Archive for the ‘Bed Sores and Pressure Ulcers’ Category

Chappy’s Golden Shores Cited Neglect Resident Beat to Death also others with Bed Sores, Sexual Assault, Physical Abuse, Medication Errors

Shame on Chappy’s Golden Shores in Hill City after MDH Cites Facility for Physical Abuse and Sexual Abuse of Residents

In a report from the MDH concerning Chappy’s Golden Shores in Hill City cited a resident was physically assaulted by staff members. Abuse was substantiated. The facility and AP1 and AP2 were responsible for the maltreatment. The client was abused when AP1 struck the client in the head and face while AP2 held the client down. AP3 stood by and watched the abuse, and did not report the abuse or intervene to stop it. Despite AP3’s failure to report or intervene, AP3 was not found responsible for the maltreatment. Several weeks after the abuse, the client was hospitalized for a brain bleed. He died to complications several weeks later.

Resident at Moorhead ReChappy's Golden Shores in Hill City Cited After Resident Developed Pressure Sores — Chappy’s Golden Shores in Hill City Cited After Resident Developed Pressure Sores

MDH Cites Chappy’s Golden Shores after Client Develops Pressure Sores

In a report from the Minnesota Department of Health it is alleged that a client at Chappy’s Golden Shores was neglected and the facility was responsible for the maltreatment. The facility did not provide the necessary care to reduce the risk and treat the client’s pressure ulcers. The lack of care and response to the client’s change of condition lead to an increase in the size of the wound on the client’s coccyx and caused increased pain and suffering for the client. The lack of early intervention contributed to the client’s death.

Chappy’s Golden Shores has Many Citations for Neglect and Abuse

The many citations from the Minnesota Department of Health include: pressure sores, emotional abuse, emotional abuse and neglect of supervision, medication errors, physical abuse, physical abuse, restraints, exploitation by facility staff, sexual abuse, emotional abuse, unexplained injury and patient rights.

Neglect was substantiated. The facility cited with sexual abuse when alleged perpetrators AP1 and AP2, engaged in sexual relations with the client. The facility chose not to intervene or report the allegations.

For a Free Consultation with an experienced elder abuse and neglect attorney call Kenneth LaBore at 612-743-9048.

A common form of neglect in elder care facilities involves medication management and administration. Most forms of elder abuse are preventable with proper care and supervision.

Report Suspected Elder Abuse

Click Here For Link To Report Abuse To Adult Protection

If you have concerns about care provided to a resident in a nursing home, assisted living or any other type of elder care provider contact Attorney Kenneth LaBore for a Free Consultation to discuss your legal rights and options.

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Resident Develops Sores at Moorhead Rehab & HCC

Written By: Kenneth LaBore | Published On: 13th January 2019 | Category: Bed Sores and Pressure Ulcers | RSS Feed

Recent MDH Substantiated Neglect Finding at Moorhead Rehab & HCC after medication error, medication theft pain management issues.

Resident at Moorhead Rehab & HCC Suffers Stage Four Pressure Sore

MDH Cites Moorhead Rehab & HCC after Resident Develops Pressure Sores – Wounds

In a report from the Minnesota Department of Health it is alleged that a client at Moorhead Rehab & HCC was neglected when the facility failed to identify multiple decubitus ulcers.

Failure to Provide Proper Care at Moorhead Rehab & HCC Leads to Decubitus Ulcers

Based on a preponderance of the evidence neglect occurred when the resident developed multiple pressure ulcers on both lower extremities. The facility failed to identify, complete a comprehensive assessment, and implement Prevalon boots to prevent the development of pressure ulcers.

For a Free Consultation with an experienced elder abuse and neglect attorney call Kenneth LaBore at 612-743-9048.

A common form of neglect in elder care facilities involves neglect of care which leads or contributes to pressure sores also known as decubitus ulcers. Residents need to have regular wound care along with pressure relief (turning and special mattress or cushions), and nutrition. Most forms of elder abuse are preventable with proper care and supervision.

Moorhead Rehab & HCC Cited with Failure to Supervise Resident who Strikes Another

According to the MDH report and based on a preponderance of the evidence, neglect occurred when a resident threw a pop can at another resident. The facility failed to supervise the resident adequately when s/he hit another resident in the face multiple times.

Report Suspected Elder Abuse

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Neglect of Wound Care at Augustana Regent at Burnsville

Written By: Kenneth LaBore | Published On: 11th November 2018 | Category: Bed Sores and Pressure Ulcers, Nursing Home Abuse and Neglect | RSS Feed

Client was Neglected at Augustana Regent at Burnsville – Failure to Provide Proper Wound Care – Decubitus Ulcer

Failure to Provide Proper Wound Care at Augustana Regent at Burnsville

In a report from the Minnesota Department of Health it was alleged that a client at Augustana Regent at Burnsville was neglected when the alleged perpetrator failed to provide wound care to the client. The physical therapist went out to see the client and noted multiple pressure ulcers and two deep tissue injuries with drainage. The client was totally dependent, but the facility failed to provide care. In addition, the client was found lying in a urine soaked brief with no bandage covering the open wound on his/her hip.

For a Free Consultation with an Experienced Elder Neglect Attorney call Kenneth LaBore Toll Free at 1-888-452-6589.

Augustana Regent at Burnsville Cited with Neglect

According to the report the allegation of neglect is substantiated. The home care provider failed to complete skin assessments, resulting in the client developing five wounds requiring skilled nursing services.

Pressure sores and other wounds are preventable in most circumstances. Poor care and a lack of well train staff leads to serious injuries.

Report Suspected Elder Abuse

If you suspect elder or vulnerable adult neglect or abuse contact the Minnesota Adult Abuse Reporting Center answered 24 hours a day, 7 days a week at 1-844-880-1574.

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Adrian County Living Cottages Resident with Wounds

Written By: Kenneth LaBore | Published On: 17th July 2018 | Category: Bed Sores and Pressure Ulcers, Nursing Home Elder Neglect | RSS Feed

Adrian County Living Cottages Cited by MDH for Client with Stage Four Pressure Ulcer Wound

Resident at Adrian County Living Develops Pressure Sores

The Minnesota Department of Health has concluded that based on a preponderance of evidence, the allegation that a client was neglected at Adrian County Living in Adrian Minnesota St. when the facility did not treat wounds and did not report to the client’s providers in a timely manner.

Adrian Country Living Cited Concerning Stage Four Pressure Ulcer

The MDH investigation neglect occurred when the facility staff failed to accurately complete and document assessments in the client’s record and the client developed a stage four pressure ulcer. In addition, the client developed a urinary tract infection and became septic, after the client’s catheter was removed and left out without a physician’s order.

The client received services from a provider licensed as a comprehensive home care provider. The client’s service plan indicated the client used the walker daily, transferred self and used the wheelchair for longer distances. The client required one staff assistance as needed for hygiene, grooming, and dressing, one staff assistance for bathing twice a week, and treatments per physician’s orders. Skin checks were completed on bath days, and the nurse reviewed and documented on the skin checks monthly. The client required a catheter and staff were to assist with all catheter care needs, keep the catheter clean, and monitor the client’s urine output. The client was diagnosed with a stage four pressure ulcer on the left hip, urinary retention and sepsis.

If you have concerns about elder abuse and neglect contact Attorney Kenneth LaBore for a Free Consultation at 1-888-452-6589

Maltreatment Neglect Cited Against Adrian Country Living Cottages Due to Resident Wound Care Omissions

There are many common of forms of elder abuse and neglect often the result of a lack of qualified well trained staff to supervise and provide the necessary resident cares. This is especially important for complete cares such as wound care. The care must be provided in a professional, sterile and time manner using the correct bandages, gauzes, pads, and protectors.

Most forms of elder abuse and neglect are preventable. If you are concerned about someone you love call Attorney Kenneth LaBore for a free consultation.

Attorney Kenneth LaBore from Guardian Legal Services, LLC has been representing victims of abuse, neglect and other injuries for decades. Our focus is on getting accountability for serious acts of maltreatment, abuse and preventable neglect.

Report Abuse and Neglect

For more information from the Minnesota Department of Health, Office of Health Facility Complaints concerning nursing homes, assisted living and other elder care providers view resolved complaints at the MDH website.

If you have concerns about wound care, physical abuse, financial exploitation or any other form of elder abuse or neglect contact Minnesota Elder Abuse Attorney Kenneth LaBore toll free at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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Free Consultation on Issues of Elder Abuse and Neglect Serving all of Minnesota Toll Free 1-888-452-6589

KSMS Our House Austin Neglect Substantiated

Written By: Kenneth LaBore | Published On: 18th March 2017 | Category: Bed Sores and Pressure Ulcers, Failure to Resond to Change in Condition, Pressure Ulcers, Wound Care | RSS Feed

Failure to Provide Proper Wound Care and Assessment – Pressure Sores – Ulcers – KSMS Our House in Austin Minnesota

KSMS Our House Austin Cited with Neglect After Serious Wounds

In a report from the Minnesota Department of Health dated, February 13, 2017, it is alleged that a client at KSMS Our House in Austin Minnesota was neglected when s/he presented to the hospital with an elevated temperature, a leg severely bruised with blisters, and a large ulcerated sore on his/her tailbone that was infected.

Negligence Supported Against KSMS Our House After Ulcerated Sore

Based on the report a preponderance of evidence, neglect occurred when the facility failed to provide proper care and treatment of the client’s coccyx, buttock, and heel wounds. The client had recurrent problems with wound healing for over two years . The facility Registered Nurse (RN) failed to provide adequate wound assessment and monitoring of the client’s wounds, and failed to provide direction and training to direct care staff who were to performing the delegated nursing task of wound care.

The client was cognitively impaired and was completely reliant on caregivers for all activities of daily living. The client could not walk and was transferred by two staff with a mechanical lift. The client was incontinent of bowel and bladder and staff performed the client’s incontinence care. The client had pressure sores on the coccyx and left heel for over two years. Direct care staff performed the client’s daily wound treatments, without any written instructions or training by the RN.

The client’s only wound assessment by the facility RN was completed in 2014. At that time, the client had a stage II pressure ulcer on the inside of the right buttock measuring 2 centimeters (cm) x 1.5 cm. There was no evidence of further RN oversight of the client’s wound. The client’s medical record was void of any wound assessments, pertaining to the client’s heel ulcer.

In March 2016, a hospital record indicated that the client still had the stage II pressure ulcer on the right buttock and had also developing stage II pressure ulcer on the sacrum. Discharge orders to the facility including instructions for dressing changes and instructions to frequently change the client’s position.

In May 2016, direct care staff documented that the client had a “big open sore on her bottom” and the client’s family member took the client to the hospital for evaluation. A culture of the wound drainage was taken. Hospital discharge orders provided to the facility included instructions for dressing changes, including the application of antibiotic ointment for ten days.

In July 2016, a hospital record indicated that the client had multiple areas of dermis loss on the buttocks and inner groin, including a 4.5 cm x 0.7 cm open lesion on the left inner groin, a 3.5 x 2.0 cm open ulceration on the right lower buttock, a 4.5 cm x 2.0 cm open ulceration on the right buttock, a 0.3 cm x 5.0 cm open ulceration on the gluteal fold, and two open areas on the left buttock measuring 0.5. cm x 0.5 cm and 0.5 cm x 0.8 cm. All areas were macerated. Hospital discharge orders were provided to the facility including instructions for wound care, perineal care, and to document the client’s wound healing each day.

In August 2016, a hospital record indicated that the client had an unstageable ulcer on the left heel and the client was admitted for hospitalization due to osteomyelitis of the heel wound with culture results positive for MRSA and Strep. The client underwent a surgical limb salvage procedure for the left heel. The client’s buttock and groin wounds were also evaluated during hospitalization. Hospital discharge orders provided to the facility included instructions for wound treatment and care of the surgical incision, which entailed application of an ace wrap to the client’s left leg.

In September 2016, a hospital record indicated that the client was emergently hospitalized due to a change in condition. On hospital arrival, the client was unresponsive, had a fever of 101 degrees, oxygen saturations not above 87% on six liters of oxygen, bilateral blue feet, and a left lower leg that was red and swollen with fluid-filled blisters. The client was admitted to the ICU with polymicrobial infections of the left leg, sacrum and urinary tract, along with pneumonia. The client’s condition did not improve with volume resuscitation and broad-spectrum antibiotics. Comfort measures were elected and the client was discharged to a skilled care facility on hospice care.

All of the client’s hospital visits from March 2016 to September 2016 were facilitated by the client’s family member, based on reports direct care staff gave the family member about the deteriorating condition of the client’s wounds. During the same time period from March 2016 to September 2016, multiple direct care staff had informed the RN that the client’s wounds were worsening, looked infected, and had drainage that soaked through the dressings. There was no evidence that the RN ever addressed the client’s wound, monitored the status of the client’s wounds for healing, or followed up on the culture results. The client’s medical record was void of any wound assessments from March 2016 to September 2016 and void of any progress notes or evidence of follow-up about the client’s wound culture. During the period March 2016 to September 2016, direct care staff performed the client’s wound dressings, without any evidence of training by the RN including the safe handling of contaminated materials. The client’s care plan completed by the RN did not contain any information about the client’s wounds.

After the client had the left heel surgical procedure in August 2016, hospital discharge instructions included application of an ace wrap to the client’s left leg following incision care. Only the RN applied the client’s ace wrap. There was no evidence that the RN monitored the client’s left leg for circulation, motor ability, or sensation. When the client was re-hospitalized in September 2016, the hospital record noted that the client’s left lower leg had an “an ace wrap that was bound too tightly” causing the appearance of “rug-burns”, in addition to an obvious cellulitis of the lower extremity which was red and swollen with fluid blisters.

When interviewed, the facility RN had no explanation regarding the inadequate nurse oversight of the client’s wounds.

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Tibia Fracture – Allegation of Neglect – Fractured Tibia – KSMS Our House in Austin

Tibia Fracture to Client Leads to MDH Complaint of Neglect Against KSMS Our House

In a report from the Minnesota Department of Health, dated February 13, 2017, it was alleged that a client at KSMS Our House in Austin Minnesota was neglected when s/he had a fall. The client had progressively worse pain after the fall and it was discovered ten days later that the client had a tibia fracture.

Substantiated Neglect Complaint After Client Fractures Tibia in Fall

Based on the report a preponderance of evidence, neglect occurred when the facility failed to thoroughly assess the client after a fall, monitor the client’s change in condition, and intervene with proper nursing care that addressed the client’s acute needs. Ten days after the fall, it was discovered that the client had a broken leg.

The client used a wheelchair propelled with his/her feet. Due to unsteadiness when standing, balance problems, and history of falls, the client needed the assistance of one staff to stand and pivot for transfers. The client needed the assistance of one staff for all activities of daily living. The client could verbally express his/her needs and desires. The client lived alone in an apartment and wore a pendant that s/he could push to alert staff when s/he needed help.

During a night in July 2016, the client paged staff at 3:45 a.m. because s/he had fallen in his/her apartment. Direct care staff responded and found the client sitting on the floor. The client told staff that his/her knees hurt. After the client fell, the client was not thoroughly assessed by a nurse at any time for ten days, even though multiple direct care staff repeatedly reported to the RN the client’s symptoms of leg pain, leg swelling, bruising, difficulty with transfers, and inability to propel the wheelchair independently. Ten days after the fall, the client’s family member took the client to the hospital due to the client’s complaints of ongoing severe leg pain.

The client’s hospital record indicated that the client had severe pain with movement and positive changes of the right leg and decreased range of motion in the right knee. The client’s right and left anterior knees had diffuse bruising with greater bruising on the right lateral tibia, and right upper arm. The client’s right calf was red, swollen, and warm to touch and was suspicious for cellulitis. X-rays confirmed the client had a right tibial plateau fracture. Conservative management of the fracture was elected. The client was hospitalized to treat the cellulitis with intravenous antibiotics. During hospitalization, the client declined with acute kidney injury and altered mental status. After being hospitalized for seven days, the client was discharged to a skilled care facility.

The facility has a full-time Registered Nursing (RN) and nurses on-call at all times, when the facility’s RN is not onsite. There was no evidence that a nurse thoroughly assessed the client’s status at any time during the ten days the client exhibited symptoms of fracture. The facility’s RN made only two brief progress notes (a note two days after the fall and another note the day before the client went to the hospital) which did not include any detailed assessment information or address changes in the client’s condition that had been reported by direct care staff. The facility’s medical record was void of any nursing progress notes prior to the client’s fall.

Statements by the facility’s RN concerning the client’s post-fall status were contradictory to multiple interviews of the direct care staff who provided care to the client after the client fell.

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Failure to Assess Change in Condition Fractured Leg, KSMS Our House Austin

KSMS Our House Austin Complaint Findings for Neglect – Failure to Assess

In a report concluded on November 13, 2014, the Minnesota Department of Health cites KSMS Our House Austin for neglect of health care failure to assess change in condition.

It is alleged that neglect of health care occurred when the alleged perpetrator (AP) failed to assess a client #1’s pain. The client had a broken leg. In addition; the AP failed to send another client #2 to the hospital in a timely manner after a change in health status.

Substantiated Neglect Against KSMS Our House Austin

Based on preponderance of evidence neglect did occur when a client’s change in condition was not assessed by the AP to ensure timely medical intervention.

The client had diagnoses that included diabetes mellitus, chronic obstructive pulmonary disease (COPD), Coronary Artery Disease (CAD) and Asthma. The client received assistance of one staff with activities of daily living (ADL) skills that included walking, medication administration, and daily accuceheck (blood sugar monitoring). The client was independent with administration of his/her insulin injections. The client’s medication regimen included pain control of Oxycodone (narcotic) 30 milligrams (mg) extended release tablets take one tablet by mouth every 12 hours. Oxycodone/APAP (narcotic) 5-325 mg tablet; take one or two tablets by mouth every 4 -6 hours as needed for pain.

On the morning of the client’s change in condition at 8:00 a.m., the staff identified, the client was “pretty out of it”. The client had oxygen levels of 86% to 93%, required assistance to put medications in his/her mouth, and was unable to self-administer the insulin. The staff notified the AP of the client’s change in condition. The AP instructed staff to administer the client’s insulin, but did not assess the client’s condition in relation to the altered mental status and inability to self-administer medications. The AP did not provide the staff with any parameters for monitoring the client or when to call the AP back. In addition, the AP informed the staff not to call 911 unless the client was unconscious. Later the same day, on the evening shift of work, the client was not able to stand up. The staff notified the AP of the client’s inability to stand. The AP instructed staff to use a mechanical lift for transfers without an assessment of the client’s status or provide the staff with any parameters for monitoring the client or when to call the AP back. Eleven hours after the first reported change in condition had not improved and staff identified the client had an oxygen level of 86%, and a temperature of 101.5. Staff did not call the AP for direction instead called 911 and the client was transported to the hospital and admitted to the hospital intensive care with a diagnosis of Toxic/metabolic Oxycodone, intermittent myoclonic jerks, acute delirium and pneumonia – likely from aspiration. The client returned to the facility after a five-day hospital stay.

If you have concerns about a failure to assess a change in condition, falls, fractures or any other form of elder abuse or neglect contact Elder Abuse and Neglect Attorney Kenneth LaBore at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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Nursing Home Abuse and Neglect Lawyer Kenneth LaBore Offers Free Consultations and Serves Clients Throughout the State of Minnesota Call Toll Free at 1-888-452-6589

Nursing Home Injuries

Written By: Kenneth LaBore | Published On: 5th February 2017 | Category: Bed Sores and Pressure Ulcers, Failure to Resond to Change in Condition, Fall Injuries, Hoyer Lift, Medication Drug Error, Nursing Home Abuse and Neglect, Patient Lift, Sexual Abuse, Wrongful Death | RSS Feed

Minnesota Abuse and Neglect Nursing Home Injuries

Minnesota Nursing Home Injuries

There are many ways that residents suffer nursing home injuries, many are falls, being dropped from lifts or injured in transfer, falls from the toilet or in the shower, fall from bed or out of a wheelchair. Since the way that many injuries happen is foreseeable the facility has an obligation to analysis and assess the risks to each resident and take reasonable measures and interventions to protect them from preventable accident situations.

Pursuant to federal and state regulations nursing homes have an obligation to keep their residents safe. They are considered vulnerable adults by legal definition since they are staying in a nursing home facility.

According to 42 CFR 483.25, nursing homes must take efforts to prevent accidents which would include falls, medication errors, or any other way you could be injured such as through the use of oxygen, smoking, scalding burns, urinary tract infections, pressure wounds and others set out in the statute.

Common Types of Nursing Home Injuries

Here are some summaries on various topics related to nursing home falls and fractures, pressure sores and other nursing home injuries:

Patient Lift Injuries

Wrongful Death from Falls

Fractures from Falls

Falls from Wheelchairs

Falls in Bathroom

Falls in Shower

Falls from Bed

Nursing Home Neglect Fractures

Bedsore Stages

Pressure Injury Stages

Pressure Sore Injury

Pressure Injuries

Nursing Home Fall Injuries Lawyer

If you or someone you love is in a skilled nursing facility or nursing home and the victim of abuse or neglect injuries contact Attorney Kenneth LaBore for a free consultation to discuss the fall or injuries and he does not charge a fee unless there is a verdict or settlement offer with the wrongdoer. Call Kenneth LaBore at 612-743-9048 or toll free at 1-888-452-6589 or send an email to KLaBore@MNnursinghomeneglect.com.

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Pressure Sore Stages

Written By: Kenneth LaBore | Published On: 3rd February 2017 | Category: Bed Sores and Pressure Ulcers, Patient Lift | RSS Feed

Pressure Sore Stages NPUAP Stage 5, Deep Tissue Pressure Injury

Pressure Sore Stages

Pressure sores stages are categorized into four key stages depending on their age, size, depth and severity. The National Pressure Ulcer Advisory Panel, a professional organization that promotes the prevention and treatment of pressure ulcers, defines each stage.

According to the Mayo Clinic, for people who use a wheelchair, pressure sores often occur on skin over the following sites:

Tailbone or buttocks
Shoulder blades and spine
Backs of arms and legs where they rest against the chair

For people who are confined to a bed, common sites include the following:

Back or sides of the head
Rim of the ears
Shoulders or shoulder blades
Hip, lower back or tailbone
Heels, ankles and skin behind the knees

Pressure Sore Stages

According to WebMD, pressure sores (bed sores) are an injury to the skin and underlying tissue. They can range from mild reddening of the skin to severe tissue damage-and sometimes infection-that extends into muscle and bone. Pressure sores are described in four stages:

Stage 1 sores are not open wounds. The skin may be painful, but it has no breaks or tears. The skin appears reddened and does not blanch (lose color briefly when you press your finger on it and then remove your finger). In a dark-skinned person, the area may appear to be a different color than the surrounding skin, but it may not look red. Skin temperature is often warmer. And the stage 1 sore can feel either firmer or softer than the area around it.

At stage 2, the skin breaks open, wears away, or forms an ulcer, which is usually tender and painful. The sore expands into deeper layers of the skin. It can look like a scrape (abrasion), blister, or a shallow crater in the skin. Sometimes this stage looks like a blister filled with clear fluid. At this stage, some skin may be damaged beyond repair or may die.

During stage 3, the sore gets worse and extends into the tissue beneath the skin, forming a small crater. Fat may show in the sore, but not muscle, tendon, or bone.

At stage 4, the pressure sore is very deep, reaching into muscle and bone and causing extensive damage. Damage to deeper tissues, tendons, and joints may occur.

In stages 3 and 4 there may be little or no pain due to significant tissue damage. Serious complications, such as infection of the bone (osteomyelitis) or blood (sepsis), can occur if pressure sores progress.

Sometimes a pressure sore does not fit into one of these stages. In some cases, a deep pressure sore is suspected but cannot be confirmed. When there isn’t an open wound but the tissues beneath the surface have been damaged, the sore is called a deep tissue injury (DTI). The area of skin may look purple or dark red, or there may be a blood-filled blister. If you or your doctor suspect a pressure sore, the area is treated as though a pressure sore has formed.

There are also pressure sores that are “unstageable,” meaning that the stage is not clear. In these cases, the base of the sore is covered by a thick layer of other tissue and pus that may be yellow, gray, green, brown, or black. The doctor cannot see the base of the sore to determine the stage.

Pressure Sore Stages Neglect Attorney

If you have questions about nursing home abuse and neglect contact Kenneth LaBore for a free consultation. There is no fee unless there is a verdict or settlement offer from the wrongdoer. Mr. LaBore can be reached directly at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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Bedsore Injury

Written By: Kenneth LaBore | Published On: 3rd February 2017 | Category: Bed Sores and Pressure Ulcers, Failure to Resond to Change in Condition, Nursing Home Abuse and Neglect, Pressure Ulcers | RSS Feed

Nursing Home Bedsore Injury is Preventable

Bedsore Injury Injuries Are Preventable

Bedsore injury is preventable with proper care and treatment and sufficient staff at nursing homes and other elder care facilities to ensure that residents who need assistance are turned and repositioned at least every two hours to assure that they do not have long periods of time without pressure relief. There are several points of the body that are more prone to bed sore pressure ulcers, including the back of the head, shoulder, buttocks, coccyx, and back of heels.

Bedsore Injury Stages

According to the Mayo Clinic, bedsores fall into one of four stages based on their severity. The National Pressure Ulcer Advisory Panel, a professional organization that promotes the prevention and treatment of pressure ulcers, defines each stage as follows:

Stage 1

The beginning stage of a pressure sore has the following characteristics:

The skin is not broken.
The skin appears red on people with lighter skin color, and the skin doesn’t briefly lighten (blanch) when touched.
On people with darker skin, the skin may show discoloration, and it doesn’t blanch when touched.
The site may be tender, painful, firm, soft, warm or cool compared with the surrounding skin.

Stage 2

At 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.
The wound may look like a fluid-filled blister or a ruptured blister.

Stage 3

At stage 3, the ulcer is a deep wound:

The loss of skin usually exposes some fat.
The ulcer looks crater-like.
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 IV

A stage IV ulcer shows large-scale loss of tissue:

The wound may expose muscle, bone or tendons.
The bottom of the wound likely contains dead tissue that’s yellowish or dark and crusty.
The damage often extends beyond the primary wound below layers of healthy skin.

Unstageable

A pressure ulcer is considered unstageable if its surface is covered with yellow, brown, black or dead tissue. It’s not possible to see how deep the wound is.

Deep tissue injury

A deep tissue injury may have the following characteristics:

The skin is purple or maroon but the skin is not broken.
A blood-filled blister is present.
The area is painful, firm or mushy.
The area is warm or cool compared with the surrounding skin.
In people with darker skin, a shiny patch or a change in skin tone may develop.

Bedsore Injury Skin Care

Residents must receive necessary skin care to help prevent pressure and bedsore injury. According to Minnesota Administrative Rule 4658.0520, Subpart (2)(B), clean skin and freedom from offensive odors. A bathing plan must be part of each resident’s plan of care. A resident whose condition requires that the resident remain in bed must be given a complete bath at least every other day and more often as indicated. An incontinent resident must be checked at least every two hours, and must receive perineal care following each episode of incontinence. Clean linens or clothing must be provided promptly each time the bed or clothing is soiled. Perineal care includes the washing and drying of the perineal area. Pads or diapers must be used to keep the bed dry and for the resident’s comfort. Special attention must be given to the skin to prevent irritation. Rubber, plastic, or other types of protectors must be kept clean, be completely covered, and not come in direct contact with the resident. Soiled linen and clothing must be removed immediately from resident areas to prevent odors.

Bedsore Injury Must Be Reported

According to Minnesota Statute 144.7065, each facility shall report to the commissioner the occurrence of any of the adverse health care events described in subdivisions 2 to 7 as soon as is reasonably and practically possible, but no later than 15 working days after discovery of the event. The report shall be filed in a format specified by the commissioner and shall identify the facility but shall not include any identifying information for any of the health care professionals, facility employees, or patients involved. The commissioner may consult with experts and organizations familiar with patient safety when developing the format for reporting and in further defining events in order to be consistent with industry standards.

The statute requires the reporting to the Commissioner of the Department of Health, stage 3 or 4 or unstageable ulcers acquired after admission to a facility, excluding progression from stage 2 to stage 3 if stage 2 was recognized upon admission.

Additional Information on Bedsore Injury

Also see some of my other blogs on this topic:

Bedsore Stages

Pressure Injury Stages

Pressure Sore Injury

Pressure Injuries

Bedsore Injury Neglect Attorney

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Pressure Sore Injury

Written By: Kenneth LaBore | Published On: 3rd February 2017 | Category: Bed Sores and Pressure Ulcers, Pressure Ulcers | RSS Feed

Nursing Staff Providing Wound Care for Pressure Sore Injury

Nursing Home Pressure Sore Injury

Residents of nursing homes have a few areas of risk that are the greatest, some like falls, being dropped from lifts, medication mistakes, sexual and physical abuse are obvious forms of neglect. Pressure sore injury is usually neglect that occurs over a period of time and due to a failure to relieve pressure usually aggravated by other factors such as a lack of nutrition and hydration and issues with sanitation and hygiene in the subject facility.

Pressure Sore Injury is Preventable

According to federal regulations, based on the comprehensive assessment of a resident, the facility must ensure that—

(i) A resident receives care, consistent with professional standards of practice, to prevent pressure ulcers and does not develop pressure ulcers unless the individual’s clinical condition demonstrates that they were unavoidable; and

(ii) A resident with pressure ulcers receives necessary treatment and services, consistent with professional standards of practice, to promote healing, prevent infection and prevent new ulcers from developing.

Pressure Sore Injury to Skin and Underlying Tissue

Picture of Pressure Sore From Healthwise

According to WebMD,pressure sores (bed sores) are an injury to the skin and underlying tissue. They can range from mild reddening of the skin to severe tissue damage-and sometimes infection-that extends into muscle and bone. Pressure sores are described in four stages:

Stage 1 sores are not open wounds. The skin may be painful, but it has no breaks or tears. The skin appears reddened and does not blanch (lose color briefly when you press your finger on it and then remove your finger). In a dark-skinned person, the area may appear to be a different color than the surrounding skin, but it may not look red. Skin temperature is often warmer. And the stage 1 sore can feel either firmer or softer than the area around it.

At stage 2, the skin breaks open, wears away, or forms an ulcer, which is usually tender and painful. The sore expands into deeper layers of the skin. It can look like a scrape (abrasion), blister, or a shallow crater in the skin. Sometimes this stage looks like a blister filled with clear fluid. At this stage, some skin may be damaged beyond repair or may die.

During stage 3, the sore gets worse and extends into the tissue beneath the skin, forming a small crater. Fat may show in the sore, but not muscle, tendon, or bone.

At stage 4, the pressure sore is very deep, reaching into muscle and bone and causing extensive damage. Damage to deeper tissues, tendons, and joints may occur.

Additional Information on Pressure Sore Injury

Also see my other blogs on this topic:

Bedsore Stages

Pressure Injury Stages

Pressure Injuries

Pressure Sore Injury Neglect Attorney

If you have questions about nursing home abuse and neglect contact Kenneth LaBore who has handled dozens of very serious pressure sore and ulcer cases for a free consultation. There is no fee unless there is a verdict or settlement offer from the wrongdoer. Mr. LaBore can be reached directly at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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Bedsore Stages

Wound Care After Bed Sore Stages Injury

Bedsore Stages of Injury

Bedsore stages is the same as the stages of a pressure injury. There are many different names for bedsores, including the same word split into bed sore, pressure injuries, pressure sores, pressure ulcer and decubitus ulcer all are a way of explaining skin breakdown which and the related wound which is then set into stages. All of these wounds are considered preventable in most cases with proper care and treatment.

According to the Mayo clinic, bedsores most often develop on skin that covers bony areas of the body, such as the heels, ankles, hips and tailbone. People most at risk of bedsores are those with a medical condition that limits their ability to change positions, requires them to use a wheelchair or confines them to a bed for a long time.
Bedsores can develop quickly and are often difficult to treat. Several things can help prevent some bedsores and help with healing.

Wound Characteristics Determine Bedsore Stages

The stages of the bedsore injuries is determined on the characteristics of the wound. To determine the stage of a wound the provider needs to examine and measure the wound and chart related characteristics such as size (length x width x depth), as well as, the color of the skin and surrounding area, smell, texture and other specifics needed to analysis the wounds origin and progress towards healing.

According to Wikipedia, pressure ulcers occur due to pressure applied to soft tissue resulting in completely or partially obstructed blood flow to the soft tissue. Shear is also a cause, as it can pull on blood vessels that feed the skin. Pressure ulcers most commonly develop in individuals who are not moving about, such as those being bedridden or confined to a wheelchair. It is widely believed that other factors can influence the tolerance of skin for pressure and shear, thereby increasing the risk of pressure ulcer development. These factors are protein-calorie malnutrition, microclimate (skin wetness caused by sweating or incontinence), diseases that reduce blood flow to the skin, such as arteriosclerosis, or diseases that reduce the sensation in the skin, such as paralysis or neuropathy. The healing of pressure ulcers may be slowed by the age of the person, medical conditions (such as arteriosclerosis, diabetes or infection), smoking or medications such as anti-inflammatory drugs.

Information About Bedsore Stages

According to St.Luke’s Health System, the stages of pressure sores bedsores is as follows:

Stage 1

The unbroken skin is red and nonblanchable. Note: It may be difficult to determine blanching in darker skin tones. The affected area may differ in color from the surrounding skin.

Goal: Prevent further progression of the injury and support blood flow.
Implement treatment plan for (Suspected) Deep Tissue Injury.
Cleanse and lightly moisturize the skin. Note: Never massage the affected area. This can cause further damage to tissue. Allow the moisturizer to dry before placing any additional pressure on the area.
Apply protective dressing, if indicated.
Evaluate nutritional intake

Stage 2

Partial-thickness skin loss has occurred and the wound bed is red-pink in color. Slough is not present, but a broken or intact serum-filled blister may be evident.

Goal: Prevent full-thickness injury and continue to promote healing.
Implement treatment plan for previous stages.
Apply dressing to keep wound bed moist and promote healing.
Protect fragile skin from adhesives.
Reevaluate nutritional intake.

Stage 3

Full-thickness skin loss has occurred. Slough may be present. Subcutaneous fat may be visible, but bone, tendon, or muscle are not. Undermining or tunneling may also be present.

Goal: Maintain a clean, moist wound bed to prevent infection and promote new tissue growth (granulation).
Implement treatment plans for previous stages.
Remove dead tissue (debridement), if needed.
Absorb drainage.
Fill the injury cavity with appropriate dressing.
Evaluate the need for nutritional consultation.

Stage 4

Full-thickness skin loss has occurred. Bone, tendon, or muscle is exposed. Slough or eschar may be present, but the base of the wound can be seen. Undermining and tunneling are often present.

Goal: Reduce drainage, remove dead tissue, and establish an environment for new tissue growth.
Implement treatment plans for previous stages.
Report bone involvement.
Treat infection with antibiotics, if indicated.
Discuss with the healthcare provider whether surgery is needed.

Unstageable

Full-thickness skin loss has occurred. Slough or eschar covers the wound base. The wound depth cannot be determined because of the slough or eschar.

Goal: Determine stage, provide moist environment, and prevent further breakdown.
Debride the wound. Do not debride the heel unless signs of infection are present.
Reassess injury stage once base is visible.
Manage pain of injury.
Assess for infection.
Discuss pressure injury with the healthcare provider.

For more information see pressures injury stages

Worsening Bedsore Stages Neglect Attorney

If you have questions about bedsore injuries nursing home abuse and neglect contact Kenneth LaBore for a free consultation. There is no fee unless there is a verdict or settlement offer from the wrongdoer. Mr. LaBore has handled dozens of bed sore and pressure injury cases and can be reached directly at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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