Maryland Bedsores Lawyer

Bedsores are a form of localized skin damage that develop from prolonged unrelieved pressure to the skin. This pressure prevents blood from traveling into the compressed area of skin between the bone and an external surface, such as a wheelchair or bed. Without intervention, bedsores can develop on the skin after as little as 12 hours of nutrient and oxygen deprivation.

Without treatment, bedsores can lead to various health problems on areas of the body that have low levels of muscle and fat. The most common cause of bedsores is nursing home neglect. For this reason, bedsores are a serious health concern that have been a problem in Maryland nursing homes for decades.

Understanding how to assess bedsores is important for the treatment process. If you or a loved one is experiencing bedsores, it is important to seek help from a medical professional as soon as possible. If you believe that the bedsores are the result of nursing home neglect, you should also contact an experienced Maryland bedsores lawyer. An experienced nursing home abuse attorney could discuss your legal options for receiving compensation.

Signs of Neglect

It is important for nursing home residents and their loved ones to keep watch for signs of nursing home neglect. By catching signs prior to the development of bedsores, individuals can address the neglect and minimize potential damages.

The most common signs of neglect are:

  • Inattention to repositioning and posture
  • Dehydration
  • Malnutrition
  • Incontinence
  • Increase or decrease in skin moisture

Assessing Bedsores and Stages

To properly assess bedsores, it is important to understand how they progress in severity over time. Bedsores are divided into five stages, from stage one (least severe) to stage four (the most severe). Proper assessment requires an understanding of each stage and its representative symptoms, which are outlined by the National Pressure Ulcer Advisory Panel (NPUAP).

Stage One

The first stage is defined by red skin around affected areas of the skin. Although the skin is still intact during this stage, affected areas are usually painful. For people with darker complexion, the skin’s color change will likely appear blue or be unnoticeable. However, individuals with lighter skin complexion will notice redness.

Stage Two

During stage two, bedsores develop into open wounds that take on a crater-like appearance. In addition, the fat in proximity to the infected regions of the skin often become exposed. In terms of appearance, bedsores at this stage are pink in color and resemble a blister filled with fluid.

Although deep tissue damage is not common during stage two, it can be identified by bruising in cases where it is present.

Stage Three

After progressing to the third stage, bedsores are officially classified as deep wounds. They take on a crater-like appearance and cause damage that extends beyond infected regions of skin and into unaffected skin layers. In some cases, they are attached to yellow dead tissue, also known as slough.

Other characteristics of this stage include:

  • Subcutaneous fat visibility
  • Tunneling
  • Undermining

Stage Four

The final stage of bedsores is the most extreme. During this time, the sores have advanced far enough that the tendons, muscles, and bones might be exposed. In addition, the bottom region of the sore is sometimes attached to slough.

In some cases, stage four bedsores can cause osteomyelitis, which is a rare bone infection caused by mycobacteria, fungi, or bacteria. Symptoms of osteomyelitis include:

  • Warmth, redness, and tenderness around infected region
  • Swelling around affected bone
  • Decreased range of motion
  • Nausea
  • Fever, fatigue, irritability

If your loved one is experiencing any of the four stages of bedsores, it is important to speak with a dedicated Maryland bedsore attorney as soon as possible.

Settings That Encourage Bedsores

Since bedsores are caused by constant unrelieved pressure, any setting where individuals sit or lie for extended periods of time can promote bedsore development. The two most common locations for bedsore development are nursing homes and hospitals.

In addition to excessive pressure, bedsores can develop from friction and shear force. Friction is the force generated from two surfaces rubbing together, such as a person’s skin and a chair. Shear refers to the gravitational force that pushes down onto a patient’s body. This force is a product of the resistance that exists between the patient’s body and a bed or chair.

Both friction and shear force can promote bedsores. For example, individuals that slide in their chair often or are frequently moved from their bed to a stretcher are at high risk for bedsores due to the frequent presence of both forces. When combined with constant unrelieved pressure, the risks of these forces are amplified.

The most common risk factors for bedsores are:

  • Limited mobility
  • Malnutrition
  • Inability to reposition
  • Loss of sensation
  • Cognitive impairment

Nursing homes are common locations for all of the above risk factors. For this reason, it is important to remain vigilant in making sure that the treatment and care procedures of Maryland nursing homes address these risks.

Common Areas for Bedsore Development

When nursing home neglect is combined with the above risk factors, bedsores are more likely to develop. However, given the variation between individual nursing home experience, bedsores don’t always manifest on the same areas of the body.

For nursing home residents in wheelchairs, common areas of the body that are affected are:

  • Back of the legs and arms
  • Buttocks and tailbone
  • Spine and shoulder blades

In cases where residents are confined to a bed, the areas susceptible to developing bedsores are:

  • Outside regions of the ears
  • Side and back of the head
  • Knees, ankles, and heels
  • Lower back and hips

Complications Caused by Bedsores

Individuals with bedsores can develop additional complications, including cellulitis, osteomyelitis, sepsis, gangrene, and necrotizing fasciitis.


An acute bacterial infection of the skin, cellulitis can affect the surface layer all the way down to the deepest layer. The most common symptoms are pain, edema, warmth, and rapidly spreading erythema. In some cases, regional lymph nodes enlarge and affected individuals experience fever.


Osteomyelitis is a rare but seriously bone infection that can spread through the bloodstream into other areas of the body. As previously mentioned, it is caused by mycobacteria, fungi, or bacteria.


When the body’s soft tissue dies from oxygen starvation, gangrene develops. It is most often seen in the body’s outermost extremities, such as the feet and hands. However, any soft tissue in the body— including organs—is at risk.

Symptoms of gangrene include:

  • Redness and swelling
  • Cold, pale skin
  • Pain or loss of sensation in affected area
  • Blisters or sores that release discharge


Sepsis is a bacterial infection of the bloodstream. It can be caused by bedsores and is particularly dangerous due to the possibility of organ failure and death.

Symptoms of sepsis include difficulty breathing, fever, increased heart rate, low blood pressure, and mental confusion.

Necrotizing Fasciitis

Individuals with stage three or stage four bedsores are at risk of developing necrotizing fasciitis, which is also known as flesh eating bacteria. It is a deadly infection—people suffering from it have a mortality rate of over 70 percent. Since the later stages of bedsores are characterized by open wounds, they are more susceptible to necrotizing fasciitis.

Symptoms of this infection include:

  • Blisters, ulcers, or black spots on the skin
  • Changes in skin color
  • Pus released from infected area
  • Severe pain and swelling
  • Diarrhea
  • Vomiting

Bedsores can cause a number of complications that are extremely painful and dangerous. Speak with an experienced attorney in Maryland if your loved one is suffering from bedsores in a nursing home. Compensation may be available.

Preventing Bedsores in Maryland Nursing Homes

The most effective way of preventing bedsores is to ensure that individuals do not experience constant pressure against their body. In environments like nursing homes, this can be very difficult for elderly or disabled individuals.

For patients in wheelchairs, it is important to ensure that they receive adequate cushioning in combination with a wheelchair that is compatible with their activities, mobility, and work. Individuals in wheelchairs should always consult a therapist for a seating evaluation. Ideally, this evaluation should be conducted by applying a pressure map around the patient’s buttocks and above the cushion to determine pressure-sensitive areas.

In situations where pressure mapping is not available, individuals should ask their seating professional about trying all possible cushions. Through this process, they can determine the best one for their needs through trial and error.

Other prevention tips for patients in wheelchairs include body repositioning every 2 hours, range-of-motion exercises to improve circulation and mobility, and reducing shear forces by keeping bed elevation to 30 degrees or less.

A Maryland bedsores lawyer can discuss bedsore prevention techniques such as these and work to determine if a nursing home acted negligently in caring for your loved one.

Universal Prevention Techniques

Outside of prevention techniques specific to wheelchairs and beds, patients can benefit from foam padding, skin inspection and cleaning, a diet plan, and surgery. Each of these techniques is applicable to patients in both wheelchairs and beds in various situations. A medical professional can help affected individuals determine the right treatment plan based on their needs.

Foam Pads

Maryland nursing homes often take advantage of “egg-create” foam pads, which are high-density, lightweight pads that can help individuals redistribute their body weight more effectively. However, it’s important to understand that these products only minimally reduce pressure. Not only that, they can increase body heat retention, which can make them ineffective for bedsore prevention if they are used for long periods of time.

Skin Inspection and Cleaning

Regular inspection and cleaning is crucial to preventing bedsores. In the early stages, such as stage one, bedsores are much easier to care for and can be prevented with proper care. Cleaning should be conducted with a small amount of warm water applied with minimal friction and force. Although soap can be effective in small amounts, it can also remove the natural protective oils on the skin.

Following initial cleaning, the next best step is applying a thin layer of moisturizing lotion. As with soap application, it should be applied lightly to avoid irritating damaged skin via shearing forces.

After gently applying moisturizer, it is recommended to apply a petroleum-based product to provide a protective barrier over the skin. However, products with aluminum and zinc oxide are not recommended due to the difficulty with which they are removed.

Ultimately, the best product for bedsore prevention depends on the situation of the individual. There are many other products that can be useful for curbing bedsore growth, such as:

  • Saline dressings
  • Synthetic dressings
  • Hydrocolloid dressings
  • Acetic acid
  • Antibiotic dressing

Diet Plan

Malnutrition is a risk factor for bedsores in Maryland nursing homes and a common condition in elderly people. Without the proper nutrients, skin can breakdown and exacerbate existing risk factors for bedsores, such as friction and pressure.

Arginine in particular is a crucial amino acid for bedsore diet plans due to its role in wound healing and collagen deposition. Treatment plans should also include zinc and vitamin A supplementation.


In certain cases, individuals must undergo surgery to treat bedsores. Surgical debridement is the most common procedure and involves removing the dead tissue, fluid, and bone from the affected areas using a scalpel.

In addition, many doctors also conduct flap reconstruction to harvest tissue from healthy regions of the body and use it to cover the bedsore wound. The goal is to reduce the risk of infection by improving both the appearance and hygiene of the affected area.

Although surgery can be very effective, it has a very high complication rate. Not only that, recovery is often long and painful. For this reason, surgery is often treated as a last resort for the more serious bedsore cases that put the affected individual at risk.

Bedsore Lawsuits in Maryland

When nursing home residents do not receive adequate treatment, bedsores can develop. These injuries can lead to infection, injury, and even death. In situations like this, affected individuals and their loved ones may be able to file a lawsuit against the nursing home facilities that are deemed responsible with the help of a Maryland bedsores attorney.

A skilled attorney could fight for your loves one’s rights and compensation for physical pain, mental hardships, and financial stress.

Stage Four Bedsores Can Be Fatal

As the most severe bedsore stage, stage four affected individuals are the most at risk of death. During this stage, bedsores can cut down through the three primary layers of skin: the epidermis, dermis, and subcutaneous tissue.

After cutting through the skin, the bedsores can make their way to the bones. In some cases, they also destroy tendons, joints, and muscle.

Although the depth of the wound varies depending on the location of the sore, stage four bedsores should always be treated as a serious complication. Without proper treatment, certain stage four bedsores can lead to death.

A common surgical procedure for stage four bedsores is debridement, which involves removing the dead skin located in and around the affected area. Another common surgery for stage four bedsores is flap reconstruction, which is when surgeons use padding to cover the affected area and provide cushion for the bone.

Contact a Maryland Bedsores Attorney Today

The increased risk of developing bedsores in nursing homes should never be underestimated. Whether you or your loved one is living in an assisted living facility, it is important to be aware of the signs of neglect, the symptoms of each stage of bedsores, and the devastating effects they can have on the body.

If you or a loved one is experiencing bedsores caused by neglect or abuse in a nursing home facility, contact a dedicated Maryland bedsores lawyer as soon as possible. Speak with a legal professional to discuss your case and learn your options and rights to compensation today.