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Written on 26th March 2020

Boyes Turner’s medical negligence lawyers have negotiated a £70,000 settlement for an elderly man who suffered a grade 4 pressure sore (the most severe grade of pressure ulcer) on his heel whilst in hospital for treatment of a swollen knee.

At risk of pressure sores

Our client was in hospital with a swollen knee. He was diabetic and had been assessed as severely frail. His knee problems meant that he needed help to turn over in bed. He was, therefore, at risk of tissue viability problems (pressure sores). During his admission and stay in hospital, failings in his initial and ongoing assessments, mistakes in his nursing care and delays in providing him with essential protective aids for his skin, such as an airflow mattress and gel heel pads, led to him developing pressure sores on his heels. Delays in diagnosis and treatment and inadequate input from the tissue viability nurse allowed the pressure sore on one heel to deteriorate to grade 4, the most severe grade of pressure ulcer in which the skin and the deeper tissue become necrotic (start to die).

Grade 4 pressure sores can indicate failings in nursing care

Grade 4 pressure sores are very severe injuries which can cause ongoing disability and leave the patient vulnerable to infection.  The development of a grade 4 pressure sore (or bedsore) in hospital, particularly in a patient already known to be at risk, often indicates that there has been negligence in the patient’s medical and nursing care.

Who is at risk of pressure sores in hospital?

The NHS website lists the following risk factors for pressure sores:

  • over 70 years of age
  • confined to bed through illness or after surgery
  • unable to move part of your body
  • obese
  • incontinent
  • have a poor diet
  • or have a medical condition which affects blood supply or movement, or increases skin fragility, such as diabetes, peripheral arterial disease, kidney failure, heart failure, MS or Parkinson's disease

Our client was in his 90s, diabetic, severely frail, recovering from an injury to his knee and unable to turn himself in bed.  Despite these risk factors he received inadequate initial assessment and checking of his pressure areas, delays in diagnosis and preventative equipment, and mistakes in his care which led to the development of a grade 4 pressure sore.

Permanent injury and care needs arising from development of pressure sore

As a result of his pressure sore injury, his mobility and independence are permanently impaired. He can now only walk short distances. He needs help with personal care and assistance with household activities, such as cooking, shopping and cleaning.

Full admission of liability and settlement achieved – no court proceedings needed

After investigating our client’s treatment, based on his own recollections, the medical records and the hospital’s own investigation (SUI) report, we sent a detailed letter of claim to the hospital. The NHS defence body, NHS Resolution, responded admitting full liability (breach of duty and causation) for our client’s injury. After working with our medical expert and our client to understand the full impact of his condition and future prognosis and his additional needs arising from his pressure sore injury, we negotiated a £70,000 settlement of the claim without the need for court proceedings.

If you have suffered serious permanent injury as a result of medical negligence and would like to find out more about making a claim, contact us by email at