Settlement achieved in case involving a Grade 4 pressure sore suffered in Folkestone care home

27th May 2022 – Our Client, Mr C, from Maidstone, Kent came to us following the death of his wife, Mrs C, in March 2019. Mrs C was diagnosed in early 1995, at the age of 27, with a severe form of Multiple Sclerosis (MS). Her MS progressed at an unusually fast pace and by 2000 she was immobile and wheelchair-bound. She lived with her family until 2012, when her MS had progressed to such an extent that she could not be properly cared for at home. At that point she was transferred to Tristford Care Home (TCH), Folkestone for residential care.

By September 2016, Mrs C was assessed as lacking capacity to manage or make decisions relating to her property and finances.

By December 2016, she was extremely disabled, with no functional use of her limbs. She suffered from Type 2 Diabetes and was also significantly cognitively impaired. She was fully dependent on staff at TCH for all her self-care, including feeding.

Mrs C was at very high risk of pressure ulcer development given her MS, immobility, reduced or lost sensation in her limbs, and her Type 2 Diabetes. She used an Azalea manual wheelchair and a Solar dynamic air mattress with a permaflow active pump.

On 1 December 2016, Mrs C attended the King’s College Hospital (KCH) London Neurology Department – a 90 minute journey from TCH – for a top up of her Baclofen pump. There was no plan for how to prevent or reduce the risk of pressure injury during the trip. She was not regularly repositioned nor were her pressure areas checked. Mrs C developed a sacral pressure ulcer either as a result of unrelieved pressure, or damage from the wheelchair mechanism, during the course of her visit to KCH that day.

The following day it was documented that she had a crease on the left side of her bottom / on her leg, and that her skin was slightly broken. By 19 December 2016 her bottom was sore and split and bed rest was recommended. On 30 December 2016 the sore was 0.8cm x 0.8cm. Care home staff treated it with dressings and cream up until that point.

On 5 January 2017 the District Nurses attending on Mrs C found a Grade 4 pressure ulcer. By 20 January 2017 they were visiting twice weekly to replace the dressing on her sacrum. On 18 March 2017 the pressure ulcer was necrotic and malodorous. At wound assessment on 30 March 2017 the sore was 4cm long x 3cm wide x 4mm deep. On 18 April 2017 Mrs C suffered a seizure. She was taken to the William Harvey Hospital (WHH) Ashford where she was diagnosed with osteomyelitis (a infection in the bone under the sore) and her pressure sore was debrided. It was not until this admission that she was reviewed by a Tissue Viability Nurse. She returned to TCH on 22 May 2017 but suffered a further seizure and was transferred back to WHH on 27 May 2017. She was moved to Barty House Nursing Home in Maidstone on 27 June 2017. The pressure sore remained, did not heal and on 9 September 2018 was 4cm x 4cm x 5cm deep. Mrs C died on 2 October 2018.

Following our instruction medical records were sought and collated, expert nursing evidence was obtained and a full Letter of Claim was drafted and sent to both the owners of Tristford Care Home and Kent Community NHS Foundation Trust, (KCT), the Trust responsible for the District Nurses.

Our nursing expert advised that both TCH staff and the District Nurses breached their duty of care to Mrs C in various ways including the failure of care home staff to prevent the pressure sore developing during the trip to KCH, the failure to undertake essential risk assessments and have a suitable care plan in place to treat and prevent deterioration of the sore, not ensuring regular repositioning and skin inspections and failure to refer to Tissue Viability Nurses within a suitable period.

But for these breaches of duty Mrs C would not have sustained the Grade 4 sacral ulcer requiring debridement and severe osteomyelitis which persisted until her death. Although the pressure sore weakened Mrs C neurological expert evidence determined that Mrs C would likely have died at the time she did due to her multiple sclerosis in any event.

Both Defendants refused to admit their own liability in this matter each claiming that the actions of their staff were not negligent and attributing the failings in care to the other Defendant. Due to the matter not progressing pre-action, proceedings had to be issued. A joint offer of settlement was then made by both the Defendants, following which the parties engaged in settlement negotiations and the case was brought to a conclusion.

Francesca Beach, Assistant Solicitor at Fairweathers who had conduct of the case, commented: “It has taken a long time for this family to get the closure they wanted from this case due to the refusal of both Defendants to acknowledge their own failings and attempts to blame each other for very poor pressure sore care. Mrs C’s final months of life were marred by the severe sacral pressure sore and consequential variety of invasive treatments all of which could have been avoided had adequate thought been given in advance as to how to safely care for her. Pressure sores are entirely preventable in a properly operated care, community or hospital environment.’’

If you or your family need the assistance of an experienced team of Clinical Negligence Solicitors surrounding an inquest or civil claim then please do not hesitate to phone us free on 0800 999 5585, request a call back or submit your case details.