Pressure sores and medical negligence | Signs of pressure sores, when negligence is to blame and making a claim

Almost 200,000 pressure sores develop in healthcare systems every year, often causing serious symptoms and putting strain on the NHS. Research shows that treating pressure sores costs the NHS more than £1.4 million every day. Unfortunately, many cases of pressure sores are due to negligence, and up to 95 per cent of pressure sores are avoidable.

Here, we explain everything you need to know about pressure sores and medical negligence, including how to spot pressure sores and how to make a negligence claim. We also discuss how negligence in hospitals, nursing homes and care homes can be responsible for pressure sores.

What are pressure sores, and how do you spot them?

A pressure sore; often known as a pressure ulcer or bedsore, is a term describing an injury to the skin and underlying tissue that is primarily caused by prolonged pressure on the skin. Pressure sores most commonly affect individuals who are confined to bed or have decreased mobility; however, they can affect anyone. Pressure sores are painful and debilitating and can cause serious harm if they are not treated quickly. Types of pressure sores can range from itchy, discoloured skin to exposed bone becoming visible in the most severe cases.

Which areas of the body are affected by pressure sores?

Pressure sores can affect any part of the body that has suffered prolonged pressure. However, they are most commonly found on bony parts of the body, such as the heels, elbows, hips and base of the spine – also known as the sacrum.

How to spot signs of developing pressure sores

Once you know the common signs of pressure sores to look out for, it can be easier to identify a pressure sore on you or a loved one. Pressure sores will initially present with discoloured skin and red patches. Those with paler skin often get red patches initially, while people with darker skin tend to find blue or purple patches. People suffering from the first symptoms of pressure sores often complain of painful and itchy skin, and there may be noticeable changes to the skin texture. For example, it may feel warm, spongy or hard.

A good way of testing whether a pressure sore may have developed is through the blanching test. This involves pressing on the coloured area with your finger. The area should go white, and if you remove pressure from the area, it should return to the darkened colour within a few seconds, which indicates good blood flow. If the area stays white, this indicates pressure damage has begun.

There are four different grades of pressure sores:

• Grade 1 sores occur when the skin is still intact, but there is light pigmentation and redness around the skin. The area may be warm, hard, itchy and painful.
• Grade 2 sores present as an ulcer or clear blister where the skin is broken.
• Grade 3 sores are subcutaneous but do not reach down as far as the muscle or bone. They are open wounds.
• Grade 4 sores are the most serious and may reach down to the muscle or bone. These ulcers can result in exposed bone being visible.

Find out more about the varying severity of pressure sores in our guide to the different types of pressure sore claims.

Who is the most at risk of developing pressure sores, and what is the Waterlow Score?

Anyone can get a pressure ulcer, but certain factors can make them more likely to form. Older people are more likely to have mobility problems and have skin that is more easily damaged through dehydration and other factors. Read more about why pressure sores are so common among elderly individuals here.

Those who suffer from poor mobility or paralysis, or are confined to bed due to illness or after surgery are also more likely to develop pressure sores. Additionally, obesity can also heighten the risk of developing a pressure sore due to a higher likelihood of mobility issues and skin challenges.

Medical conditions that affect blood supply also make skin more fragile or cause movement problems. These can include diabetes, peripheral arterial disease, kidney failure, heart failure, multiple sclerosis (MS) and Parkinson's disease.

Additionally, individuals with urinary and bowel incontinence are also more at risk of developing pressure sores due to excessive moisture on the skin.

Using equipment such as beds that don’t provide appropriate pressure relief for long periods can also heighten the risk of developing pressure sores.

The Waterlow Score

The Waterlow assessment calculates the risk of pressure ulcers developing on an individual basis through a simple points-based system. Staff can consider factors including the build/weight of a resident, their height, skin condition, sex/age, continence, mobility and special risk factors like tissue malnutrition, medication, major surgeries, trauma, and neurological deficit. Healthcare facilities such as hospitals, nursing homes and care homes can then use a combination of factual information about a resident’s health along with their best clinical judgement to match answers to the most suitable choices on the score card. Depending on the risk score of a resident, staff can then take the required steps to prevent pressure sores from developing and look out for signs of pressure sores.

However, individuals who at a higher risk of developing pressure sores are not always protected against pressure sores or provided with the adequate treatment if a pressure sore does develop. In these cases, medical negligence is likely to be the reason.

CLick this link to find out more about the Waterlow Assessment

How can medical negligence lead to pressure sores?

Some of the most common reasons for medical negligence claims relating to pressure sores include:

• Failure to conduct adequate and correct risk assessments, including miscalculation of the risk level.
• Inadequate treatment or failure to use pressure ulcer equipment.
• Inadequately trained nursing staff.
• Lack of sufficient record keeping.
• Prolonged delay in starting treatment.

When there is a delay in diagnosing pressure sores or starting pressure sore treatment, this can exacerbate the symptoms, and discomfort can worsen. Overall prognosis can also become bleaker, and the healing process can be more prolonged. In some of the worst cases, complications can include:

• Sepsis.
• Cellulitis.
• Infections.
• Squamous cell carcinoma, a type of cancer.
• Necrosis, or the death of tissue due to the failure of its blood supply, can even become life-threatening.

Furthermore, when hospital staff or care home workers do not monitor the signs of pressure sores on patients, they can become significantly worse. Negligence can also occur when there is an incorrect diagnosis of pressure sores or a failure to prevent pressure sores by using methods such as helping immobile patients to regularly change their position in a bed or chair.

Could you be eligible for compensation?

In a vast majority of cases, hospital, nursing home or care home negligence is the cause of pressure sores developing. Negligent treatment by medical professionals in hospitals, care homes or care homes can cause pressure scores if there is a failure to ascertain a patient's Waterlow score.

Medical negligence law firms such as Wake Smith can work with care experts to help retrace any treatment that took place in a hospital or care home environment in order to evaluate whether a pressure sore has resulted because of negligence. If the evaluation of the evidence proves that a pressure sore has been caused by clinical negligence and any of the factors above can be proven, a law firm such as Wake Smith can help you to achieve the compensation you deserve.

Making a claim

Contact us at Wake Smith, and we will guide you through the process. We will help you to gather the necessary evidence and get the compensation you deserve for your claim.

For over 200 years, Wake Smith has been helping people to receive justice. At Wake Smith, we have an excellent team of clinical and medical negligence specialists, including members of the specialist Law Society Panel and of Action against Medical Accidents. We will compassionately guide you through every step of your claim, ensuring that you receive any compensation you are entitled to. Read more about our medical and clinical negligence services here.

Do you suspect you or a loved one developed a pressure sore due to hospital, care home or nursing home negligence?Contact us here to find out how we can help.

What happens in a medical negligence claim?

In a medical negligence claim, it will be determined whether there was a failure by the healthcare provider to ensure that the patient received a reasonable level of care and whether the patient was harmed as a result of a breach of the duty of care. The case may be settled out of court, or it may need to go to court to be resolved. At the end of the claim, you may receive compensation.

Find out what can impact your compensation in our guideWhat to expect when making a pressure sore negligence claim.

What is the difference between making a claim and making a complaint?

Unlike pressure sore claims, complaints do not result in compensation. However, a complaint may allow you to receive an explanation and apology for the pressure sore. Complaints should be made within six months.

Related content

Types of pressure sore negligence claims

Pressure sores in elderly individuals

Making a pressure sore negligence claim