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November 7th 2019

Hospital Negligence

Patient developed ‘full thickness skin loss’ pressure sores due to hospital’s failures and poor nutritional support

Samantha Gardner

Samantha Gardner

Solicitor, Clinical Negligence

Patient developed ‘full thickness skin loss’ pressure sores due to hospital’s failures and poor nutritional support

A 53-year-old man who developed ‘significant’ pressure sores whilst an inpatient at Hull Royal Infirmary has been awarded £22,500 damages following legal representation from Hudgell Solicitors.

A 53-year-old man who developed ‘significant’ pressure sores whilst an inpatient at Hull Royal Infirmary has been awarded £22,500 damages following legal representation from Hudgell Solicitors.

It comes after Hull and East Yorkshire Hospitals NHS Trust (now Hull University Teaching Hospitals NHS Trust) admitted failing to take appropriate measures to prevent sores developing after he’d undergone lengthy spinal surgery.

The Trust also admitted that poor nutritional care of the patient was a contributory factor in his sores developing, also slowing his speed of recovery and delaying the start of his rehabilitation.

The man, who has asked not to named, agreed to share details of his case to raise awareness around post-surgery care. He had spent time in the Intensive Care Unit of the hospital having undergone spinal surgery in Hull in February 2016 and developed sudden numbness and weakness in his legs.

The patient had been transferred to Hull two days after he’d had part of his colon removed at another hospital, after suffering abdominal pains.

However, despite his lack of mobility post operation – and being an obvious high risk of developing sores as a result – no special measures were initially put in place.

Action was only taken when staff noticed a red sore area had developed at the bottom of his back, 12 days after his operation. He was then seen by the Tissue Viability Nurse and a special mattress was provided.

These measures proved too late to prevent the sore developing to a ‘Grade 3’ pressure ulcer – classed as being ‘full thickness skin loss.’

Lack of consideration to prevent sores ‘unforgiveable’

As part of a medical negligence claim against the Trust, led by Hudgell Solicitors, it was alleged staff had also failed to manage the patient’s nutritional care post operation, leading to him being ‘left without nutrition for nine days’.

Sam Gardner, of the medical negligence team at Hudgell Solicitors, said this would have, on the balance of probabilities, contributed on to the development of his pressure ulcer, adding that he should have been provided with a special mattress as soon as he came out of intensive care.

She also criticised the use of the Waterlow scores test to assess the risk of developing pressure sores, saying results were ‘woefully poor, inaccurate and varying’.

She said: “There were clear failings in care in this case as a pressure relieving mattress should have been provided for this patient much sooner.

“The expected level of care and treatment, especially within a critical care or high dependency environment, would be that a patient who had undergone lengthy spinal surgery, and therefore experienced sensory loss in that area, would automatically be considered at a very high risk of developing pressure sores.

“Given he’d recently undergone emergency major abdominal surgery, it is unforgiveable that preventing such sores developing was not a major consideration.

“In cases such as this, there is a duty on the health care provider to take appropriate measures to avoid pressure sores by changing the patient’s position often, by using protective mattresses, cushions or limb protectors and by ensuring they drink plenty of water and eat regular meals.

“This did not happen. They should also be advising patients of the significant risk they can put themselves at by not complying with positional changes, which didn’t happen in this case either.

“There was also a failure to refer our client to a dietician for a period of nine days to address his nutritional needs, and to start intravenous nutrition.

“This was a case where some of the most basic elements of hospital care were not provided. It is something we see far too often and is completely unacceptable.

“Pressure sores can be hugely painful and long-lasting. The fact is though that the vast majority are avoidable with appropriate care.”

Trust ‘truly sorry’ for failures in pressure area prevention and nutritional support

In admitting breaching its duty of care, NHS Resolution, acting on behalf of the Trust, said: “It is agreed the claimant did not receive the service that he was entitled to and for this the Trust is truly sorry.

“It is agreed that the claimant developed a grade 3 pressure ulcer due to failures in pressure area prevention and nutritional support leading to a delay in recovery.”

The Trust also admitted that due to its errors the patient had further suffered in that his transfer to the specialist Yorkshire Regional Spinal Injuries Centre for on-going care and rehabilitation, at Pinderfields Hospital, was delayed.

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