Legal aspects related to pressure ulcers
Soldevilla Agreda J.J., Navarro Rodríguez S.

SUMMARY

   Over the past few years, Spain has been experiencing a significant increase in questionable health care practices.

   During the long process which aims to dismiss pressure ulcer (PU) as a banal, especially inevitable process due to being closely related to old age and terminal illness, it is becoming apparent that patients and their families are now reacting, complaining and suing for lack of prevention or inadequate treatment, something that has already been happening for years in other countries with similar cultural and economic characteristics.

   A revision on the impact and the way the pressure ulcer issue is being legally dealt with in our surrounding countries (United Kingdom, United States, Germany...) from the point of view of penal law, civil law or through disciplinary procedures, has made a very noticeable difference in the way professionals, institutions and people behave with regards to this subject.

   With an entirely instructive purpose, the legal configuration of our country’s health care practice is described, as well as the types of liability and procedures which may be applicable to this process, including some specific considerations, such as PU as a biomarker for elder abuse and neglect, the protocol for the prevention and treatment of PU as the center’s responsibility, liability for the lack of adequate material for the prevention and treatment of PU, informed consent previous to applying a technique, medical history and specific PU records including photographs, PU as cause of hospital admission, and discharge of patients with PU.

   The current issue of nurse prescribing in the field of PU care and other chronic wounds is considered as a ‘deeply-rooted, allowed and applauded practice for years’ in Spain.

   Finally, details and discussions on judicial pronouncements of cases related to such wounds in the last few years allow us to conclude that, despite the increase in the number of sentences related to PU, the number that represents the sentences which were categorically pronounced as cause of PU due to care deficiency, negligence or malpractice is only symbolic, and the small sentences and indemnity payments are particularly striking. Perhaps the same old spirit of devaluation of these wounds, which is present in the professional environment and society in general, has moved into the judiciary, particularly into experts and/or forensic surgeons, unable to estimate the real dimension of the problem (loss of health and quality of life) and the fatal consequences of PU (including death), also forgetting that they are predictable in almost every situation.

KEY WORDS

    Pressure ulcers, legal repercussions, legal implications.

Vol. 17 nº4-2006