Wound care has increasingly been recognized as a specialty in recent years, coinciding with the rise in the number of elderly persons living with chronic conditions, such as diabetes and heart disease, that increase the risk of development of wounds, both acute and chronic. As our knowledge and ability to better treat acute and chronic wounds has increased, so too has our legal obligation to both prevent wounds and treat them properly when they occur. Malpractice lawsuits due to improper wound care are not uncommon, thus it is every medical professional’s responsibility to ensure that wounds are treated according to best practice.
Malpractice lawsuits may result from the development of ulcers that should never have developed. The term “never event” refers to medical errors that should never occur; this term was coined in 2001 by the CEO of the National Quality Forum. Today there are six groups containing 29 events. Under the Care Management heading are any stage lll, stage lV or unstageable pressure ulcers that present after admission to a health care facility (AHRQ, 2016). As an event that should never occur, the development of a pressure ulcer leads to increase health care costs and prolonged hospitalizations, not to mention the pain and suffering endured by the patient. As such, the development of pressure ulcers, which are seen as preventable in most circumstances, can render individuals and institutions at risk of being named in a malpractice suit.
Lack of Knowledge and Training
There are many ways in which wounds can be improperly cared for, leading to malpractice lawsuits. Health care workers who lack knowledge and/or training may fail to recognize the developing ulcer, may fail to recognize when a wound is getting worse rather than improving or may fail to identify the type of wound, thus applying the incorrect dressing or treatment. Such errors can lead to infection, loss of limb and even death in some cases. Facilities such as nursing homes, where there are typically more health care aids than licensed personnel such as registered nurses, are particularly vulnerable. Allegations regarding skin and wound care are the second-leading cause of malpractice suits in nursing homes (Chizek, 2003).
Another problem that can increase the risk of malpractice suits is that of improper documentation. In some cases, although the proper treatments have been instituted, proper documentation of wound healing has resulted in a malpractice suit.
Another issue of concern is that individuals who are not properly trained in wound care may not understand the necessary wound-related documentation required for patients during their treatment. As a result of incorrect documentation, lawsuits often find against the facility, due to the appearance of incompetence, even if appropriate procedures were followed (Fowler, 2010; Fife & Yankowsky, 2013).
As can be seen, practitioners must keep up to date concerning wound care education. This is challenging, considering the wound care field has grown exponentially in recent years, with new products and procedures gaining favor and much research into wound care practices being performed. Wound care certification is one way to decrease the risk of a malpractice suit. Becoming a certified wound care specialist can not only make you a more valuable employee, but can protect you from potential legal problems stemming from improper wound care.
Never Events. The Agency for Healthcare Research and Quality. 2016. https://psnet.ahrq.gov/primers/primer/3/never-events
Chizek M. Wound Care and Lawsuits. Advance Healthcare Network for Nurses, 2003;5(7):31.
Fowler E. (2010). Deposed: A Personal Perspective, Legal Issues in the Care of Pressure Ulcer Patients: Key Concepts for Healthcare Providers, Medline.
Fife CE, Yankowsky K. Avoiding Legal Pitfalls for Home Health Services in Wound Care. Today’s Wound Clinic 2013;7(4).