Kennedy’s terminal ulcer and pressure injury: two different aspects of medical liability related to the same injury

Submitted: April 26, 2023
Accepted: June 9, 2023
Published: July 25, 2023
Abstract Views: 562
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PDF (Italiano): 249
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Recent case law shows disadvantageous legal disputes with a major defeat due to negligence in treating pressure ulcers, even when they are wrongly-diagnosed terminal lesions, such as Kennedy’s terminal ulcer, and, therefore, untreatable illnesses that do not imply medical liability. The authors examine both the recent case law, based on deaths that occurred in the last 15 years, and linked, even partially, to pressure injury, and medical records, underlining the differences between these two injuries and focusing on the possible forms of medical liability and current judicial trends.

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Citations

Ayello EA, Jeffrey ML, Diane L, et al. Reexamining the literature on terminal ulcers, SCALE, skin failure, and unavoidable pressure injuries. Adv Skin Wound Care 2019;32:109-21. DOI: https://doi.org/10.1097/01.ASW.0000553112.55505.5f
Alvarez OM, Brindle CT, Langemo K, et al. The VCU Pressure Ulcer Summit. The search for a clearer understanding and more precise clinical definition of the unavoidable pressure injury. J Wound Ostomy Continence Nurs 2016;43:1-9. DOI: https://doi.org/10.1097/WON.0000000000000276
Sibbald RG, Krasner DL, Lutz J. SCALE: Skin Changes at Life’s End: final consensus statement: October 1, 2009. Adv Skin Wound Care 2010;23:225–36. DOI: https://doi.org/10.1097/01.ASW.0000363537.75328.36
Krasner DL, Stewart TP. SCALE wounds: unavoidable pressure injury. Wounds 2015;27:92–4
Milne CT, Corbett LQ, Bubuc DL, eds. Wound, ostomy, and continence nursing secrets. Philadelphia, PA: Hanley & Belfus Inc; 2003: p. 198-9.
Gardner WJ. Prevention and treatment of bedsores; an air mattress accomplishing alternation of pressure points. J Am Med Assoc 1948;138:583. DOI: https://doi.org/10.1001/jama.1948.62900080001008
Zang K, Chen B, Wang M, et al. The effect of early mobilization in critically ill patients: A meta-analysis. Nurs Crit Care 2020;25:360-7. DOI: https://doi.org/10.1111/nicc.12455
Alderden JG, Shibily F, Cowan L. Best Practice in Pressure Injury Prevention Among Critical Care Patients. Crit Care Nurs Clin North Am. 2020 Dec;32(4):489-500. doi: 10.1016/j.cnc.2020.08.001. DOI: https://doi.org/10.1016/j.cnc.2020.08.001
EPUAP, NPUAP, PPPIA. Prevention and Treatment of Pressure Ulcers. Clinical Practice Guideline. The intrnational guideline ed. 2019
Langemo DK. The hot seat: the reality of skin failure. 18th Annual Clinical Symposium on Advances in Skin & Wound Care. Chicago, IL 2003.
Sibbald RG, Krasner DL, Lutz. J. SCALE: Skin Changes at Life's End: Final Consensus Statement: October 1, 2009. Adv Skin Wound Care. 2010 May;23(5):225-36. DOI: https://doi.org/10.1097/01.ASW.0000363537.75328.36
Kennedy KL. The prevalence of pressure ulcers in an intermediate care facility. Decubitus 1989;2:44-5.
Ayello EA, Levine JM, Langemo D, et al. Reexamining the Literature on Terminal Ulcers, SCALE, Skin Failure, and Unavoidable Pressure Injuries. Adv Skin Wound Care 2019;32:109-21. DOI: https://doi.org/10.1097/01.ASW.0000553112.55505.5f
Hanson D, Langemo DK, Olson B, et al. The prevalence and incidence of pressure ulcers in the hospice setting: analysis of two methodologies. Am J Hosp Palliat Care 1991;8:18-22 DOI: https://doi.org/10.1177/104990919100800506
Langemo DK, Brown G. Skin fails too: acute, chronic, and end-stage skin failure. Adv Skin Wound Care 2006;19:206-11. DOI: https://doi.org/10.1097/00129334-200605000-00014
Schank JE. Kennedy terminal ulcer: the "ah-ha!" moment and diagnosis. Ostomy Wound Manage 2009;55:40-4.
Codice di Procedura Penale, art. 533.
Taylor JS. Malpractice implications of pressure ulcers. Adv Wound Care 1994;7:43-4, 46, 48-9.
Hastings KE. Legal aspects of the pressure ulcer guidelines. Decubitus 1991;4:36-8.
Meehan M, Hill WM. Pressure ulcers in nursing homes: does negligence litigation exceed available evidence? Ostomy Wound Manage 2002;48:46-54.
Anders J, Heinemann A, Leffmann C, et al. Decubitus ulcers: pathophysiology and primary prevention. Dtsch Arztebl Int 2010;107:371-81; quiz 382. DOI: https://doi.org/10.3238/arztebl.2010.0371
Hastings KE. Legal aspects of the pressure ulcer guidelines. Decubitus 1991;4:36-8.
Edsberg LE, Langemo D, Baharestani MM, et al. Unavoidable pressure ulcer injury: state of the science and consensus outcomes. J Wound Ostomy Continence Nurs 2014;41:313-34 . DOI: https://doi.org/10.1097/WON.0000000000000050
Gibelli F, Bailo P, Sirignano A, Ricci G. Pressure ulcers from the medico-legal perspective: A case report and literature review. Healthcare 2022;10:1426. DOI: https://doi.org/10.3390/healthcare10081426
Brown AM. Clinical negligence claims for pressure injuries from the perspective of a tissue viability medico-legal nurse expert. Br J Community Nurs 2022;27:S14-S20. DOI: https://doi.org/10.12968/bjcn.2022.27.Sup9.S14
Pascall E, Trehane SJ, Georgiou A, Cook TM. Litigation associated with intensive care unit treatment in England: an analysis of NHSLA data 1995-2012. Br J Anaesth 2015;115:601-7. DOI: https://doi.org/10.1093/bja/aev285
Cass. pen. Sez. II, Sent., (ud. 06/12/2012) 08-03-2013, n. 10994.
Cass. civ. Sez. III, Ord., (ud. 18/05/2018) 27-09-2018, n. 23164.
Cass. civ. Sez. III, Ord., (ud. 26/09/2019) 08-11-2019, n. 28823. DOI: https://doi.org/10.4236/opj.2019.98B004

How to Cite

Garcea, R., & Savelli, P. (2023). Kennedy’s terminal ulcer and pressure injury: two different aspects of medical liability related to the same injury. Italian Journal of Wound Care, 7(2). https://doi.org/10.4081/ijwc.2023.101