DuroDerm and Nursing Home Lawsuits

Our lawyers see a lot of pressure sore ulcer cases.  These bedsores come in many shapes, locations and sizes based in part on their etiology.

What Is DuoDerm?

There are a number of dressings and treatment options available. DuoDERM, a hydrocolloid, is an occlusive gel dressing that helps maintain a moist wound bed. The idea is to reduce the amount of skin breakdown that is inevitable as a result of friction that comes with life such as putting on clothes, brushing up against bedsheets, etc.

The hydrocolloid in DuoDERM helps provide absorbency and a “moist gel-like environment” that helps promote moisture to rehydrate, soften, and liquefy the tissue. On contact with the wound drainage, the hydrocolloid matrix forms a cohesive gel that supports moist wound healing.

Exudate, a thick fluid or drainage that leaks from the capillaries into the wound, is part of the normal inflammatory process. However, when the wounds healing process has been delayed or produces excessive drainage, it can be detrimental to the healing process.

The goal with any wound dressing is to remove excess fluid to maintain a healthy yet moist wound. This allows for the exchange of gasses, the ability to insulate the wound and protect the wound from outside contaminants that can be infectious. When changing the dressing, you want to have as little trauma involved as possible. The goal treating a bedsore wound is to maintain a clean and covered area.

Drainage Is Key

Hydrocolloid dressings such as DuoDERM work best with a wound that has a mild to moderate amount of drainage. DuoDERM dressings are impermeable to water oxygen and bacteria. DuoDERM dressings are popular because they rarely stick to the wound itself and can be removed without tearing the tissue underneath. Unlike other dressings, it can be placed on wet wounds and wet surrounding skin and will remain in place.

DuoDERM patches need to be changed regularly. The patches are meant to be used as pressure prevention. If they left on too long, they can, paradoxically, produce bed sores.

Why Is DuoDERM Used to Treat Bedsores?

DuoDERM is used to treat bedsores because it has the ability to not stick to the wound and be taken off without injuring the skin. A DuoDERM dressing can be used on all types of bedsores. Because a DuoDERM patch can create a moisture barrier, it is important to always make sure that the bedsores are not infected. Otherwise, a DuoDERM dressing could exaggerate the problem. As long as the infection is not present, a DuoDERM patch will normally cause a wound to begin smelling strongly after a couple of days without any cause for concern.

What Are the Side Effects of DuoDERM?

The mistake nursing homes make with a DuoDERM patch is they don’t bother to change it frequently. This can exacerbate a bedsore wound. You also need, as you will see below, to make sure the patient is not allergic to DuoDerm.

What Are Example Stories of Use of DuoDERM in Nursing Home Lawsuits?

These are not cases where DuoDerm caused a pressure sore. We don’t see nursing home lawsuits that center around DuoDerm. But these lawsuits tell stories that are sometimes instructive to understand that the failure to treat a bedsore, which can include not using a dressing like DuoDerm, can lead to gave injuries and death.

• 2015, Mississippi: $173,306 Verdict. A 95-year-old nursing home resident died from osteomyelitis caused by an infected stage IV bedsore. Her estate alleged that both the nursing home and treating hospital provided improper treatment. They claimed that the nursing home staff failed to conduct a comprehensive wound assessment after they discovered a stage II bedsore around her coccyx. Instead, her treating physician ordered its cleaning and the application of DuoDERM. However, he did not require the staff to periodically reposition her. Within three weeks, her bedsore developed into stage IV and became necrotic. She also experienced incontinence was thought to have been caused by a urinary tract infection. The physician used a Foley catheter to treat her incontinence. Three days later, she was admitted to the University of Mississippi Medical Center. The hospital staff discovered an infected stage IV bedsore, prerenal azotemia, and dehydration. They gave her antibiotics for the urinary tract infection but did not give topical antibiotics for her wound. The staff also performed a vacuum-assisted closure on her. These treatments were unsuccessful, and her condition worsened. She was transferred to another hospital for hospice treatment. The woman died there less than a month later. Her estate’s nursing expert testified that the nursing home staff should have performed a comprehensive wound assessment and periodically rotated her. Their internal medicine expert testified that the staff should have used topical antibiotics and prevented the application of pressure on the wound. After a bench trial, the judge awarded a $173,306 verdict.
• 2012, Pennsylvania: $300,000 Verdict. A 71-year-old nursing home resident’s estate alleged that the facility staff failed to treat her bedsores. She had been readmitted to the facility after being hospitalized for a fever. Her estate alleged that she developed multiple bedsores shortly after being readmitted. About three weeks later, she was transferred to the hospital. Its staff diagnosed her with chronic respiratory failure, sepsis, and stage III-IV bedsore. Three days later, she underwent surgical debridement. The woman died two years later from unrelated causes. Her son sued the nursing home for negligence. He alleged that they failed to keep records on her wounds, failed to properly heal them, and failed to reduce her infection risk. The defense counsel argued that the woman developed her bedsores at the hospital, not at the nursing home. Their experts also argued that the facility’s staff provided appropriate treatment. This included ointment application, DuoDERM application, the insertion of a Foley Catheter, and the placement of a specialty mattress. The jury found that the facility’s negligence caused her bedsores and awarded the estate $300,000.
• 1999, Texas: $5,000,000 Settlement. A 70-something woman alleged that she developed significant bedsores and lost over 20 pounds during her 30-day stay at a nursing home. After 30 days, she was transferred to a hospital, where she stayed for three months. Its staff found that she was dehydrated and malnourished. They also discovered that her stage IV coccyx bedsore reached her bone and necessitated multiple debridement procedures. By the time they discharged her, she was sufficiently hydrated, sufficiently nourished, and had a cleaned bedsore that was granulating. She then spent time in two separate nursing homes, where she developed stage III and stage IV bedsores. However, a few years later, her bedsores fully healed, and she was well-nourished. She sued the nursing home, alleging that her 30-day stay at the facility resulted in her bedsores. The woman alleged that they neglected to reposition her, properly hydrate her, properly feed her, and protect her skin from being exposed to fecal matter and urine. The nursing home denied liability, claiming that her pre-existing conditions caused her injuries. They also claimed that she and her family failed to notify that she was allergic to DuoDERM, which caused her bedsore to significantly deteriorate. This case settled for $5,000,000.