Wednesday, September 16, 2009

Pressure Sore Kills

Verda Henry, a 73-year-old life-long NY resident, entered a County nursing home in 2005 after she fell and injured her arm, thinking she would receive therapy and be home in a month.

Two years later, after repeated denied requests to go home, the grandmother of 15 died in the New Rochelle nursing home, partially because of a horrific, infected bedsore, according to her family and court records.

Henry's daughter, Patricia, filed a Nursing Home lawsuit against the Sutton Park Center for Nursing and Rehabilitation and said she and her children visited her normally active mother every day at Sutton Park, often for eight hours.

"There would be a nurse and she would run between floors and they had no time," Henry said. "Nobody checks on her. Nobody feeds her. Every time we asked to take her home there was a reason we couldn't."

One day, Patricia Henry went to change her mother's gown and noticed the bedsore, already in an advanced stage, over her mother's tail bone.

Within days the sore was infected and she heard her mother's last words - screams - as doctors scraped at blackened skin.

"You could put your whole hand down in her back," she said. "You could see the bones and spinal cord. It was like raw meat. Mommy screamed until she couldn't scream no more."

An administrator at the home said it could not immediately comment on the case. South Shore Medical Center did not return a call for comment.

Bedsores, or pressure ulcers, are lesions caused by unrelieved pressure on the skin. They are largely preventable by making sure a patient is regularly moved or turned every two hours, but are also often fatal once infected.

Patricia Henry's lawyer said there is no systemwide recordkeeping of bedsores, so that patients or families comparing nursing homes can make informed decisions.

Henry said she wants justice for her mother, who died a painful death because of a negligent system.

"I'm sorry I saw it, but I'm glad I saw it," Henry said. "They weren't telling us how bad it was and my mother couldn't tell me anymore."


Pressure Sore Stats

Data from the National Nursing Home Survey, 2004

  • In 2004, about 159,000 current U.S. nursing home residents (11%) had pressure ulcers. Stage 2 pressure ulcers were the most common.
  • Residents aged 64 years and under were more likely than older residents to have pressure ulcers.
  • Residents of nursing homes for a year or less were more likely to have pressure ulcers than those with longer stays.
  • One in five nursing home residents with a recent weight loss had pressure ulcers.
  • Thirty-five percent of nursing home residents with stage 2 or higher (more severe) pressure ulcers received special wound care services in 2004.

Pressure ulcers, also known as bed sores, pressure sores, or decubitus ulcers, are wounds caused by unrelieved pressure on the skin (1). They usually develop over bony prominences, such as the elbow, heel, hip, shoulder, back, and back of the head (1-3). Pressure ulcers are serious medical conditions and one of the important measures of the quality of clinical care in nursing homes (1,4). From about 2% to 28% of nursing home residents have pressure ulcers (2,3). The most common system for staging pressure ulcers classifies them based on the depth of soft tissue damage, ranging from the least severe (stage 1) to the most severe (stage 4). There is persistent redness of skin in stage 1; a loss of partial thickness of skin appearing as an abrasion, blister, or shallow crater in stage 2; a loss of full thickness of skin, presented as a deep crater in stage 3; and a loss of full thickness of skin exposing muscle or bone in stage 4. Clinical practice guidelines for pressure ulcers have been developed and provide specific treatment recommendations for stage 2 or higher pressure ulcers, including proper wound care (5). This Data Brief presents the most recent national estimates of pressure ulcer prevalence, resident characteristics associated with pressure ulcers, and the use of wound care services in U.S. nursing homes.