Nurse Case Study: Failure to prevent and properly treat decubitus ulcer.

Failure to prevent and properly treat decubitus ulcer – continues to Stage IV – defense verdict. 

The plaintiff’s decedent, age 62, was taken to the emergency room of the Hospital in September 2005 with complaints of abdominal pain and right arm contracture. The decedent had a complex medical history, including a stroke in 2001 which had left her bedridden and unable to speak. She also had congestive heart failure, renal insufficiency, liver cirrhosis, mild anemia, morbid obesity, high blood pressure, constipation, gallbladder disease, ventral hernia, urinary tract infection and small vessel disease. 
At admission the decedent was noted with a Stage II ulcer on her posterior thigh that was healing. Ten days after admission the decedent was noted as having a Stage II sacral pressure ulcer. Eleven days later it had progressed to a Stage IV decubitus ulcer that was grossly gangrenous and fluctuant with surrounding cellulitis. Two days later the wound was measured as ten centimeters by 13 centimeters. The ulcer continued to worsen throughout the hospitalization and was three inches deep when the decedent was discharged to a long-term acute care hospital in early November 2005. The woman died of unrelated causes three days later. 
The case was tried on a survival action only. The plaintiff claimed that the ulcer would not have occurred if the hospital’s nurses had properly turned and repositioned the patient every two hours. The plaintiff also claimed that the nurses failed to properly describe and document the wound and that the ulcer had become a deeper Stage II or IV ulcer sometime before an infectious disease physician examined it. 
The defense conceded that the nurses did not document a full description of the pressure ulcer but argued that the bedsore was an unpreventable ulcer which was due to the woman being near the end of her natural life and that it was untreatable when it developed due to the decedent’s inability to heal. 
According to Jury Verdict Reporter a defense verdict was returned. 
With permission from Medical Malpractice Verdicts, Settlements & Experts; Lewis Laska, Editor, 901 Church St., Nashville, TN 37203-3411, 1-800-298-6288.

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