Bed Rail Entrapment

Bed rail entrapment is a silent killer in nursing homes. Bed entrapment can cause serious injuries, making nursing home residents more likely to die. The risk of entrapment is escalating, with about 2.5 million hospital and nursing home beds causing potential accidents in the United States.

Many nursing facilities have outdated and illegal bed rail systems that present an additional risk to the resident. In many incidents, residents were severely injured when facilities failed to follow established protocols on using restraints and bed rails. Entrapment between the bed rail and the frame can lead to asphyxiation and strangulation.

patients injured or killed due to bed rail injury

Between 1995 and January 1, 2019, 803 incidents of patients and residents caught, trapped, entangled, or strangled in beds with rails were reported to the US Food and Drug Administration (FDA).

Of these FDA entrapment reports, 480 people died, 138 had nonfatal injuries, and 185 were not injured because staff intervened to prevent injuries. Most patients were frail, elderly, or confused.

Attorneys for Nursing Home Residents Injured or Killed Due to Bed Rail Injuries

Did your loved one suffer injuries or die from bed entrapment? If so, our bed rail entrapment attorneys can take immediate action against the facility. Let us review your case and gather evidence to prove your compensation claim.

The personal injury attorneys at Nursing Home Law Center, LLC represent nursing home neglect cases where residents are harmed through negligence, abuse, and medical malpractice. Contact our nursing home abuse lawyers at (800) 926-7565 for a free case review to explore your legal options.

The Medical Facility's Obligation to Prevent A Bedrail Injury

Skilled nursing facilities must choose the best type of bed rail for each resident appropriately, and staff must consider many factors. When a resident is injured by bed entrapment, there is a strong chance that the nursing home staff has either done something wrong or acted negligently.

The Centers for Medicaid Services (CMS) has issued safety guidance for bed rails. Side rails might not be used as restraints unless it is necessary to treat a particular medical condition. Raised side rails typically restrain residents because they tend to stay in bed.

For that reason, homes must have a valid reason to use a side rail. They can increase the risk of entrapment and other severe injuries as a restraint, and their usage needs to be documented.

Subject to documentation and assessment, there are beneficial uses for them, provided that it is not used without the proper justification and consideration of the risk of entrapment. For example, bed rails can assist a resident in getting into and out of bed.

Some nursing facilities receive health citations on their Medicare inspections because they have used bed rails without justification.

Nursing Facilities Bed Rails Selection

Some of the factors that nursing facilities should consider when selecting a bed rail for the resident include:

  • The benefits of using bedrails – Rails could reduce the risk of a patient falling when getting out of bed. Also, the railing could help turn and reposition the resident in the bed, reducing the risk of pressure ulcers.
  • Other alternatives to bedrails are restrictive and often pose a risk of entrapment. Can the same ends be achieved without the use of bed rails? Is there a care program that staff can institute to eliminate the need for bed rails?
  • The risks of bedrails – Some bed rails have led to strangulation, caused by residents falling when attempting to climb over the rail. Secured bedrails also prevent patients from performing ordinary activities of daily life, resulting in bed entrapment leading to feelings of isolation.

Nursing facilities must consult with the resident's physician and the family before making this decision. Selecting bedrails is a decision that must be made with forethought, considering the risk of bed entrapment.


Statistics On Bedrail Entrapment

Bedrail entrapment will usually be reported to the Food and Drug Administration (FDA) as the relevant Government regulator overseeing bed rail use. The Centers for Medicare and Medicaid Services also govern bedrails in skilled nursing facilities, while the actual product is considered a medical device.

Statistics reveal that residents are more likely to die than not when they experience bedrail entrapment. Exacerbating the trauma and fatality rates is that nursing home residents are frail, disorientated, have severe pain, and might not be able to dislodge themselves when trapped in the manner that a healthy person would.

Separately, there are also reports to the Consumer Products Safety Commission. from 2003 to 2012, there were 143 deaths from bedrail entrapment. An overwhelming majority of these deaths occurred in those over sixty.

Why Are Bed Rails Dangerous?

According to the FDA (Food and Drug Administration) and the US Consumer Product Safety Commission (CPSC), using bedrails in hospitals and nursing facilities has led to severe trauma and death. Many of the reports involved falls and bed entrapment.

Nursing homes cannot use bed railing for residents in every nursing home or hospital situation. Also, not all bed rails are compatible with every mattress, and staff must use the correct bed rail matched to the proper bed.

When misused, they pose a high risk of entrapment and a significant hazard to the mobility challenged and those with altered mental status, including delirium and dementia.

Potential Entrapment Risk of A Side Rail And Bed Frame

Common risks of bed rails for nursing home residents are:

  • Strangling or suffocating entrapment risk when patients are caught between rails, between the bedrails and mattress, or between the rail and side edge of the headboard
  • Risk of bodily injury when patients or part of their body are caught between rails or between the bedrails and mattress, especially the neck, chest, and head
  • Head injury when residents hit their heads against the side edge of the head/footboard
  • Severe injury risk from falls, especially head trauma, when residents climb over rails
  • Entrapment injuries risk such as skin bruising, cuts, and scrapes
  • Risk of inducing agitated behavior when bed rails are used as physical restraints
  • Risk of entrapment when feeling isolated or unnecessarily restricted
  • Risk of preventing patients who can get out of bed from performing routine activities such as going to the bathroom or retrieving something from a closet

The FDA has a Hospital Bed System Dimensional and Assessment Guidance to Reduce Entrapment that is available online for nursing home employees to view images of various types of entrapment.

Nursing home staff can reduce entrapment and promote the bed safety of residents with a cursory check on residents' beds and mattresses to identify a potential entrapment risk.

When A Resident Is Trapped Between a Mattress And Bedrail

Entrapment injuries often occur when a resident or patient has their heads wedged between the mattress and the bedrail or stuck between the bed rails. Becoming wedged in the bed rail typically impacts the head, and the neck, with the patient or resident's airflow being cut off, leading to suffocation.

Falls are another deadly risk that occurs. Residents could attempt to climb over the bedrails to get out of bed. Dropping off a high bed can result in a patient falling on their heads or injuring their necks, causing severe injury or death.

The potential risks of injury become more pronounced when the resident is disoriented.

The Nursing Home's Potential Liability

Several theories suggest a nursing facility can be liable for an injury due to bed rail entrapment:

  • The facility failed to justify using the bedrail in the first place (nursing home negligence).
  • The staff did not correctly install the rail to the bed frame, creating a safety hazard risk.
  • The nursing home staff did not adequately supervise the use of the rail to optimize bed safety.
  • The facility should have found the resident entrapped in enough time to free them.
  • The medical facility or site purchased a defective bedrail.

Bed Railing Entrapment Injuries FAQs

Our personal injury attorneys understand that many families have unanswered questions when dealing directly with nursing homes and insurance companies when their loved one is injured through entrapment. A lawyer from our law offices has answered some of those questions below.

Contact our affiliate lawyers at the Nursing Home Law Center at (800) 926-7565 for additional information.

What Are the Alternatives to Bed Rails?

The Food and Drug Administration (FDA) recommends other bed rail alternatives, including lowering the bed frame, adding foam bumpers, or rolling guards. Some nursing facilities use concave mattresses to reduce entrapment and the potential of a patient rolling off the hospital bed.

Nursing facilities often violate federal and state laws using bed frame side rails instead of monitoring or supervising residents. Bed railing poses a high entrapment risk of the patient falling or becoming entangled.

What Is Bed Entrapment?

Older, frail, and infirm adults risk bed entrapment when the nursing facility installs bed railing or improperly fitted grab bars. The victim can quickly become trapped between the bed frame, and the side rail or rail supports when openings or gaps are large enough to entrap their chest, head, or neck.

Residents can also suffer bed entrapment:

  • Between the rail supports or the bars of the split side rails
  • The separate side rails
  • Locked between the mattress and the rail on the side
  • Stuck between the footboard, the side rail, or the head rail
  • Between the end of the rail and the side edge of the headboard

Commonly getting hurt from bed entrapment by nursing home residents causes suffering from delirium, agitation, uncontrolled body movement, acute urinary retention, pain, confusion, and fecal impaction.

When Should Bed Rails Not Be Used?

Nursing homes must follow Centers for Medicare and Medicaid Services (CMS) guidelines when they use bedrails for their patients, according to the Food and Drug Administration (FDA).

The nursing staff and doctors must carefully assess residents with severe medical and mental conditions, including incontinence, sleeping issues, memory problems, uncontrolled body movement, and pain, along with those who cannot walk safely without assistance.

The nursing facility must ensure that the resident is an appropriate candidate for a bed railing. It should never be a substitute for the required monitoring, especially for individuals with a high risk of falls, who could see it as entrapment.

Why Can't Nursing Homes Use Bed Rails?

According to the FDA (Food and Drug Administration) and US Consumer Product Safety Commission (CPSC), installed bed railing might be extremely dangerous to nursing home residents.

The staff and doctors must follow established safety guidelines and regulations in treating elderly residents in nursing facilities and hospitals. The FDA stated that over 4000 facility residents annually receive treatment and local emergency rooms for bed rail-related trauma.

The FDA also revealed that half of all reports on bed railing accidents involve wrongful death. Many of these victims were found lodged between the bed frame and the railing resulting in their death.

How Do You Prevent Bed-Railing Trauma?

If you visit your loved one or family member in a nursing home, check the following to prevent bed entrapment and ensure bed safety:

  • Verify that the staff professionally installed the bed railing, ensuring hospital bed safety
  • Push the bed mattresses as far away from the rails as possible to see if you can stick at least four fingers between the mattress and rails
  • Staff regularly inspect bed frames, mattresses, and accessories to ensure the correct functioning of equipment.
  • Lower one or more sections of the side rail, such as the foot rail
  • Use proper-size mattresses or mattresses with raised foam edges on beds to prevent residents from being trapped between the mattress and rail.
  • Reduce the gaps between the solid or air mattress and side rails
  • Many side rails are installed, disassembled, and reassembled in nursing facilities, leading to the wrong mattress on the wrong bed. Ensure the bed frames and bed rails fit with the correct hospital bed

The Hospital Bed Safety Workshop – or HBSW – has developed mitigation guidelines and assessment guidance to help long-term care facilities reduce entrapment risks in existing hospital bed systems or legacy beds.

The bed entrapment assessment guidelines are intended to be used along with clinical resident assessments and focus on modifying current beds to make them safer for residents.

When Are Bed Rails Used in Hospital Beds for Elderly Patients?

It might be impossible for some home Health Care residents to move independently without assistance. However, many mobility-challenged residents believe they can move independently and will try to get out of bed but fall to the floor.

In other instances, the resident might have dementia or Alzheimer's and tend to get out of their hospital bed and wander, subjecting them to various dangers and even death.

When this happens, intervention might be needed to reduce the risks to resident safety.


Has Your Loved One Been Injured in a Nursing Home by Bedrail Entrapment? Talk To an Experienced Attorney

Were you or a loved one injured in a bed guard accident? The elder abuse attorneys at the Nursing Home Law Center can get the justice your family deserves. Our lawyers will handle every aspect of the process to obtain a financial settlement through a negotiated settlement or jury trial award.

Contact our law firm today at (800) 926-7565 (toll-free phone call) or through the contact form to schedule a free consultation. All discussions and sensitive information shared with our nursing home abuse lawyers remain secure and confidential through an attorney-client relationship.

Our lawyers operate on a contingency fee basis, so you don't have to pay us any attorney fee for our legal services unless we win your case.


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