Pressure Injury
Pressure injury cases, involving decubitus ulcers at various stages of severity, are among the most common claims in long-term care and hospital-based litigation. These cases allege that healthcare providers failed to prevent, properly stage, or adequately treat pressure injuries, resulting in pain, infection, prolonged hospitalization, sepsis, or death. Expert testimony is essential because pressure injury prevention is governed by well-established, evidence-based protocols that define specific interventions required for at-risk patients, and deviation from these protocols is readily demonstrable through medical records. The progression from intact skin to a Stage IV or unstageable wound reflects a timeline of failed care that experts can reconstruct with precision.
Medical and nursing experts in pressure injury cases evaluate whether the facility identified the patient as at-risk using validated assessment tools, whether prevention protocols were implemented and documented, and whether treatment of existing wounds followed accepted standards. A wound care expert assesses whether the pressure injury was accurately staged using the National Pressure Injury Advisory Panel classification system, whether appropriate wound care products and modalities were used, and whether the wound progressed due to inadequate treatment. A nursing expert evaluates whether turning and repositioning schedules were maintained, whether pressure-redistributing support surfaces were provided, and whether nutritional assessments and interventions were conducted. A physician expert evaluates the medical management of wound-related complications including infection, osteomyelitis, and sepsis, and determines whether the pressure injury contributed to the patient's morbidity or death.
Wound care specialists with certification from the Wound, Ostomy and Continence Nursing Certification Board evaluate prevention protocols, staging accuracy, and treatment adequacy. Geriatric medicine experts assess the overall medical management of elderly patients at risk for pressure injuries. Nursing experts with long-term care or acute care experience evaluate turning schedules, documentation practices, and staffing adequacy. Plastic surgery experts assess the need for surgical wound management including flap procedures for advanced pressure injuries. Infectious disease experts evaluate wound infection management and the relationship between pressure injuries and sepsis. Nutritionists assess whether nutritional support was adequate to promote wound healing.
Pressure injury experts must demonstrate that their opinions are based on established standards from the National Pressure Injury Advisory Panel, CMS regulatory requirements, and published clinical practice guidelines for pressure injury prevention and treatment. The expert must show that the facility had notice of the patient's risk through admission assessment tools such as the Braden Scale and that specific, required interventions were either not implemented or not documented. Under Daubert, the expert must connect the failure to prevent or treat to the patient's specific injury using the clinical timeline documented in the medical record.
Tell us about your case and we will match you with a qualified expert within 48 hours.