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July 20, 2023

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Bedsores, also known as pressure sores, pressure ulcers, or decubitus ulcers, are injuries to the skin and underlying tissue resulting from prolonged pressure on the skin, inhibiting the blood supply.

They most often develop on skin that covers bony areas of the body, such as the heels, ankles, hips, and tailbone.

While life-saving medical treatments are available for treating pressure ulcers, providing nursing home residents with proper care can prevent nearly all severe bedsores.

Did your loved one develop a stage 4 bed sore because of negligent healthcare providers?

The personal injury attorneys at Rosenfeld Injury Lawyers, LLC represent nursing home residents who develop preventable life-threatening complications.

Contact nursing home bed sore lawyers at (888) 424-5757 or use the online form to schedule a free case review to discuss your case.

All confidential or sensitive information you share with our legal team remains private through an attorney-client relationship.

Stage 4 Bed Sore

Definition and Causes of Pressure Ulcers

Pressure ulcers are caused by pressure against the skin that limits blood flow to the skin and the tissues beneath it.

Other risk factors related to immobility can make the skin vulnerable to damage and contribute to developing pressure ulcers.

These factors include:

  • Friction: This occurs when the skin rubs against clothing or bedding.
  • Shear: This happens when two surfaces move in the opposite direction.

Pressure Ulcer Sore Stages

Bed sores, or pressure ulcers, are injuries to the skin and underlying tissue resulting from prolonged pressure and inhibited blood supply to the skin.

Pressure ulcers occur on skin that covers bony areas of the body, such as the:

  • Heels
  • Ankles
  • Shoulder blades
  • Hips
  • Tailbone

They are widespread among nursing home residents and others with medical conditions that limit their ability to change positions or cause them to spend most of their time in a bed or chair.

Bed sores can develop rapidly, sometimes within hours or days, and left untreated, can take months to heal.

The severity of these sores can vary greatly, with some healing with proper treatment while others may never heal completely.

It is crucial to understand that bed sores fall into different stages based on their depth, severity, and other characteristics.

Recognizing the Warning Signs of Pressure Ulcers

It’s essential to be vigilant for the warning signs of bed sores or pressure ulcers.

The affected area can include unusual changes in skin color or texture, swelling, pus-like draining, an area of skin that feels cooler or warmer to the touch than other areas, and tender areas.

If left untreated, bed sores can lead to severe complications, including infections that can burrow into joints and bones, leading to damage and reduced function.

In rare cases, a skin ulcer can lead to sepsis, a life-threatening infection that can spread throughout the body.

Treating Pressure Sores: Prevention and Proper Care

Preventing pressure ulcers is critical to proper medical care for anyone with limited mobility.

This involves the following:

  • Frequently repositioning to avoid stress on the skin
  • Maintaining good skin hygiene
  • Ensuring proper nutrition and hydration
  • Using cushions or special mattresses to relieve pressure
  • Keeping the skin clean and dry
  • Protecting with moisture barrier creams
  • Inspecting daily for warning signs of a pressure ulcer

Healthcare providers, particularly those working in nursing homes, must provide proper care to prevent bedsores and treat them promptly if they do occur.

Negligence in this area can lead to severe harm and may be considered a form of nursing home abuse.

If you or a loved one has suffered from bedsores due to negligence or elder abuse, you may have legal recourse and should consider seeking a free case review from a nursing home abuse lawyer.

Stages of Pressure Ulcers

Elderly bedsore stages are classified into four stages based on their severity:

  • Stage 1: The skin isn’t broken but is red or discolored. The pressure injury may be tender, painful, firm, soft, warm, or cool compared with the surrounding skin.
  • Stage 2: The outer layer of skin (epidermis) and part of the underlying layer of skin (dermis) is damaged or lost. The wound may be shallow and pinkish or red. It may look like a fluid-filled or ruptured blister.
  • Stage 3: The ulcer is a deep wound. The loss of skin usually exposes some fat. The ulcer looks crater-like on the skin’s surface. The bottom of the wound may have some yellowish dead tissue. The damage may extend beyond the primary wound below layers of healthy skin.
  • Stage 4: This is the most severe stage. Many layers are affected in this stage, including the body’s deeper tissues, such as the muscle and bone. There might be a large wound, or a new wound might surface above the original wound. There is a high risk of serious infection at Stage 4 bedsores.
  • Unstageable: This means that medical professionals cannot determine the exact stage of a wound. It could be any stage between 1 and 4. Unstageable wounds are usually profound, with necrotic (dead) tissue present. They may also have signs of infection, such as increased pain, swelling, redness, or discharge.
  • Deep tissue injury: Healthcare professionals suspect there may be a deep tissue pressure injury, but it is not visible. It could be any stage between 1 and 4, and the signs of infection could also be present.

If pressure injuries are left unhealed for an extended period, they can cause severe damage to the skin and underlying tissues.

A thorough assessment by a healthcare professional is necessary to diagnose and treat pressure sores properly.

This should include wound care, nutritional advice, and possibly medication or therapies that promote healing and fight infection.

Stage 4 Bed Sores and Suspected Deep Tissue Injury

Stage 4 bedsores are the most severe form of pressure sores.

They involve full-thickness tissue loss with exposed bone, tendon, or muscle.

Slough or eschar may be present on some parts of the wound bed.

Often, tunneling and undermining are associated with stage 4 pressure ulcers.

Characteristics of Stage 4 Bedsores

At Stage 4, the bedsore has become so deep that there is damage to the muscle and bone, and sometimes tendons and joints.

Stage 4 ulcers can extend into muscle and supporting structures such as fascia, tendon, or joint capsule, making osteomyelitis or an abscess possible.

In these pressure injuries, exposed bone/muscle is visible or palpable.

Complications and Risks of Stage 4 Bedsores

According to the Centers for Disease Control and Prevention, the complications of stage 4 bedsores can be life-threatening and require immediate medical treatment.

They include:

  • Cellulitis: This is a potentially serious bacterial skin infection. It appears as an enlarged, red, warm, and tender area.
  • Bone and joint infections occur when a pressure ulcer infection reaches the bones and joints. Joint infections (septic arthritis) can damage cartilage and tissue.
  • Cancer: Long-term, non-healing wounds (Marjolin’s ulcers) can sometimes develop into squamous cell carcinoma.
  • Sepsis is a potentially deadly condition that can arise if a pressure sore becomes infected. Sepsis can lead to shock, organ failure, and death.

Stage 4 Bedsore Statistics

According to the National Center for Health Statistics:

  • Over 2.5 million people in the United States develop bedsores yearly.
  • Between 3% and 14% of all patients admitted to hospitals in the United States develop at least one pressure ulcer.
  • The prevalence of pressure ulcers in nursing homes is around 11%.
  • The mortality rate for patients with pressure ulcers is between 25% and 85%.

Pressure Ulcers and Nursing Home Negligence

Bedsores are often a sign of neglect and can be the basis of a lawsuit against a nursing home or other health care provider.

Bedsores can quickly develop when nursing home staff members fail to care for their residents properly.

Identifying Negligence in Nursing Homes Leading to Bedsores

Negligence in nursing homes can manifest in various ways, often leading to serious health complications like bedsores.

It’s essential to recognize these signs of negligence to protect loved ones and ensure they receive the care they deserve.

  • Extended Periods of Immobility: One of the most common causes of bedsores is prolonged pressure on the skin, which often occurs when residents are left in the same position for extended periods. Regular repositioning is crucial to prevent pressure ulcers; failure can indicate negligence.
  • Inadequate Nutrition and Hydration: Proper nutrition and hydration are vital in maintaining skin health and promoting wound healing. If a resident is not receiving adequate nutrition and hydration, their risk of developing bedsores increases significantly. Neglecting this aspect of care is a serious form of negligence.
  • Poor Hygiene Practices: Cleanliness is vital in preventing bedsores and promoting the healing of existing sores. If a nursing home fails to maintain good hygiene practices, such as regular bathing and changing linens, it can increase the risk of bedsores and other pressure injuries. This lack of primary care is a clear sign of negligence.
  • Inadequate Care for Incontinent Residents: Incontinence can lead to skin irritation and increase the risk of bedsores. Proper care for incontinent residents, including regular changing and skin cleaning, is essential. Failure to provide this level of care can be a sign of negligence.
  • Failure to Provide Pressure Relief Devices: Special mattresses, cushions, and other devices can help redistribute pressure and prevent bedsores. If an assisted living facility fails to provide these necessary devices for residents at high risk of bedsores, it may be a sign of negligence.

Recognizing these signs of negligence is the first step in advocating for the rights and well-being of nursing home residents.

If you suspect negligence, seeking legal advice is crucial to ensure the responsible parties are held accountable.

If you or a loved one has suffered from bedsores due to the negligence of a nursing home or other healthcare provider, it’s important to understand your legal rights.

You may be entitled to compensation for the pain, suffering, and medical expenses incurred due to this negligence.

Considering a Lawsuit for Negligence-Related Bedsores

A lawsuit should be considered when elder abuse or negligence is evident under certain circumstances.

These situations may include:

  • Preventable Bedsores Caused by Negligence or Abuse: Bedsores are often preventable with proper care and attention. If bedsores develop due to negligence, such as leaving a resident in the same position for extended periods or failing to provide adequate nutrition and hydration, a lawsuit may be warranted.
  • Failure to Notify Family and Physician: Nursing homes are responsible for promptly notifying a resident’s family and physician when bedsores are first identified. If the nursing home failed to do so, this could be a sign of negligence.
  • Inadequate Care: Appropriate care is critical to prevent further complications once bedsores have developed. This includes regular cleaning and dressing of the wounds, providing pressure relief, and monitoring for signs of serious infection. If the nursing home failed to provide this level of care, it could be grounds for a lawsuit.
  • Significant Suffering from a Bedsore: If the resident has suffered significantly due to advanced-stage bedsores, such as experiencing severe pain, requiring surgery, or developing life-threatening infections, a lawsuit may be necessary. This suffering is often a direct result of the nursing home’s negligence.

In these situations, it’s vital to seek legal advice.

A personal injury lawyer with experience in nursing home negligence cases can help you understand your options and guide you through seeking justice and compensation.

Potential Defendants in a Pressure Ulcer Lawsuit

Potential defendants in a bedsore lawsuit can include:

  • Nursing home facility: If the facility fails to provide adequate staffing, training, or resources, it could be held liable.
  • Individual staff members: If they were negligent in their care, they could be held personally liable.
  • Physicians: They could be liable if they failed to diagnose or adequately treat the bedsores.

Prevention and Care for Bedsores

Preventing a pressure ulcer is more manageable than treating them but requires careful attention and care.

Preventive Measures Against Bedsores

Preventive measures against bedsores include:

  • Regular repositioning: Changing a person’s position every two hours can help to relieve pressure and improve blood flow to the skin and deeper tissues.
  • Good nutrition: Adequate nutrition and hydration can improve skin health and healing.
  • Skin care: Keeping the skin clean and dry can help to prevent bedsores.

Comprehensive Treatment Approaches for Bedsores

A multifaceted approach is often necessary for treating pressure sores.

Bedsores, particularly those that have progressed to advanced stages, can pose significant health risks and complications.

The primary goals of medical treatment are to alleviate pain, prevent or manage infections, and promote wound healing.

Treating pressure injuries

Wound Cleaning and Dressing

The first step in treating pressure sores is cleaning and dressing the wound thoroughly.

This process often involves saline or a mild soap solution to gently cleanse the area, removing any debris or bacteria that could lead to infection.

After cleaning, the wound is dressed with a suitable dressing.

The type of dressing used can vary depending on the stage and severity of the bedsore.

Still, it often includes hydrocolloid or foam dressings that maintain a moist environment to promote healing and protect the wound from further damage.


Debridement is a critical part of the proper treatment process for bedsores.

This procedure involves the removal of dead, damaged, or infected tissue from the open wound to expedite the healing process in deep tissues.

Debridement can be performed in several ways, including surgical, mechanical, enzymatic, or autolytic (using the body’s enzymes).

The choice of debridement method depends on the condition of the decubitus ulcer, the patient’s overall health status, and the healthcare provider’s judgment.


A surgical procedure may be required in severe cases, particularly Stage 4 bedsores.

Surgical intervention aims to repair the damage caused by the bedsore, alleviate pain, and prevent or treat complications.

This could involve flap reconstruction, where healthy skin and tissue are moved from one part of the body to the wound site.

Sometimes, a skin graft (transplanting skin from one area to another) may be necessary.

Pressure Relief

Alongside these treatments, it’s crucial to alleviate the pressure that caused the bedsore in the first place.

This can involve special mattresses, mattress overlays, or cushions to redistribute pressure to promote blood flow to deadly infections.

Regular repositioning of the patient, with the help of nursing home staff members, is also a crucial part of pressure relief and prevention of further bedsores.

Remember, each patient’s situation is unique, and treatment plans should be tailored to their needs and circumstances.

Regular follow-ups and wound assessments are vital to monitor the healing process and adjust treatment to ensure the affected area is treated correctly.

Legal professionals play a crucial role in bedsore cases.

They can help victims, and their families understand their rights and navigate the legal process.

How Lawyers Can Help in Bedsore Cases

Nursing home abuse attorneys can assist in bedsore cases by:

  • Investigating the cause of the bedsores: This can include reviewing medical records, interviewing staff members, and consulting with medical experts.
  • Filing a lawsuit: If negligence is found, a lawyer can help to file a lawsuit against the responsible parties.
  • Negotiating a settlement: Many cases are resolved through a settlement rather than a trial. A lawyer can negotiate a fair settlement with the defendant’s insurance company.
  • Representing the victim in court: If a settlement cannot be reached, a lawyer can represent the victim and advocate for their rights.

Successful Verdicts and Settlements in Bedsore Cases

There have been many successful verdicts and settlements in bedsore cases.

These cases often involve significant compensation for the victims, as they can result in severe pain, suffering, and medical expenses.

For example, in one case, a jury awarded $28 million to a woman who developed bedsores in a nursing home.

In another case, a man received a $1.5 million settlement after developing bedsores in a hospital.

Personal Injury Lawyer: Your Ally in Pursuing Justice for Bedsore Cases

Have you or a loved one fallen victim to nursing home neglect, resulting in the development of severe bedsores?

If so, you don’t have to face this challenging situation alone.

A personal injury lawyer specializing in nursing home abuse and neglect cases can be your steadfast advocate, fighting for your rights and seeking the compensation you deserve.

Personal injury lawyers bring a wealth of knowledge and experience to the table.

We understand the intricacies of the law surrounding nursing home neglect and can help you navigate the often complex legal process.

Your Advocate in Bedsore Cases

Our personal injury lawyers operate on a contingency fee basis. You don’t have to worry about upfront legal fees or hourly charges.

Instead, your lawyer will only receive a payment if they win your case or achieve a settlement on your behalf.

This arrangement ensures that your lawyer is motivated to secure the best possible outcome for you.

If you’re ready to take the first step towards seeking justice for the harm caused by nursing home neglect, don’t hesitate to reach out.

Call (888) 424-5757 today to discuss your case with a dedicated and compassionate legal professional.

We are ready to listen, guide, and fight for your rights and financial compensation.


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