Pressure Sores and Bed Sores arising in nursing home patients are a major source of nursing home neglect and medical malpractice cases. Medical malpractice cases against a nursing home arise when patients are not properly treated or when a delay in treatment causes the condition to become much worse. Pressure sores and bed often occur in people that cannot move around easily. However, they can be prevented or treated if diagnosed in a timely matter. Pressure sores, also known as pressure ulcers arise when the skin and tissue underneath break down from continued pressure and poor circulation. When the skin breaks down, it becomes red. Open sores develop after the skin changes. In severe cases, the pressure ulcer causes destruction of muscle or even bone underneath the skin. The National Pressure Ulcer Advisory Panel (NPUAP) created a process for evaluating pressure sores and bed sores. There are five stages, State I being the earliest signs, Stage IV being the most advanced. These stages include: Stage I: Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area. The area may be painful, firm, soft, warmer or cooler as compared to adjacent tissue. Stage I may be difficult to detect in individuals with dark skin tones. May indicate "at risk" persons (a heralding sign of risk) Stage II: Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister. Presents as a shiny or dry shallow ulcer without slough or bruising.* This stage should not be used to describe skin tears, tape burns, perineal dermatitis, maceration or excoriation. *Bruising indicates suspected deep tissue injury Stage III: Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling. The depth of a stage III pressure ulcer varies by anatomical location. The bridge of the nose, ear, occiput and malleolus do not have subcutaneous tissue and stage III ulcers can be shallow. In contrast, areas of significant adiposity can develop extremely deep stage III pressure ulcers. Bone/tendon is not visible or directly palpable. Stage IV: Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often include undermining and tunneling. The depth of a stage IV pressure ulcer varies by anatomical location. The bridge of the nose, ear, occiput and malleolus do not have subcutaneous tissue and these ulcers can be shallow. Stage IV ulcers can extend into muscle and/or supporting structures (e.g., fascia, tendon or joint capsule) making osteomyelitis possible. Exposed bone/tendon is visible or directly palpable. Nursing homes can be negligent if they do not properly assess the patient for the likelihood of developing a bed sore, if they do not turn the patient on a regular schedule or do not bathe the patient on a regular schedule, and finally, if they do not properly treat the patient after the diagnosis of a pressure sore. There are strict time limitations for filing nursing home neglect lawsuits in Michigan. The failure to meet these deadlines can destroy your case so it important that you contact a Michigan nursing home abuse and neglect lawyer at the first sign of abuse.
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