Six months after a crash on the 215 Beltway, a client with a C6 spinal cord injury develops a sore over the tailbone. It starts as a red patch that does not fade. Within weeks the skin opens, the wound reaches muscle, and a surgeon books a flap procedure. Then the adjuster calls it a new medical problem unrelated to the collision. Nevada law reads the situation differently. Courts here usually treat pressure sores as compensable harm flowing from the original injury. A paralysis case has to plead them that way from the first demand.
Skin breakdown is not a side story in a spinal cord case. It drives hospital readmissions, it stalls rehabilitation, and it can end a life the crash did not. So the claim has to capture that risk while the file is open. A closed settlement shuts the door for good.
Why Skin Breakdown Follows Paralysis
Sensation is the body’s alarm system. A person without sensation below the injury level never feels the ache that tells everyone else to shift position. Blood flow to the compressed tissue drops, and the tissue dies from the inside out. The National Institute of Neurological Disorders and Stroke describes this plainly in its overview of spinal cord injury. Pressure sores are areas of skin that have broken down from continuous pressure and reduced blood flow. People with paraplegia and tetraplegia carry that risk every day.
The same source explains the prevention routine. Position changes on a schedule, careful skin checks and specialized support surfaces all reduce the risk. None of that happens by accident. Somebody has to turn the patient, inspect the skin and order the right cushion. Once that routine slips, a wound can move from a red mark to an open crater in days.
Why Southern Nevada adds its own pressure
Summer here runs long and dry. Heat, sweat and dehydration all worsen skin integrity. A power outage in July can also leave a client without a working alternating pressure mattress. Rural distance matters too. A family in Pahrump or Mesquite drives into Las Vegas for wound care. So appointments stretch, and the gaps show up in the tissue. Those facts belong in the damages story rather than in a footnote.
The Legal Principle Behind Pressure Sores as Compensable Harm
Nevada follows the ordinary rule that a defendant answers for the harm its conduct set in motion. A wrongdoer takes the injured person as found. So the chain of liability keeps running through the foreseeable consequences of the original injury. The question in a paralysis case is not whether the crash caused the wound directly. The question is whether the wound is a foreseeable consequence of the paralysis the crash caused.
Framed that way, the answer usually comes easily. Medical literature has treated skin breakdown as a predictable complication of paralysis for decades. Every rehabilitation discharge packet in the valley warns about it. A defendant who caused a spinal cord injury cannot credibly call the most documented complication of that injury a surprise. Our overview of how spinal cord injury victims can fight for maximum compensation shows where future complications enter a damages model.
What the Defense Will Argue
The blame the patient theme
Expect an argument that the client skipped turns, refused equipment or ignored instructions. NRS 41.141 gives that argument a home. Comparative negligence reduces recovery. It bars recovery entirely when the plaintiff’s share exceeds the combined fault of the defendants. Still, the argument runs into practical trouble. A person with limited hand function cannot perform a full weight shift alone. A client without funded attendant care cannot hire the help the discharge plan assumed. So the honest response is a record of what care the client could actually get.
The intervening cause theme
The second argument tries to hand the wound to somebody else. Defense counsel points at a hospital, a nursing facility or a home health agency. That later care gets labelled an intervening cause. Nevada juries hear those arguments, though the original defendant does not walk away simply because a later provider also failed. Negligent medical care that follows a tort often sits within the risk the tortfeasor created. Both defendants can end up in the same case.
When a Facility Made It Worse
A second claim sometimes exists against the facility, and it lives under different rules. NRS 41A.015 defines professional negligence as a failure to use reasonable care, skill or knowledge. The comparison runs against similarly trained and experienced providers under similar circumstances. NRS 41A.017 then defines provider of health care by listing specific professions and facilities. That list names licensed physicians, licensed nurses and physical therapists. It also names a licensed hospital, clinic or surgery center. So whether a long term care operator falls inside chapter 41A depends on its license class.
Two procedural traps follow. NRS 41A.071 requires dismissal of a professional negligence action filed without a supporting affidavit from a medical expert. That expert has to practice in a substantially similar area. The affidavit also has to name or describe each provider alleged to be negligent. And it has to set out the specific acts separately as to each defendant. NRS 41A.097 then sets a shorter clock. For injury on or after October 1, 2002, one limit is three years from the date of injury. A second limit runs one year from discovery of the injury. Whichever comes first controls, subject to the tolling provision in that section.
Facility licensing sits under a separate chapter. NRS 449.0302 directs the Board to adopt licensing standards for each class of medical facility and facility for the dependent. Complaint records at the state licensing bureau often show a facility’s history. Look for earlier findings on wound care, staffing or skin assessments.
Damages a Pressure Sore Actually Drives
Wound care is only the visible cost. The wider picture reaches nearly every category of loss in a catastrophic injury file.
- Surgical debridement, flap reconstruction and the long bed rest after each procedure.
- Hospital readmissions for infection, including osteomyelitis and sepsis.
- Specialty support surfaces, wheelchair cushions, seating evaluations and replacement cycles across a lifetime.
- Attendant care hours, which usually rise after a serious wound and rarely return to the prior level.
- Lost rehabilitation progress, because weeks of bed rest undo conditioning and transfer skills.
- Depression, anxiety and social withdrawal tied to isolation during healing.
- Reduced work capacity, which a vocational analysis has to account for directly.
A life care plan carries this weight. So does vocational testimony, since a wound history changes the assumptions behind any return to work opinion. Our discussion of when to hire a vocational expert for a spinal cord injury claim explains the timing.
Proof That Wins the Causation Fight
Causation here turns on documents that exist while the wound is fresh. Wait a year and half of them are gone.
- Risk assessment scores recorded on admission and at intervals, plus whatever the score triggered.
- Turning and repositioning schedules, along with the flow sheets showing whether staff followed them.
- Serial wound photographs with measurement, staging and dates.
- Nutrition notes, albumin values and any dietitian consult.
- Equipment orders, delivery records and denial letters from an insurer or a supplier.
- Staffing schedules for the unit on the days the wound advanced.
- Home health visit notes and family caregiver logs.
Who explains the wound to a jury
Treating clinicians carry more weight here than hired experts. A wound care nurse can describe the turning schedule in plain terms. A physiatrist can connect the injury level to the risk. A plastic surgeon can explain why a flap needs weeks of bed rest afterward. Line those voices up early, because treating providers move practices and leave the state. Then let a retained expert fill only the gaps the treating team cannot cover.
Send preservation letters to every facility and agency involved as soon as a wound appears. Electronic charting systems keep audit trails. Those trails show when an entry happened and who made it, and they answer questions no narrative note will.
Deadlines and What Happens if the Client Dies
A Nevada action for injuries to a person carries a two year limit under NRS 11.190(4)(e). A professional negligence claim against a covered provider runs on the shorter schedule in NRS 41A.097. So a single wound can sit inside two different clocks. The shorter one usually controls the strategy.
Sepsis from a pressure sore does kill people with paralysis. NRS 41.100 provides that no cause of action is lost by reason of death. So a claim survives when a client dies while the injury case is pending. The executor or administrator may then maintain it. That section also states what the estate can recover. The list includes losses the decedent incurred before death, plus damages for pain, suffering or disfigurement. A separate wrongful death action under NRS 41.085 belongs to the heirs and the personal representative. The two actions may be joined when they arise out of the same wrongful act.
Building the Record From Day One
Good spinal cord cases treat skin as a standing agenda item. Ask about it at every client meeting, in the same breath as bladder management and spasticity. Photograph anything that looks suspicious, and date the photographs. Then get the treating physiatrist on record about lifetime risk. Waiting lets a defense expert define that risk first. Treating pressure sores as compensable harm from the first demand keeps the whole file honest. The framework for the wider claim sits on our catastrophic injury page.
Insurers often argue that future wounds are speculative. In reality the clinical literature and the client’s own history give a jury something concrete. A client who has already had one sore shows a documented pattern. That pattern belongs in the life care plan rather than in an argument about possibilities.
Talking Through a Nevada Spinal Cord Injury Wound Claim
The Bourassa Law Group reviews spinal cord injury files with the wound history front and center. That review costs the family nothing. We gather the charting, the equipment records and the staffing data. Then we bring in the clinicians who can explain what should have happened. Start the conversation through our contact page whenever you are ready.
This article gives general information about Nevada law and is not legal advice. Reading it creates no attorney client relationship. Charts, photographs and dates decide a wound claim, so gather those records early.
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