Tag Archives: pressure sore

District Nurses mismanagement of pressure sore leads to death of disabled patient

Mrs R was a mother of 3 in her early 50s and suffering from Multiple Sclerosis when she developed a pressure sore to her sacrum.  This was identified during an admission to hospital.  When she was fit to be discharged arrangements were made for the community nursing team to manage the sore.

Despite identifying the sore as grade 3 and noting that an air mattress was needed, this was not then ordered for a further 30 days.  Over the next few weeks it was clear that the wound was deteriorating and becoming necrotic.  A Tissue Viability Nurse (TVN) was eventually asked to see Mrs R and she prescribed good treatment which would soften and debride the wound and kill and protect against bacteria however this advice was not followed and instead a dressing was applied which would not alter the wound status.

The wound continued to worsen and became inflamed and the TVN recommended hospital admission as it was suspected that she was becoming septic.  Mrs R was treated with intravenous antibiotics but her pressure sore was now described as grade 4 and so she was discharged from hospital with a Topical Negative Pressure (TNP) dressing however the district nursing team were unable to manage the TNP and it transpired that it had not actually been working since she was discharged from hospital.

Over the next few days Mrs R looked increasing unwell.  She was losing weight and was suffering nausea and her family were struggling to cope with the dressing of the wound and caring for her.  The community nurses continued to visit but the record keeping became sparse and less detailed.  Mrs R continued to decline until she was admitted to hospital after being found unresponsive.  On admission, bone was seen to be clearly visible through the wound to her sacrum.  She was severely septic and no treatment could be offered.  She sadly passed away shortly after, only 5 months after the sore was first noticed.  It was concluded that the most likely source of the infection was her pressure sore.

We were approached by Mrs R’s husband and sons to investigate the standard of care their wife and mother had received and the independent expert reports we obtained were damning of the standard of nursing case given to Mrs R.  In particular, the independent nursing experts was of the view that they had failed to:

  1.        Arrange for pressure relieving equipment soon enough
  2.        Arrange for a TVN visit soon enough
  3.        Follow the TVN’s advice and the Trust’s own policy for managing pressure wounds
  4.        Manage dressings appropriately
  5.        Arrange for further review/earlier re-admission to hospital

With proper treatment the view was that Mrs R’s sore would have healed and a second medical expert agreed that the failures in her treatment and care resulted in her death from sepsis.

When these allegations were put to the Trust responsible for the community/district nurses, we were faced with denials and the Trust were very keen to push the burden and the blame on Mrs R and her family.

As a result court proceedings were commenced but shortly after solicitors acting for the Trust entered into negotiations to settle the claim and Mr R agreed to accept a five figure sum.

This was a terribly sad case.  Mrs R and her family had been dogged by her ill health for years but they had rallied.  For her to be failed so absolutely when she desperately needed help most devastated them.

Pressure sores require careful and intensive treatment.  They don’t resolve on their own and as this case shows they can prove to be fatal.  If you or someone you know has suffered a pressure sore or deterioration of a sore due to poor medical care and treatment, please contact us for a free discussion.

Ashleigh Holt – October 2018

Avoidable pressure injuries admitted by hospital as part of their duty of candour

Mrs P, an 80 year old lady at the time of treatment, developed severe pressure injuries to her heels and buttock whilst an inpatient at the James Cook University Hospital.  The pressure sore to her right heel was particularly serious, requiring multiple courses of antibiotics due to infection of the bone, hospitalisation, surgical debridement and taking 9 months to heal.

Initially, she did not consider that these sores may have developed as a result of substandard treatment.  However, the hospital adhered to their duty of candour which stipulates that medical professionals should be open and honest with patients and admit when something has gone wrong.  It was only after they told her they thought the sores were avoidable did she decide to contact us for advice.

We took her case on to investigate the standard of the nursing care whilst she was an inpatient.  Our nursing expert was critical of the nurses who had been responsible for Mrs P and identified a number of failings in their care, in particular failing to ensure adequate pressure relief by the use of repositioning and pressure relieving devices.  We then obtained expert evidence from a vascular surgeon on the effects of the injuries Mrs P sustained and he was also critical of the treatment she received from her treating doctors – she was suffering from leg ischaemia which required revascularisation surgery.  Had this been performed earlier, the injuries to her heels would have been avoided.

The hospital was slow to respond to our allegations of negligence and only did so once we were about to issue court proceedings.  They admitted liability and the claim was settled shortly thereafter for £25,000.

In this case, the hospital followed the duty of candour policy and informed Mrs P that, in their opinion, the injuries she sustained were avoidable.  Often, hospitals and doctors are not so forthcoming.  If you think you have suffered an injury as a result of negligent treatment, please contact us on 01642 231110 and one of our solicitors will be happy to advise you.  There is no obligation on you to pursue a claim and the initial discussion is free of charge.

Kathryn Watson – September 2018

Pressure sores whilst in intensive care

Mrs J was admitted to hospital in October 2012 with sepsis and multi organ failure and she was not expected to survive.  She required admission to the intensive care unit where she remained for 2 months, for much of which she was in a coma.  Fortunately, she pulled through but when she regained consciousness, she was told she was paraplegic as a result of her condition and had developed pressure sores to her sacrum, buttock and heel which took a long time to heal.

It was the evidence of nursing expert that the pressure sores developed because of the hospital’s failure to reposition her whilst she was so unwell.  The hospital claimed that she was too unwell to be moved and if they had tried to reposition her, she probably would have died.  However, our expert was of the opinion that if this was the case, she should have been nursed on a specialist bed and mattress which would have turned her and the pressure injuries would have been prevented.

The hospital defended this case throughout and only accepted our offer of settlement for a 5 figure sum a few weeks before Trial.  The claim was limited to damages for the pain and suffering Mrs J experienced as all of the expenses she had would have been incurred in any event as a result of her paraplegia and not because of any negligence on the part of the hospital.

Kathryn Watson, August 2017

The Misery of Pressure Sores

In 2014 Mr G suffered a serious stroke, leaving him effectively paralysed down his right hand side. He was initially treated on a specialist stroke ward before being discharged to a nursing home but a few weeks after his discharge Mr G developed an infection and required readmission to hospital.

On this occasion he was admitted to an elderly care ward, rather than the stroke ward he had been on previously and the nursing care he received left much to be desired. While previously Mr G had been regularly repositioned while on the stroke ward to prevent the development of pressure sores, on the elderly care ward he was left lying in one position for long periods of time.

This lack of care resulted in 2 pressure sores developing on Mr G’s heels.  Once they have been allowed to develop pressure sores can take a very long time to heal and they can be extremely painful.  Sadly Mr G passed away a few months later.

Mr G’s family asked us if anything could be done about the treatment he had received. After investigating his treatment, we wrote to the hospital and put our allegations to them that it was substandard for to have failed to put adequate measures in place, such as a pressure relieving mattress or a system of positional changes, to prevent the development of Mr G’s pressure sores.

In their response the hospital admitted that they had failed to provide Mr G with an adequate level of care and made an offer to settle the claim, which was accepted by Mr G’s family.

Pressure sores continue to be a significant problem.  They can delay someone’s recovery and prolong hospital stay.  The healing process can be lengthy and they have a huge social cost.  Even once healed, the after effects can be debilitating and in some cases pressure sores can prove fatal.

If you or anyone you know has suffered pressure damage as a result of poor nursing care please get in touch with us to see how we can help you.

Dan Richardson – October 2016

Hospital fails to learn from its mistakes

In 2007 Mr L developed pressure sores on both of his heels during a stay in hospital due to him not receiving an appropriate pressure relieving mattress. He instructed us to bring a claim on his behalf and as a result we were successful in recovering a significant amount of compensation.

Although Mr L’s wounds eventually healed he was required to follow a rigorous foot care regime in order to stop further sores developing, due to the increased vulnerability identified by our plastic surgeon.

In 2012 Mr L was readmitted to the same hospital. Mr L had diligently maintained his skin care regime and as a result had suffered no further pressure injuries to his heels. Despite being injury free for around 4 years after only two weeks in the hospital it was noticed that pressure sores had been allowed to develop on both of Mr L’s heels. When his notes were consulted it was quickly apparent that the nursing staff had failed to follow the required skin care regime for the entire time Mr L had been admitted.

Around a month after these second pressure wounds developed Mr L was told that he had contracted MRSA, with the infection having entered his body through the new sores on his heels. As a result he was again admitted to hospital and started on a course of very strong antibiotics with some very unpleasant side effects.

Unfortunately Mr L passed away shortly after this admission for reasons unrelated to the MRSA or his pressure injuries. After his death Mr L’s wife instructed us to bring a claim against the hospital for the suffering her husband had experienced before his death as a result of the pressure sores.

After investigating the claim we formally put our allegations of negligence to the hospital. The hospital admitted that they had been at fault but denied that Mr L’s MRSA was a result of the pressure injury. A very low offer of compensation was made. This was not accepted and as no further appropriate offers were made we issued court proceedings. Shortly after the issue of proceedings, and following further negotiations with the hospital, the case finally settled at an appropriate amount.

This was a very unfortunate case of a man repeatedly let down by the same hospital, and suffering entirely preventable injuries as a result. It is hoped that following Mr L’s second admission better procedures have been put in place at the hospital to minimise the risk of these preventable pressure injuries occurring in the future.

Dan Richardson, April 2015

Pressure sore causes death

K was in her late 80s when she was admitted to hospital with a pinched nerve in her neck which left her unable to move her arms or legs.  Surgery was not recommended due to her age and she remained in hospital awaiting physiotherapy which unfortunately she was never able to undergo.

Just over two months later she was discharged into a care home but during her time in hospital she had developed a grade 3 pressure sore on her right heel which had become infected.  She sadly passed away a further two months later, with the death certificate recording one of the 3 causes of death as her infected pressure sore.

The case was investigated on behalf of her family/Estate and the hospital accepted that no appropriate risk assessment was carried out during her time at the hospital. They accepted that this would have identified that K was at a high risk of developing pressure sores, and that she should therefore have been nursed on a pressure relieving mattress.  They also agreed that no appropriate care plan was prepared or wound assessment carried out which meant that once the pressure sore had been noticed it continued to deteriorate without the required treatment.

The hospital agreed that as a result of the substandard nursing care she received she went on to develop a grade 3 pressure sore on her right heel which became infected and on the balance of probabilities, contributed to her death. K’s estate accepted £15,000 compensation representing funeral expenses, travel expenses on behalf of her relatives and her pain and suffering up to an including her death.

Andrew Walker