Cases You May Review as Nurse Expert: Bedsores & Pressure Sores

Do you wonder about the types of cases you will be asked to review as a Nurse Expert? 

Unless you focus on one specific area, you will likely be asked to review a variety of cases as a Nurse Expert. This is where your nursing expertise, education, training, and clinical skills will be used. 

Whenever I receive a call from an attorney or even, at times, from a family member and I am asked for help to review medical records, several points, and questions come to mind for me to ask. 

What are the specific issues and concerns? Do they think abuse and neglect may have occurred?  

Often there is a time limit that comes into play, and you need to consider whether you have the time to conduct a review within the given time frame. 

But most importantly, you must consider whether the case is in your area of nursing expertise. And if it is a clinical area you are not experienced in, you must say so upfront so there will not be a misunderstanding.  

One area of case review that occurs far too often is pressure sores, also called bedsores or pressure injuries.  

These sores are NOT a normal part of aging.  Frequently, these can be found, as I call it, “where the sun does not shine.”   

Often, the sores are in an area that is private, and the nursing home resident, your loved one, would be embarrassed to show them to a family member or to anyone.  

And once these sores have been found, either by a family member or a friend, they must be treated because, if left untreated, they can be deadly. 

In a nursing home, also called long-term care, rehabilitation center, or extended care center, these pressure sores are what is called a “never event.” This means they should not occur in the facility, and if they do, these wounds must be treated at once. 

Many names are used for sores that can develop over a bony pressure area, such as the buttock, hip, heel, shoulder, elbow, leg, and back of the head.  

These ulcers tend to be very painful. They cause misery, suffering, and infection. They reduce the quality of life and may even result in early death. 

We hear about these “bedsores,” and it is difficult at times to even look at them when visiting our loved ones in the nursing home.  But pictures are important and helpful to a case.  

It is often wondered, what do I do if the family finds a bedsore or if someone died from an infection of a bedsore? And certainly, none of this should ever be overlooked in the review.  

This is where a nurse expert comes in to review a case because the family has reached out to an attorney for help. The attorney will send the medical records to the nurse expert for review and to establish whether there is merit in the case. 

The nurse puts her skills to work, reviews the deviations of the nursing standard of care, and reports any failures to the attorney.  References to specific regulations, both federal and state, are often necessary and included. 

Each state can be slightly different, and each case can be different. However, the nursing skills a reviewing nurse will use are the same.   

The nurse expert will use her clinical skills to help the attorney move forward on the cases received. 

The image above is from a Florida case. 

But sadly, there are cases in every state, and these situations occur far too often. 

In every case review, the nurse expert working with the attorney is an asset to review, organize, and discuss the deviations in the nursing standard of care.   

Remember, these pressure sores, bedsores, and pressure injuries are a “Never Event” in a facility and should have never happened! 

Lastly, here is an example of a case filed and settled; it shows you just how much such a case is actually worth.