Beyond Bedsores: Building Strong Pressure Ulcer Cases with Clinical Evidence
Pressure ulcers—commonly known as bedsores—are more than just surface wounds. In legal settings, they often indicate serious breakdowns in patient care, particularly in nursing homes, rehab centers, and hospitals. When these injuries progress unchecked, they can lead to infection, sepsis, amputation, or death.
But not every pressure ulcer equals malpractice.
To build a compelling case, attorneys need to demonstrate when the ulcer developed, what care was provided (or not), and whether it could have been prevented. That’s where expert clinical review becomes critical.
At Lexcura Summit Medical-Legal Consulting, our legal nurse consultants (LNCs) assist attorneys in evaluating pressure ulcer cases through detailed analysis of medical records, construction of timelines, and application of clinical expertise. Here’s how we go beyond surface-level documentation to reveal neglect, causation, and liability.
🩺 Understanding Pressure Ulcers in a Legal Context
Pressure ulcers are injuries to the skin and underlying tissue caused by prolonged pressure, typically over bony areas such as:
Sacrum
Heels
Hips
Elbows
Back of the head
They’re classified into stages (I–IV) depending on severity. In litigation, Stage III and IV ulcers, as well as unstageable or deep tissue injuries (DTIs), are often considered "never events"—meaning they are generally preventable with appropriate care.
⚠️ Common Allegations in Pressure Ulcer Cases
Failure to reposition the patient regularly
Inadequate skin assessments or risk scoring
Poor documentation of wound progression
Delayed provider notification
Lack of wound consults or interventions
Understaffing or a lack of follow-through on care plans
📌 Attorneys must prove not just that the ulcer occurred—but that it occurred because of preventable lapses in care.
🔍 How Lexcura Summit Builds Strong Pressure Ulcer Cases
✅ 1. Reconstructing the Wound Timeline
We review daily nursing notes, skin assessments, wound care documentation, and photographs (when available) to determine:
When the ulcer first appeared
How quickly it progressed
Whether wound care was initiated and followed
If deterioration was reported or addressed
📁 A timeline helps establish when care failed and whether earlier intervention could have changed the outcome.
✅ 2. Evaluating Risk Assessments and Care Plans
Tools like the Braden Scale help facilities assess risk for pressure injuries. Residents identified as high-risk should have care plans that include:
Turning schedules
Pressure-relieving mattresses
Nutrition and hydration monitoring
Frequent skin inspections
We assess whether these interventions were:
Documented clearly
Implemented consistently
Adjusted based on changing risk levels
📌 Gaps here are a strong indicator of systemic neglect or noncompliance with care standards.
✅ 3. Reviewing Wound Documentation and Staging
Proper wound documentation is critical. We identify:
Incorrect or delayed staging
Wounds were charted inconsistently between shifts
Lack of photo evidence or measurements
Wounds listed as “present on admission” without proof
📌 Misclassification or poor charting can impact both liability and defense.
✅ 4. Connecting the Injury to Causation and Damages
A pressure ulcer is often part of a larger picture of functional decline:
Infections
Hospital transfers
Pain and immobility
Death from sepsis
We tie the presence and progression of wounds to declining condition, quality of life, and wrongful death claims, helping attorneys establish causation and assess case value.
✅ 5. Comparing Care to National Guidelines
Our LNCs compare the care provided to the standards of:
National Pressure Injury Advisory Panel (NPIAP)
CMS Guidelines
State nursing regulations
Facility policies and procedures
📌 This helps demonstrate apparent deviations from expected care practices.
📁 Real Case Example
Case: Stage IV Sacral Ulcer in Long-Term Care Facility
An immobile resident developed a Stage IV pressure ulcer after being found in the same position for over 8 hours. Lexcura Summit’s review uncovered missing repositioning documentation, outdated Braden scores, and delays in wound care consults. The case settled for $950,000 after demonstrating clear failure to follow preventative protocols.
🛡️ Why Law Firms Trust Lexcura Summit
Over 200 licensed medical professionals with wound care and LTC experience
HIPAA-secure portals and fast, 7-day turnaround
Specialists in elder neglect, wrongful death, and pressure injury cases
Trusted by plaintiff and defense attorneys nationwide
Custom chronologies, annotated records, and deposition support
Final Thoughts
Pressure ulcers don’t just happen—they develop over time due to missed care, poor planning, or systemic understaffing. At Lexcura Summit, we help attorneys uncover the clinical truth behind the wound, providing the evidence needed to pursue justice or defend care decisions.
📞 Contact Lexcura Summit Medical-Legal Consulting today to strengthen your next pressure ulcer case with expert clinical analysis and strategic clarity. www.lexcura-summit.com or Tel: 352-703-0703
