Gangrene is a complication that may develop due to the death of tissue in and around a pressure sore. Severe pressure sores may result in the reduction of blood flow in and around the wound. The reduced blood flow increases the ability of bacteria to grow. Bacteria produce toxins that the body is unable to remove.
When a nursing home patient develops a bed sore that progresses to gangrene, there is indeed cause for concern from a medical and legal perspective. The personal injury attorneys at Rosenfeld Injury Lawyers LLC represent victims who have been neglected in skilled nursing facilities and have developed bed sores with complications like gangrene. If your loved one developed a severe condition that might involve gangrene in a nursing home setting contact our office for a free case review to determine if a claim for civil damages is appropriate.
Gangrene is a Secondary Condition
The development of gangrene is usually the result of a lack of health care when a wound or bedsore becomes infected beyond control. Gangrene is a life-threatening complication that kills the tissue around the wound and restricts blood flow. Bacteria can begin to grow immediately in the affected area if the tissue is void of oxygen and nutrients. As the affected tissue deteriorates it tends to develop foul odors and a green or black discoloration. In some cases, there is no effective antibiotic to stop the progression of the condition which may result in surgical debridement or the amputation of the limb.
While gangrene can claim the victim's life, the deadly infection is often secondary to other conditions including an untreated open wound or pressure sore. The condition typically attacks the body's extremities including the toes, fingers, hands, and feet. It can quickly spread to vital organs and other limbs.
The Elderly and Disabled are at Risk
Typically, gangrene is a condition that may occur in individuals that suffer from low blood circulation. This means that individuals with peripheral vascular disease, diabetes, the disabled, and other medical conditions with low blood pressure are most at risk. In fact, nursing home residents are most susceptible to developing gangrene along with other severe conditions.
The elderly, disabled, and individuals rehabilitating can quickly develop a pressure sore that, like gangrene, develops from a change in blood flow circulation in certain areas of the body including the legs and feet. Without an adequate blood supply, the patient's skin tissue can quickly die and begin rotting and causing a flesh-type wound. While the medical team in a nursing facility might state that a pressure sore (pressure wound, bedsore, pressure sore, decubitus ulcer, pressure ulcer) is unavoidable, most bedsores can be prevented with adequate treatment when following an effective Care Plan.
Often, gangrene will develop on the patient's heels, in between the patient's toes, and on their heels in locations that are furthest from the heart. The condition often develops in nursing home residents who are bedridden and forced to remain on their back while lying in bed for hours at a time. Other times, the pressure wound will develop by the constant rubbing of a toe, foot, heal, knee, hip, or sacrum (tailbone) against a mattress or bedsheet.
Friction can also cause a life-threatening bedsore. These types of wounds often develop when the nurse or nurse's aide repositions the resident's body using a towel or bedsheet that causes sheering friction against the skin.
Different Forms of Gangrene
Most forms of gangrene produce necrotic outcomes where the tissue in the affected area dies due to a lack of oxygen and nutrients caused by restrictive blood flow circulation. Doctors classify the condition in three specific categories including gas, wet, and dry gangrene.
- Dry Gangrene – Typically, an arterial occlusion or restrictive blood flow circulation will cause dry gangrene that usually does not involve a bacterial infection. This form of gangrene is the easiest to treat. Typically, patients will recover completely or suffer minimal scarring. Usually, the affected area will heal with significant tissue loss. In rare cases, there is a possibility that sepsis (blood infection) or the gangrene will spread to other areas. This contention usually begins with a sense of coldness or numbness in the affected area, especially if it develops in the lower limbs. The damaged flesh will appear bluish (pale) and degrade to a brown/reddish condition and eventually turn black. Some doctors can easily diagnose dry gangrene because of its mummified appearance where the skin will eventually shrink in size and slough away. If the darkened area remains, the wound doctor may decide to perform surgical debridement to cut away the necrotic (dead) tissue or amputate the appendage.
- Wet Gangrene – This form of gangrene is often caused by bacterial involvement and a loss of blood flow circulation. Effective treatment requires immediate medical intervention to avoid a systemic problem. Most pressure sores and decubitus ulcers are caused by wet gangrene that is often visually identified by fever, swelling and redness, and complaints of intense pain. However, the patient might also experience other symptoms including oozing (wet) fluid from the open wound, a foul odor, and black coloration in the flesh. Without immediate care, the condition can easily progress to a more serious gas gangrene that is more difficult to treat.
- Gas Gangrene – This type of gangrene is often caused by a bacterial infection that, without effective treatment, can result in death. Gas gangrene progresses rapidly, producing gas bubbles and swelling caused by bacterial respiration that damages skin and blood flow circulation. In severe cases, black bubbles of gangrene gas will erupt just under the surface of the resident's skin. This deadly form of gangrene requires immediate hospitalization and aggressive, intense life-saving treatment to stop the progression that could lead to sepsis and eventual death.
If the doctor misdiagnoses a gangrene condition, their mistake could cause the resident their life. In many incidents, the gangrene will travel to internal organs or strangulate the intestines which might not be as easily identifiable as damage to the skin and underlying tissue. Because of that, diagnosis and effective treatment are crucial to save the resident's life and prevent the disease from spreading to nearby organs or causing a systemic infection.
Many of the common symptoms associated with the development of gangrene affect the resident's skin and are identified by:
- A foul-smelling discharge that leaks from the skin wound or its underlying tissue;
- Numbness that follows severe pain in the affected area;
- Apparent infected skin and underlying tissue;
- Skin discoloration that takes on a dark black or dark green hue, based on the type of developing gangrene;
- Intense pain and tissue swelling around the infected skin and tissue;
- A developing fever in a general sense of feeling ill; and
- The development of septic shock (blood infection) which can occur immediately once the gangrene spreads to others of the body.
Diagnosing Gangrene in Wounds
Deterioration of tissue ensues once the toxins accumulate in the wound. Ultimately, as the tissue begins to die, the common gangrene symptoms may occur (black or green discoloration of the skin and foul odors). The infected wound is often the result of inattention by the nursing staff or their inability or unwillingness to follow the resident's Care Plan.
A medical professional can use a variety of tests to identify the presence of gangrene including taking a tissue biopsy and drawing a blood sample.
Treating a life-threatening condition of gangrene often requires extensive surgical procedures that can help identify the extent of the dangerous infection. Typically, the surgeon will remove the infected area through a surgical debridement and follow-up with strong antibiotics and other effective treatments. Even if the surgery and antibiotics are successful, the gangrene can leave permanent scarring that often necessitates follow-up reconstruction surgery. Without treatment, the condition can quickly spread to other areas of the body and eventually cause the patient's death.
Other effective treatments for gangrene include maggot therapy (where live larvae debride the area and consume the necrotic (dead) tissue), vascular surgery that repairs the damaged area to restore blood flow circulation, and hyperbaric oxygen therapy that helps to manage anaerobic bacteria which is the leading instigator of spreading wet gangrene. Typically, the doctor's prognosis of a resident healing from wet or gas gangrene will depend on how much tissue is affected, the type of bacteria that is causing the damage, and the resident's overall health.
When Neglect is Involved
Typically, bedsores and cases of gangrene that develop in a nursing facility are often the result of a negligent staff of caregivers who failed to do their duties to provide loving care to the residents. Many individuals that developed life-threatening conditions are unable to reposition their bodies without the help of others. When this nursing staff fails to follow the established protocols and the resident's Care Plan, the victim can quickly develop an infected bedsore that, without immediate treatment, could degrade to gangrene or sepsis (blood infection).
The gangrene injury attorneys at Rosenfeld Injury Lawyers LLC understand the embarrassment individuals and families feel when gangrene is involved. Don't make the mistake of assuming the officials with the medical facility or the insurance company will be as sympathetic! If your loved one has developed gangrene following the development of a pressure sore, we invite you to discuss your loved ones care with attorneys who are experienced in prosecuting pressure sore lawsuits involving nursing homes, hospitals, and other types of medical facilities.
Even in circumstances where the medical facility insists that proper care was provided, it may befit you to get a second opinion from an outside source who can objectively review the care.
Caregiver Neglect in the News
- March 2015, Tucson Arizona – A Pima County jury ordered an academic medical center to pay the family of a local man $6.5 million to resolve a pressure ulcer lawsuit that involves five years of litigation. The family filed the case against Banner-University Medical Center – Tucson claiming medical negligence and wrongful death. The lawsuit involved the hospitalization of the family's father who developed a bedsore while under their care that advanced to a life-threatening Stage III condition.
Lawsuit documents state that the patient's pressure ulcer was caused by malnutrition. The plaintiffs' lawyer stated that the decedent had lost 45 pounds while under the care of the nursing staff and doctors at the hospital. According to Medicare, a Stage III bedsore is a “never event” in medical centers in hospitals, meaning the condition is preventable and should never occur. The family filed the case citing medical negligence and later amended the lawsuit to include wrongful death after their father passed away in 2012. The family members receiving monetary compensation included three siblings. The jury awarded $1 million to each sibling and $3.5 million to the Arizona Protective Services that provides vulnerable adults protection against neglect and abuse.
Hire an Attorney
The pressure sore injury attorneys at Rosenfeld Injury Lawyers LLC understand the life-threatening condition you endured was not your fault. Our attorneys have held nursing homes, hospitals and medical professionals financially responsible for our clients' damages. We have successfully obtained millions on behalf of the victims and their family members to ensure they were adequately compensated to cover their medical expenses, household bills, lost wages, loss of future earnings, pain, suffering, and emotional damage and we can help your family too.
Our legal team encourages you to contact our attorneys today to schedule a free, no-obligation case consultation to discuss the merits of your monetary recovery claim. We accept all personal injury cases, wrongful death lawsuits, and nursing home abuse injury claims through contingency fee arrangements. This legal contract postpones the payment of legal services until after we have successfully completed your case through a negotiated settlement or a jury verdict.
Our law firm gets results quickly because we understand you need money now. We probably offer every client a “No Win/No-Fee” Guarantee, meaning if we are unable to secure financial compensation on your behalf you owe us nothing. All information you share with our law office will stay confidential.