Patient falls: what went wrong?

Legal nurse consultants who handled medical malpractice cases often make decisions about liability for patient falls.

A review of nursing malpractice claims dealing with many different types of claims revealed that the allegations fit into one of these six categories:

• failure to follow standards of care;
• failure to use equipment in a responsible manner;
• failure to communicate;
• failure to document;
• failure to assess and monitor; and
• failure to act as a patient advocate.

These six allegations apply to patient fall cases. The plaintiff’s expert witness may allege any of these deviations occurred. Here are some actual fall-related cases.

Failure to follow standards of care

• failure to follow the care plan intervention that two people were needed to transfer a patient
• failure to support a paraplegic patient during a shower caused a fall and fractured pelvis
• failure to respond to a patient’s call for help resulted in the patient getting up on her own and falling
• failure to appropriately train staff in transfer techniques resulted in a head injury when patient was being transferred out of bed
• failure to respond to a patient’s request for help to get off a commode

Failure to use equipment in a responsible manner

• failure to use bed alarms and sensors
• failure to ensure that batteries were working in sensors
• failure to properly maintain a Hoyer lift, resulted in a fall
• failure to use a low bed
• failure to put up a side rail before rolling a patient on her side led to a fall off the bed
• failure to lock the wheels of a bed or wheelchair
• failure to ensure that doors to the outside or stairwells were not left propped open on units with cognitively impaired patients

Failure to communicate in patient falls cases

• failure of the nurse to fill out forms instructing the aides on how to follow fall precautions for a woman with a previous history of a fractured hip
• failure to report a fall
• failure to instruct caregivers on proper transfer techniques

Failure to document

• failure to establish and record a plan to prevent falls in a patient with 57 falls and 18 head injuries
• failure to report and record details of a fall
• failure to record telephone orders for fall prevention measures

Failure to assess and monitor

• failure to monitor a patient who fell repeatedly ultimately resulted in loss of an eye during a fall in a parking lot
• failure to assess and monitor a patient following a head injury led to undetected increases in intracranial pressure and death

Failure to act as a patient advocate

• failure to report signs of lethargy consistent with over-sedation was followed by a fall
• failure to question excessive doses of psychotropic medications

Learn more about how to analyze the liability and damages associated with patient falls cases. See our Patient Falls Value Pack.

Sharpen your skills for the analysis of a patient fall case. Invest in the recording of a 6 hour course on patient falls: Falls Course: The Impact of Head Injury. View it at your convenience through our digital downloads.