Hospital-Acquired Pressure Injuries Ranking in US Lawsuits
Hospital-acquired pressure injuries (HAPIs) rank as the second most common claim in medical malpractice lawsuits in the United States. 1
Financial and Legal Impact
The litigation risk associated with HAPIs represents a substantial financial burden for healthcare institutions:
Personal injury litigation from HAPIs contributes to an estimated annual financial risk of $5.97 million for an average 160-bed hospital, making it one of the two primary drivers of revenue loss (alongside insurance nonpayment for PI treatment). 2
The Center for Medicare and Medicaid considers HAPIs the most frequent preventable event, underscoring their prominence in quality metrics and regulatory scrutiny. 1
Context Within the Broader Malpractice Landscape
While HAPIs rank second overall in lawsuit frequency, it's important to understand how this compares to other common malpractice allegations:
Failure to diagnose remains the most common malpractice allegation across medical specialties, particularly in acute stroke management where 36% of cases involved missed diagnoses. 3
Failure to treat represents the second major category of general malpractice litigation, with specific treatment failures (such as failure to administer tPA in stroke) generating substantial claims. 3
In pediatric ambulatory care, 37% of medical errors were treatment-related, with 85% being medication errors, demonstrating the varied nature of malpractice claims across different settings. 3
Clinical and Mortality Consequences
The high ranking of HAPI lawsuits reflects their serious clinical impact:
An estimated 2.5 million Americans develop HAPIs annually, with these injuries causing patient harm, discomfort, and even death. 4, 1
For an average 160-bed hospital, HAPIs contribute to approximately 16.4 deaths annually related to avoidable pressure injuries, in addition to 911 days added to hospital length of stay. 2
Pressure injuries not only cause pain but also restrict movement and may lead to infection, affecting stroke prognosis and increasing nursing care time, length of stay, and medical expenditures. 5
Critical Pitfall to Avoid
The preventable nature of HAPIs makes them particularly vulnerable to litigation—because regulatory bodies and courts consider them largely avoidable with proper care protocols, hospitals face heightened liability when these injuries occur. 1 This preventability standard differs from conditions like stroke where diagnostic complexity may provide more defensible grounds, explaining why HAPIs generate such frequent litigation despite being less immediately life-threatening than some other hospital complications.