Bedsores and Pressure Ulcers in New York City Nursing Homes: A Sign of Neglect?

When an older adult develops a bedsore, also known as a pressure ulcer or pressure injury, it might be more than a medical concern. In some cases, it may indicate that a nursing home failed to offer proper care.

Bedsores form when prolonged pressure restricts blood flow to a portion of the skin and underlying tissue. They are most common among individuals who have restricted mobility, spend a lot of time in bed or a wheelchair, or are unable to reposition themselves without help. With good preventative care, many pressure injuries can be avoided or detected before they worsen.

For families in New York City, discovering that a loved one has developed a serious bedsore can raise an important question: Was the injury unavoidable, or did the nursing home’s failure to provide proper care contribute to it?

Are Bedsores a Sign of Nursing Home Neglect?

A bedsore does not necessarily indicate nursing home neglect. Even when a resident is receiving appropriate care, pressure injuries can occur, especially if the resident has major medical issues or other risk factors.

However, nursing facilities must screen individuals for pressure ulcer problems and implement appropriate preventive measures. When staff fails to reposition a resident, offer proper nutrition and hydration, keep the resident’s skin clean and dry, use appropriate support surfaces, or respond to early warning indications, the resulting injury may indicate poor care.

The circumstances surrounding the bedsore are therefore very important. A minor pressure injury that is quickly diagnosed and treated differs greatly from a major injury that has been left untreated for days or weeks.

Understanding Pressure Ulcers: Stages and Warning Signs

Pressure ulcers develop when sustained pressure or pressure combined with friction or shear damages the skin and underlying tissue. They can range from an area of intact, discolored skin to a deep wound involving muscle, bone, or other structures.

The four stages, plus unstageable and deep-tissue injuries

Healthcare professionals generally classify pressure injuries into four stages:

• Stage 1: The skin remains intact, but there is persistent discoloration or another change in the affected area. The area may also feel warmer, firmer, softer, or more painful than surrounding skin.
• Stage 2: There is partial-thickness skin loss, potentially appearing as an open wound or blister.
• Stage 3: The injury involves full-thickness skin loss and may expose or damage fatty tissue. The wound can become significantly deeper.
• Stage 4: The injury involves extensive tissue loss and can expose or damage muscle, tendon, cartilage, or bone.

There are also pressure injuries described as unstageable, when the full extent of tissue damage cannot be determined because the wound is covered by slough or eschar, and deep tissue pressure injuries, which involve damage beneath intact or minimally damaged skin.

A worsening pressure injury can lead to infection, sepsis, hospitalization, surgery, and other serious complications.

Where bedsores form and how fast they develop

Bedsores frequently appear on locations where bone is close to the skin, such as the tailbone, hips, heels, elbows, shoulders, back of the head, and ankles. Residents who spend a significant amount of time sitting might develop pressure injuries affecting their buttocks and other places in contact with a wheelchair or chair.

There is no set period for a bedsore to develop. The risk is determined by several factors, including the individual’s mobility, circulation, nutritional state, overall health, and the amount and duration of pressure. This is why regular examinations and tailored preventative measures are essential.

What Care a Nursing Home Must Provide to Prevent Bedsores

Nursing homes should identify residents who are at increased risk for pressure injuries and implement appropriate preventive measures.

Depending on the resident’s condition, preventive treatment may involve regular repositioning, mobility assistance, the use of appropriate beds or cushions, skin inspection, adequate hygiene, moisture management, and nutritional or hydration considerations.

When a pressure injury occurs, staff should monitor existing injuries and implement a proper treatment plan. Changes in the wound should be documented and communicated to the resident’s healthcare providers when appropriate.

The specific treatment required is determined by the resident’s medical needs. Failure to follow the resident’s care plan or respond correctly to identified risk factors may be significant evidence in a negligence claim.

Avoidable vs. Unavoidable: The Standard That Decides These Cases

One of the most crucial considerations in a nursing home bedsore lawsuit is whether the pressure injury was reasonably preventable.

A nursing facility may claim that a resident’s condition made pressure injuries unavoidable. For example, a resident may have significant medical issues, limited movement, poor circulation, or other circumstances that make prevention more difficult.

However, an underlying medical issue does not automatically absolve a facility of liability. The question is whether the facility provided proper care given the resident’s known health risks.

Missed repositioning, inadequate monitoring, failure to follow a care plan, poor wound care, insufficient nutrition, or delays in seeking medical treatment are all examples of evidence that a pressure injury may have been avoided.

Can You Sue a Nursing Home for Bedsores in New York?

Potentially, yes. A person or their legal representative may be entitled to file a claim if a nursing home’s negligence or insufficient care causes or contributes to a preventable pressure injury.

In most cases, demonstrating that a bedsore occurred is not enough to win the lawsuit. The evidence must show that the facility or its personnel failed to provide the level of care required under the circumstances, which caused or contributed to the resident’s injuries.

Depending on the circumstances, a claim may seek reimbursement for medical treatment, additional care, pain and suffering, and other damages caused by the injury.

Nursing home lawsuits may include extensive medical data as well as questions regarding the facility’s procedures, staffing, recordkeeping, and treatment decisions. An attorney may collaborate with medical specialists and other experts to assess whether the care delivered was appropriate.

What If the Bedsore Led to Death? Wrongful Death and Survival Claims

A severe pressure ulcer can cause significant infection and other life-threatening consequences. If a nursing home resident dies because of injuries allegedly caused or worsened by negligent care, the family’s legal options may extend beyond a standard personal injury claim.

New York law accepts both wrongful death and survival claims, although they serve different functions.

A wrongful death claim typically involves losses incurred by specific remaining family members as a result of the death. A survival claim, on the other hand, can address claims made by the deceased person that survive their death, including some damages linked with the time between injury and death.

The specific claims and damages available are determined by the circumstances, including the cause of death, the resident’s estate, and applicable New York laws.

Evidence That Proves or Disproves Neglect

A nursing home bedsore case often turns on the medical and facility records. Important evidence may include:

• Nursing assessments and pressure-ulcer risk assessments
• Care plans and records showing repositioning or mobility assistance
• Wound-care records
• Photographs documenting the wound’s appearance and progression
• Medication and treatment records
• Nutrition and hydration records
• Hospital and physician records
• Staffing and incident records
• Communications between the facility and the resident’s family
• Records showing when the injury was first discovered and reported

The timeline can be particularly important. Records may help establish when a pressure injury first appeared, what staff knew about it, what treatment was provided, and whether the condition worsened before the resident received appropriate medical attention.

Facilities may also have documentation supporting their position that reasonable preventive measures were provided. A complete investigation should therefore consider evidence on both sides rather than assuming that the existence of a bedsore alone establishes negligence.

New York Deadlines You Can’t Miss

The deadline to file a nursing home injury claim in New York depends on the type of case and the party being sued. In general, personal injury claims based on ordinary negligence are generally subject to a three-year statute of limitations. However, a claim that is legally classified as medical malpractice generally must be filed within two years and six months.

Additionally, a wrongful death claim generally must be filed within two years of the person’s death under EPTL 5-4.1.

Finally, claims involving New York City or certain other government entities may require a Notice of Claim within 90 days, with additional deadlines that can apply to the lawsuit itself.

These are general time limits, not a determination of how long you have to bring your particular case. A bedsore claim may involve questions about negligence, medical malpractice, wrongful death, or other legal theories, and different deadlines can apply. An attorney can determine which statute of limitations applies, identify any notice requirements, and calculate the deadline for your particular claim.

What to Do Right Now If You Suspect Neglect

If you suspect a loved one’s bedsore is the result of inadequate nursing home care, document your observations. Take images of the injuries as needed, and save copies of medical records, hospital records, care plans, and facility correspondence.

Obtain information from the nursing home regarding the date on which the pressure injury was identified, the type of care that is being administered, and the precautions that have been implemented. If your loved one develops symptoms of a dangerous infection or a quickly worsening wound, seek medical assistance immediately.

You should also keep records of the resident’s condition prior to and following the injury. Changes in mobility, discomfort, cognition, hunger, or ability to engage in typical activities may be relevant in determining the amount of the injury.

Suspect Your Loved One’s Bedsore Was Preventable? Talk to a New York City Nursing Home Neglect Lawyer

A pressure ulcer does not automatically mean a nursing home was negligent. But a serious or worsening bedsore can raise legitimate concerns when staff fail to recognize the resident’s risk, follow a care plan, provide appropriate preventive measures, or obtain timely medical treatment.

Greenberg & Stein P.C. represents individuals and families dealing with injuries caused by negligence in New York City. If you suspect that a loved one’s pressure ulcer was preventable, contacting an experienced nursing home neglect attorney can help you understand your legal options and the evidence needed to evaluate a potential claim. Call us at 212-681-2535 to to review your case.