Lawyer Resources for Bed Rail Entrapment

Bed-rails-in-nursing-homesEven though they are often used to prevent patients from falling out of bed, bed rails can cause injury as well. Especially with those who are confused, frail, or older, bed rail injury is more common than one might assume. Many people have been seriously injured or lost their life because they became stuck between a bed frame/mattress and the bed rail. If they are unable to get themselves out of that situation, the patient ultimately suffocates.

What are they?

Bed rails are the adjustable plastic or metal bars used in nursing homes to help patients get up. Alternatively they are used to prevent patients from falling out of bed in their sleep or when rolling over. Unfortunately, it is possible for a patient to become trapped between the mattresses and the bed rails. Especially older, frail patients are far more likely to encounter this problem. Patients in bed rails are at a far greater risk if the bed frame and the bed rails do not match up well together. This causes a large gap between the mattress and the bed rail, a gap in which the person can become stuck.

Not an isolated incident

Even though the rails are in place to prevent injury, statistics from the FDA suggest that they often accomplish the exact opposite. The numbers between 1985 and 2008 are high – 722 incidents in that period of patients strangled, entangled, trapped, or caught in these bed rails. While they certainly provide some benefits, some of the potential risks of these bed rails include:

  • Scrapes, cuts, and bruising of the skin.
  • Using bed rails may lead to a patient becoming increasingly agitated if the rails are applied as a restraint.
  • In an effort to get over the rail, the patient may suffer serious injury if they lose their balance and fall.
  • For some patients the use of bed rails makes them feel unnecessarily restricted or isolated.
  • Being placed in bed rails can make it impossible for some older patients to perform routine activities without assistance. These may include getting something to eat or drink or going to the bathroom.
  • Bodily injury, suffocation, strangulation, or death. This may occur if part of the patient’s body is caught between the mattresses and bed rails.

It is also possible that staff members do not install the bed rail correctly. This again increases the odds of serious bodily harm. It is also important that staff members remember to remove the supports upon the removal of the bed rail.

Only when necessary

Even though there is no denying that bed rails can provide great support for patients who may otherwise have a hard time getting up on their own, it is important that bed rails are only used when necessary and only by people who have experience in setting them up. Failure to provide these basic safety necessities is never acceptable. If you are worried that something may not be right or you notice that the mattress does not match with the bed rail, be sure to speak out before it leads to problems.

A law firm with experience handling bed rail injury cases

An entrapment, strangulation or other type of bed rail injury needs to be examined closely to determine the liability both on the part of the nursing home or medical facility where the incident occurred, but also with an eye towards the bed manufacturer or distributor. Rosenfeld Injury Lawyers has investigated and successfully prosecuted bed rail cases against the entities described above and will work with diligence to ensure the same is done for your family.

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Entrapment is a Nursing Home ThreatAmongst a myriad of issues faced by patients in nursing homes, one that requires immediate and serious concern is the entrapment of patients in the bed rails. Bed rail entrapment refers to patients being trapped in the rails of their bed, which causes obstruction in their movement and makes them unable to get out of their bed. Being stuck in the bed rails for hours leads to suffocation and immobility, which eventually results in the death of the patient. This is a commonly experienced problem in most nursing homes and is making people unsure of their decision to send their loved ones to nursing homes.

Cases of Bed Rail Entrapment in Nursing Homes

Several cases of patients being severely locked in the bed rails in nursing homes have been reported in the past. These include that of a patient who had his head and torso trapped in the head side rail and foot and head rails respectively and his lower body hanging down towards the floor. This patient died a little while after experiencing this accident. Another case is of an eighty-year-old woman whose head was caught between the mattress of her bed and the head side rail, her arm was locked in the rail on the foot side; she too passed away due to this shocking episode. In one other case, an old man was entrapped between the bars of the side rail of his bed and received serious injuries on his head.

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Poor Maintenance in Nursing Home Causes DeathNursing Home Tragedies

Nursing home tragedies have become a very common cause of death for severely ill or crippled patients. This issue is so much serious that residents who are otherwise recovering steadily, suffer severe injuries and emotional stress at the hands of caregivers who our society trusts with their loved ones.

Of all kinds of nursing home tragedies, neglect tops the list with 58.5% share. No doubt, a neglectful staff at an elderly care home can be the cause of a painful and regretful death because most residents admitted to such facilities do not have any control over their movements and actions, thereby being completely dependent on their caregivers.

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Death from bed rail entrapmentIt seems that for every episode involving of complex medical care that goes wrong during an admission to a nursing home or hospital, there are at least a handful of ‘adverse events’ that result simply from the fact that someone at the facility wasn’t doing his or her job properly.

Not all bad outcomes are the result of negligent care

In reviewing hundreds of medical malpractice cases, one of the most difficult parts of the evaluation process is explaining to families how an adverse outcome doesn’t necessary equate to a viable case in a legal sense.  As a party initiating a medical negligence lawsuit, the individual or family bringing the case has the burden of proving their case and must establish not that there was just a bad outcome—but most crucially, the poor outcome existed because of a ‘deviation in the standard of care’ on the part of the treating physician or staff— a much more difficult hurdle to cross than simply demonstrating that someone was injured.

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Bedrails Related FatalitiesOne of the fixtures of nursing homes and other long-term care facilities is the ‘hospital’ bed. Many of us have become so accustomed seeing this piece of medical equipment in patient rooms that we hardly give much thought to the fact that these devices are indeed medical equipment– and when not used properly, there’s an opportunity for patient injury or even death.

A patient dying due to problems with his bed?

As shocking as it may initially sound, patients are routinely injured or killed when they become entrapped in the bed that they were given by a facility. A recent New York Times article, “Consumer Agency Finds Most Adult Bedrail Deaths Are Among Those 60 and Older” discussed how the Consumer Product Safety Commission (CPSC) released a report chronicling bedrail safety from 2003 through 2011. All told, data from death certificates and emergency room visits suggests that 155 deaths and nearly 37,000 injuries were directly attributable to complications with bedrails on hospital beds.

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Screen-shot-2010-07-23-at-2_03_44-PM2When you consider forms of cruel treatment, maybe you consider beds of nails or solitary confinement? However, another form of cruel treatment— the use of restraints, is commonly used with innocent nursing home patients. At some facilities, patient restraints are a commonly used tool used by facilities in lieu of providing actual hands-on patient care by facility staff.

In the past, nursing homes used physical restraints such as: bed rails, lap belts, vests, wrist ties and special chairs to assist them in literally controlling their patients.  In addition to de-humanizing patients, the use of restraints was attributed to rapid physical deterioration and increased rates of patient injury.

In response the the poor publicity and family outrage, many skilled nursing facilities have made great efforts to reduce use of restraints.  The reduction in restraint usage was recently discussed in an article by Megan Brooks on Medscape.

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Picture-133To many, the use of bed rails on a hospital bed provides an added level of safety  to prevent falls for patients who may be in a weakened physical state.  While use the of bed rails may be appropriate in certain situations, research tells us that bed rails are still significantly overused and can endanger patients by allowing them to become entrapped in a gaps created between the rail and the side of the mattress.  The entrapment risk can quickly kill a patient within minutes.

The New York Times recently reported on potential dangers associated with the unnecessary use of bed rails in the nursing home setting.  The Time article cites Steven Miles, a geriatrician and bioethicist at the University of Minnesota who has studied the usage of bed rails amongst the elderly.

“Rails decrease your risk of falling by 10 to 15 percent, but they increase the risk of injury by about 20 percent because they change the geometry of the fall,” Miles notes.

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More than 20 years after Congress passed the the 1987 nursing home regulatory law (OBRA) which granted nursing home residents the “right to be free” restraints for discipline or staff convenience–much progress needs to be made to accomplish that goal.

Once widely thought to prevent nursing home residents from falling and wandering off, the use of physical restraints is not nearly as common in most nursing homes. According to a recent USA Today article, the use of physical restraints amongst nursing home residents has been drastically reduced over the past 20 years.  Medicare statistics verify 21.1% of residents were restrained on a daily basis in 1991 compared to just 5.5% in 2007, the most recent full-year set of statistics available.

‘Restraints’ are generally known as any device used to prevent a resident from wandering or falling,gerichair or residents who may be easily agitated (due to uncontrolled pain).  The most commonly used restraints used in the nursing home setting are bed rails and geri-chairs. However, nursing homes have been be known to use make-shift ‘tie downs’ thereby securing residents to beds, benches, dining chairs and even toilets.

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Bed rails are a common source of injury and death amongst the nursing home population.  In efforts to minimize risk, the FDA has established different ‘zones’ of the bed to determine potential for getting caught in the rails.  In order to fully appreciate how bed rail gaps are measured, I found this video. 

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Despite long standing warnings from the FDA, bed rail entrapment continues to be a real threat to the safety of people in nursing homes, hospitals, and long-term care facilities.  After FDA warnings were issued on rail safety, many manufacturers began production of safer designs.  Although the warnings have been issued, the FDA has not imposed any bed rail recalls on beds known to commonly be the source of injury and death.  The lack of formal action by the FDA will likely result in future incidents involving: injury, fractured bones, strangulation, asphyxiation and death.iStock_000005950383XSmall

The safer rail designs have yet to make there way to the places they are needed.  At many facilities there is little incentive to discard a usable bed, despite the fact that the design may be antiquated and unsafe.  Further, many beds are rented from medical supply companies that have a substantial inventory of beds with older designs.

Rental beds are typically the least safe beds in use today.  Many rental companies pay little attention to the combination of parts used when distributing beds for home and facility use.  It is common to see a mattress designed for one bed used with the frame from a different manufacturer.  The combination of mattresses and bed frames results in unintended ‘gaps’ in which a person can easily get caught.

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Injuries Caused by Defective Bed PartsA recent NPR radio program discusses bed rail safety in nursing homes.  The increased demand for hospital beds in nursing homes, hospitals, hospice programs, and in home use has resulted in a shortage of certain bed parts.  For example, mattresses may be improperly sized to the type of beds.  Using improperly sized mattresses may result in gaps between the end of the mattress and the bed rails.  The gaps allow patients to get wedges between the mattress and rail.  The entrapment may result in suffocation, falls, lacerations or even death.

Listen to the full discussion here.

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