It is estimated that 4–10% of patients admitted to acute hospitals in the UK will suffer from a pressure sore while in hospital. It is estimated that up to 20% of residents in nursing and residential homes may be affected. High incidence of pressure ulcers is widely regarded as an indicator of poor quality care provision whether this be in a hospital or care home setting. In addition, district nurses and GPs should not delay in referring a patient to hospital for a pressure sore that is not getting better. New guidance was rolled out nationally from April 2019 to make Trusts more consistent in dealing with how pressure ulcers are defined and harm reported.
Here is more information about pressure sores and examples of just a few past pressure sore compensation claims.
Causes of Pressure Sores
Unrelieved pressure on a specific area of the body will compromise the blood supply to the skin and underlying tissues causing that area to become damaged. This is a pressure ulcer. Typically, pressure ulcers occur in a person confined to a bed or a chair most of the time. These pressure ulcers are more commonly known as ‘bedsores’, or ‘pressure sores’.
Risks of getting a Pressure Sore
Whilst everyone is potentially at risk of developing a pressure sore, they are more likely to occur in people who are:
- seriously ill,
- have impaired mobility (people who are confined to a wheelchair, in particular),
- have poor posture,
- suffer from compromised skin
- or who are malnourished.
The most vulnerable people are those aged over 75. The impact of pressure sores can be psychologically and physically challenging. They can be debilitating and often result in greatly reduced quality of life for those who suffer them.
Where do Pressure Sores occur?
The parts of the body most at risk of developing pressure sores are those that are not covered by a large amount of body fat and are in direct contact with a supporting surface, such as a bed or a wheelchair. For example, if you are unable to get out of bed, you are at risk of developing pressure sores on your:
- shoulders or shoulder blades
- elbows
- back of your head
- rims of your ears
- knees, ankles, heels or toes
- spine
- tail bone (the small bone at the bottom of your spine)
If you are a wheelchair user, you are at risk of developing pressure ulcers on:
- your buttocks
- the back of your arms and legs
- the back of your hip bones
Severity of Pressure Ulcers
Many healthcare professionals use the European Pressure Ulcer Advisory Panel (EPUAP) grading system to describe the severity of pressure ulcers. The higher the grade, the more severe the injury to the skin and underlying tissue.
Grade one
A grade one pressure ulcer is the most superficial type of ulcer. The affected area of skin appears discoloured – it is red in white people, and purple or blue in people with darker-coloured skin. Grade one pressure ulcers do not turn white when pressure is placed on them. The skin remains intact, but it may hurt or itch. It may also feel either warm and spongy, or hard.
Grade two
In grade two pressure ulcers, some of the outer surface of the skin (the epidermis) or the deeper layer of skin (the dermis) is damaged, leading to skin loss. The ulcer looks like an open wound or a blister.
Grade three
In grade three pressure ulcers, skin loss occurs throughout the entire thickness of the skin. The underlying tissue is also damaged, although the underlying muscle and bone are not. The ulcer appears as a deep, cavity-like wound.
Grade four
A grade four pressure ulcer is the most severe type of pressure ulcer. The skin is severely damaged and the surrounding tissue begins to die (tissue necrosis). The underlying muscles or bone may also be damaged. People with grade four pressure ulcers have a high risk of developing a life-threatening infection.
Complications of Pressure Sores
Pressure sores can be serious and lead to life-threatening complications such as blood poisoning or gangrene. Gangrene in limbs can lead to amputation. Even a grade 1 (see below) pressure ulcer can be very painful indeed. However, the vast majority of pressure ulcers can be prevented with proper care.
Prevention
There are a number of measures that can be taken to reduce the risk of someone developing pressure ulcers:-
- Skin injury due to friction and shear forces should be minimised through correct positioning, transferring and repositioning techniques.
- Pressure-redistributing equipment should be used.
- Reduce underlying risk factors such as poor nutrition.
- Education and training – e.g., mobility, positioning, skin care, use of equipment – for patients and their carers.
- Eliminate any source of excess moisture due to incontinence, perspiration or wound drainage.
- Consider the use of emollients if the skin is dry or barrier products if the skin is excessively moist.
- People at high risk of developing pressure ulcers should use higher-specification foam mattresses rather than standard hospital foam mattresses.
Past Compensation for Pressure Sore Claims
- £100,000 and upwards may be claimed. In serious cases, for example, where a diabetic patient suffers the loss of their leg, owing to substandard care of pressure areas.
- £25,000 to the family of a 52-year-old lady, who died from septicaemia, after suffering a spinal infection because of a Grade 4 bedsore on her sacrum. This developed while in hospital because she was left (strapped into) a chair for 6 hours at a time. She was unlikely to have survived her hospital stay without any disability, in any event, because she had suffered from a serious bleed to her brain that was untreatable. She may not have recovered from the bleed at all. However, the level of neglect to this patient was shocking and compensation was deservedly obtained.
- £11,500 to the family of a care home resident who suffered dehydration, malnutrition and a grade 4 sacral pressure sore which contributed to her premature death
Our friendly team of specialist lawyers at Medical Solicitors have ample experience of bringing pressure sore claims when pressure sores could and should have been avoided. We conduct most of our Clinical and Medical Negligence claims under ‘No Win, No Fee’ agreements, also known as Conditional Fee Agreements so our clients do not have to worry about how they can possibly afford to pay for the legal costs of pressure sore compensation claims. You have nothing to lose in speaking to us.