Expert Witness Evaluation of Liability for Healthcare Fall

Injurious healthcare falls are one of the most common reasons why providers are sued. Spinal cord injuries, head injuries, and fractures make these serious cases for attorneys and nursing expert witnesses.

Many states have regulations that govern who is qualified to act as a liability expert. These factors make a strong expert witness: a combination of recent or current clinical practice that matches the clinical setting where the fall occurred, excellent communication skills, and analytical ability. Nursing experts should be evaluating the standard of care for nursing cases.

There are so many factors that could cause a fall, but from a liability perspective, the issue that is of high concern for attorneys, risk managers, expert witnesses and insurance carriers is which of those healthcare falls could have been prevented. If the fall took place in a healthcare facility, ask these questions.

Healthcare Fall Analysis

• Which healthcare falls should have been prevented by the actions of either the healthcare providers or the people who designed the environment in which the fall occurred?
• Was the patient identified as being at risk for falls?
• How was that risk communicated to others?
• Were measures implemented to prevent the fall?
• Was the call light at the bedside utilized to call for assistance?
• Was the patient capable of using the call bell?
• Was the bed in its lowest position?
• Were lights on in the room or under the bed to help light the area at night?

• Was the new plan implemented to minimize the opportunity for other falls to occur?
• Was the patient given anti-skid slippers?

• Is it possible to determine how soon the individual was found after he had sustained a healthcare fall?
• What was done at the time of the fall?
• Was the patient appropriately monitored after the fall to detect injuries?
• What did the assessment reveal?
• Did the nurse communicate the findings to the physician?
• Were X-rays ordered and performed?
• Was there an injury and how soon was that injury treated?

• If the patient fell and hit his head, was the chart reviewed, was the individual on anti-coagulation blood thinner such as Heparin or Coumadin?
• Was this communicated to the physician so that head scans could be performed to see if there was some type of bleed in the head?
• Was there a change in mental status after the healthcare fall?
• What were the vital signs?

• Were there specific conditions which contributed to the fall?
• Was the person assessed and monitored?
• What medications had the patient received prior to the fall? Did they have side effects that could have contributed to the fall?
• Was the patient’s risk for falls identified after the fall and the plan of care changed?

This material came from Pat Iyer MSN RN LNCC’s book. She is the author of Analyzing Falls, Pressure Sore and IV Therapy Cases. Learn how to analyze these cases after you grab your copy here. Sharpen your skills for the analysis of a patient fall case. Invest in our hour course on patient falls: Falls Course: The Impact of Head Injury. View it at your convenience through our digital downloads.