Bedsores — also called pressure ulcers, pressure injuries, or decubitus ulcers — are wounds that develop when sustained pressure cuts off blood flow to skin and underlying tissue. They most commonly form where bone presses against skin: the tailbone, heels, hips, elbows, and shoulder blades.
Pressure ulcers develop along a four-stage continuum from superficial redness to deep wounds exposing bone and tendon. Stages 1 and 2 are early and treatable; Stages 3 and 4 represent serious medical emergencies and are almost universally considered evidence of preventable neglect.
A nursing home's standard of care requires regular skin assessments, a documented turning schedule (repositioning every 2 hours), pressure-relieving mattresses, adequate nutrition, and proper wound care. When these protocols are ignored, bedsores form.
Three primary factors — pressure, moisture, and friction — combine to cause bedsores. In a well-staffed nursing home, all three are manageable. In a neglectful facility, they are not.
| Stage | Appearance | Depth | Prognosis | Legal Significance |
|---|---|---|---|---|
| Stage 1 | Non-blanchable redness, intact skin | Surface only | Reversible with proper care | Low–Medium |
| Stage 2 | Shallow open wound, blister | Partial thickness | Heals with treatment | Medium |
| Stage 3 | Crater-like full-thickness wound | Through dermis into fat | Slow healing, high infection risk | High — likely neglect |
| Stage 4 | Deep wound exposing bone/tendon | Full thickness to bone | Can be fatal; sepsis risk | Very High — near-certain neglect |
Stage 3 and Stage 4 Bedsores Are Almost Always Neglect
Medical experts widely agree that advanced-stage bedsores do not develop in patients receiving proper nursing care. Their presence is strong evidence that a facility failed its duty of care.
Treatment depends heavily on stage. Early-stage bedsores (1 and 2) can heal with pressure relief, moisture barriers, and simple dressings. Advanced stages require intensive intervention:
- Debridement — removal of dead tissue to prevent infection spread
- Wound packing — specialized dressings to manage drainage
- Negative pressure wound therapy — vacuum-assisted wound closure
- Surgical reconstruction — flap surgery for Stage 4 wounds
- IV antibiotics — when infection has spread to bone (osteomyelitis)
- Hospitalization — often required for Stage 3 and 4 cases
Even with aggressive treatment, Stage 4 bedsores can lead to sepsis — a life-threatening blood infection — and death. The medical costs alone can exceed $100,000.
To bring a successful bedsore negligence claim, an attorney must generally establish:
Bedsore cases often settle for $500,000 to over $3 million
The amount depends on stage, complications, whether the facility had prior violations, and whether death resulted. Get a free case evaluation to understand your specific situation.
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