed. In the morning she was then found on the floor and upon examination it was noticed she had suffered various fractures – hip and arm.  It was evident that this lady had fallen out of bed.  Prior to her fall, upon observation, she had a high temperature, was delirious and suffered with confusion.  She was not able to fully communicate her needs.  Given her state of delirium and poor cognition it would have been appropriate to have left the railings at the side of the bed upright to manage her safety.  Had that been the case, she could not have fallen out of bed and her injuries would not have occurred.

The NHS naturally denied all liability initially, but we were able to produce the NHS’s own statistics at the time that 1 in 200 patients fall out of a hospital bed!

There is some useful information that can be found on the NHS website relating to the use of bedrails –“Bedrails Safer Practice Notice

We also referred the NHS to their own “Never Events List” 2011/12– which relates to “serious, largely preventable patient safety incidents that should not occur if the available preventable methods have been implemented by healthcare providers” – ie there are certain things that should never happen in a hospital environment. We also sent the NHS their own  cartoon below – which really speaks for itself.  Leaving the side rails of the bed down is against the hospital’s Bedrails policy and one of those events that should never have happen. In our clients’ cases, had the bedrails been put up, the severe injuries suffered would never have been sustained.

The Never Events Policy and List have recently been updated. For more information click https://improvement.nhs.uk/resources/never-events-policy-and-framework/

If you know of a similar incident, why not get in touch and see if we can assist you with a claim for compensation.