If you or a loved one has suffered from pressure sores as either a hospital inpatient or care home resident, you may be entitled to claim compensation. Pressure sores can be especially painful, taking time to fully heal, and can cause a great deal of suffering as a result. In severe cases, they can even lead to dangerous and life-threatening complications.
In this guide to pressure sore claims, we explain how these types of claims can arise, what compensation you could expect to receive and what requirements have to be met to be eligible to claim for bed sores.
What are pressure sores?
Pressure sores, also commonly known as pressure ulcers or bed sores, are injuries to the skin and underlying tissue that typically occur when a person remains immobile for prolonged periods of time. These sores are usually caused by excessive pressure on the surface of the skin arising out of continuous contact with either a bed or a wheelchair.
Anyone can get pressure sores, although this type of skin and soft tissue injury is most common in hospital patients or care home residents who lack sufficient mobility to be able to shift their own body weight. If a person is immobile, either temporarily or permanently, and confined to a bed or wheelchair for several hours at a time, without the ability to move some or all of their body, they will be highly susceptible to suffering from pressure sores.
Additional factors that can increase the incidence of pressures sores include being aged over 70, where older people are more likely to have skin that is easily damaged through dehydration and other factors, or those suffering from medical conditions that either make the skin more fragile, affect the blood supply or cause movement problems. These could include diabetes, peripheral arterial disease, kidney failure, heart failure, multiple sclerosis and Parkinson’s disease. Things like obesity, malnutrition, poor diet, smoking, as well as urinary and bowel incontinence, can also increase the risk of pressure sores.
Overall, however, limited mobility is often the primary factor in the development of pressure sores, where these sores are especially common on parts of the body that are consistently in contact with, for example, a bed or wheelchair for long periods of time. Those parts of the body without the protection of fat and muscle to cushion the pressure on the bone can also be badly affected. Common pressure sore sites include the back of the ears, the base of the spine, shoulder blades, elbows, hips, inner knees, heels and ankles.
Can you claim compensation for pressure sores?
Anyone who is required to spend time in hospital or a residential care home is entitled to expect a minimum standard of care, regardless of whether that care is provided through the NHS, via local authority funding or paid for privately. In many cases, where a patient in hospital or a resident within a care home environment suffers from pressure sores, this is often because the level of care falls far short of what is acceptable in those circumstances.
Compensation for pressure sores can be sought for various shortcomings, in each scenario involving some negligence on the part of the relevant healthcare professionals, including:
- a failure to carry out an assessment of the risk of developing pressure sores, known as a Waterlow assessment, where the higher the Waterlow score for the person in question, the higher the risk of developing sores
- a failure to accurately assess a patient or resident’s needs
- a failure to regularly check the skin for early signs and symptoms of pressure sores
- a failure to regularly reposition someone who is bed-bound or wheelchair-bound
- a failure to adequately treat any pressure sores
- a failure to prevent infection of any pressure sores.
These allegations of negligence in the context of pressure sore claims are not exhaustive and may need to be used in combination with each other.
Other allegations could include, for example, a failure to provide a patient or resident with a healthy and balanced diet although, as a standalone allegation, it would be difficult to prove that an inadequate diet was the primary cause of pressure sores. However, where the necessary dietary requirements to keep a person healthy are not met by a hospital or care home provider, and where a vulnerable individual has not been kept properly hydrated to help with any healing process, this will be indicative of substandard care all around.
How do pressure sore claims happen?
Healthcare professionals should always be alert to the risk of pressure sores developing in patients and residents, where they are required to carry out a specific risk assessment, taking into account factors such as age, gender, mobility, continence, skin type, appetite and special risk factors. They should also carefully monitor the individual’s skin and, where necessary, use preventative measures, such as regular repositioning to help minimise the risk of a pressure sore from developing or an existing pressure sore from getting worse.
Moving and regularly changing position not only helps to relieve the pressure on sores that have already developed, this also helps to prevent pressure sores from forming in the first place. This means that once the care team has assessed the risk of a person developing pressure sores, they should draw up a repositioning timetable for anyone incapable of moving themselves. For some people, with a high risk of developing sores, this should be as often as once every 15 minutes, whilst for others it could be once every 2 to 4 hours.
Other preventative and remedial measures when it comes to pressures sores could include the use of a specially designed mattress or pressure-redistributing cushion to reduce or relieve pressure. Special dressings can also be used to help protect pressure sores, keep the area clean and free from infection, and to help speed up the healing process.
It often follows that in cases where pressure sores have developed, or become especially serious, some or all of the above preventative or remedial steps may have been lacking in an individual’s care programme. In most pressure sore claims, these come about following the development of a pressure sore or poor management of one, either as a result of a failure to carry out a basic risk assessment and/or to implement an appropriate care plan.
How are pressure sore claims usually graded?
When it comes to claiming compensation for pressure sores, this type of injury can be graded into the following four different categories:
Grade 1 pressure sore
This is typically where the skin is not broken at first, but part of the skin has become discoloured, where people with pale skin tend to get red patches, while people with dark skin tend to get blue or purple patches. If the discoloured patches do not turn white when pressure is applied, or they feel either unusually warm, spongy or hard, this is an indication that it is a Grade 1 pressure sore. In this early stage, the skin will be painful and tender to touch. There may also be itchiness in the affected area;
Grade 2 pressure sore
This is where the symptoms above are present, but these have got worse, and there is now an open wound or blister starting to develop;
Grade 3 pressure sore
This is where any open wound or blister has reached the deeper layers of the skin, presenting like a crater on the surface with underlying yellowish tissue
Grade 4 pressure sore
This refers to very deep wounds, in some cases with exposure of tendons and muscles, or even as far as the bone, with noticeable blackened dead tissue.
Even though pressure sores can occasionally form in a few hours, these will usually develop gradually. In most cases, there are early signs and symptoms that can be used to detect the onset of pressure sores which properly trained healthcare professionals should be aware of. These are essentially the symptoms as set out above for a Grade 1 pressure sore. As pressure sores fall into four different stages in terms of how severe they are, it is incumbent on anyone treating a patient or resident to ensure that any sores do not get progressively worse, where Grade 3 or 4 sores will very often indicate a lack of appropriate care.
The majority of pressure sores are identified at an early stage, and so can be managed and treated effectively without any serious consequences. Still, if nothing is done to treat pressure sores, or these are not treated properly, they can potentially develop into more serious problems, including bacterial infections. In severe cases, untreated pressure sores can lead to life-threatening complications, such as bone infections or even blood poisoning.
Importantly, the stages of pressure sores are not always time-related, where the progression of this type of injury is often due to how fragile or delicate a person’s skin is. Still, all healthcare professionals, whether in hospitals or residential care homes, have a duty of care to ensure that the risk of pressure sores is minimised in the context of the patient or care home resident in question. Further, where sores develop, they are under a duty to take steps to prevent these from developing into something far more serious.
How much is pressure sore claims compensation?
When it comes to compensation for pressure sore claims, provided it can be proven that there was some negligence or want of care on the part of the treating healthcare team, much will depend on the severity of the injury to the skin and underlying soft tissue.
When assessing the severity of an injury, the court will take into account the amount of pain, suffering and loss of amenity caused in consequence of a pressure sore. It will also look at how long it took for the affected area to heal, or any prognosis period where a full recovery has not yet been achieved. Any added complications will also be factored in, especially in the most serious cases, where a victim has suffered some form of infection.
In cases where the impact of pressures sores has been severe, this may have resulted in time off work where, in addition to any compensation for the injury itself, a claim can be made for loss of earnings. There may also be a valid claim for medication and dressings, as well as the costs of any care, even if this has been given for free by a family member.
How do prove pressure sore claims?
As with any claim for personal injury, there are various legal requirements that must be met to be able to successfully pursue pressure sore claims. These include being able to prove that the relevant healthcare team was in some way negligent or in breach of their duty, where the standard of care received fell below what could reasonably have been expected.
A prospective Claimant must also be able to show, with reference to expert medical evidence, that any negligence/breach caused or contributed to the development of a pressure sore. Finally, any Claimant must show, again with reference to medical evidence, the extent to which their injuries caused them pain, suffering and loss of amenity.
Importantly, pressure sores can sometimes develop even with the highest standards of care. It is therefore imperative that anyone seeking compensation for their injury is able to prove, on a balance of probabilities, that some wrongdoing on the part of their healthcare team caused their injuries. Details as to the level of care provided, together with photographic evidence of the affected area and progression of the injury, can be extremely useful here.
It is also important that any pressure sore claims are brought within 3 years of the date of injury, as this is typically the limitation date for pursuing these types of claims. When seeking to sue healthcare professionals for the onset or exacerbation of pressures sores, it is therefore always best to seek expert advice as soon as possible from a specialist lawyer.
Pressure sore claim FAQs
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Legal disclaimer
The matters contained in this article are intended to be for general information purposes only. This article does not constitute legal advice, nor is it a complete or authoritative statement of the law, and should not be treated as such. Whilst every effort is made to ensure that the information is correct, no warranty, express or implied, is given as to its accuracy and no liability is accepted for any error or omission. Before acting on any of the information contained herein, expert legal advice should be sought.
Author
Gill Laing is a qualified Legal Researcher & Analyst with niche specialisms in Law, Tax, Human Resources, Immigration & Employment Law.
Gill is a Multiple Business Owner and the Managing Director of Prof Services - a Marketing Agency for the Professional Services Sector.
