Bed Sores

Bed sores, also known as pressure sores or decubitus ulcers, are often caused by negligence at nursing care facilities, rehabilitation facilities, or hospitals.

How do Bed Sores Happen?

Bed sores are caused by:

  • Pressure: Prolonged pressure on a certain area of the body will decrease blood flow causing loss of oxygen and death to underlying tissue.  
  • Shearing: Shearing is when the body moves in an opposite direction as the bed or wheelchair. That force creates friction and breakdown of the skin leading to a skin ulcer. 
  • Friction:  Friction occurs when a medical device, sheet, or tight clothing rubs against the skin causing a bed sore or ulcer.

Four Stages of Bedsores

Bedsores are “graded” or “staged” based on their severity:

Stage 1
There is a persistent area of red skin that may itch, cause pain, and/or feel warm to the touch.
Stage 1 wounds are superficial and go away shortly after the pressure is relieved.
Stage 2
There is skin loss at the outermost layer of skin or the skin’s deeper underlying tissue layer, or both.  
Stage 2 wounds are an open sore that looks like a blister surrounded by red or purple discoloration. 
Stage 3
The pressure ulcer extends through all the skin layers down to the muscle, damaging or destroying the affected tissue and creating a deep, crater-like wound.
Stage 4
This is the most serious and advanced stage of pressure ulcers where large-scale loss of skin occurs, with damage to the underlying muscle, bone, and tissue.

Stage 4 bedsores are extremely difficult to heal and can lead to lethal infections commonly identified as sepsis, even with aggressive treatment.   

Stage 4 bedsores typically develop on:

  • Tailbone, hips, or buttocks
  • Shoulder blades and spine
  • Heels
  • Back of the head or ears


  • The facility did not conduct an initial assessment for skin breakdown.
  • The facility did not devise a plan to detect, prevent, and treat the ulcer, bedsores, or wounds.
  • The hospital did not follow its own plan of care.
  • The patient developed the bedsores while at the facility or the sores got worse.
  • The facility did not follow the doctor’s instructions or failed to coordinate with the proper medical personnel.
  • The facility did not properly or frequently rotate the patient in order to prevent bedsores from emerging.