This case involves a 90-year old male who fell out of a wheelchair in a nursing home and suffered several injuries. He was being wheeled out by a nurse towards a window. The patient fell forward out of the wheelchair. The footpads on the wheelchair were facing upwards and his feet were hanging in the air. His feet got caught on the floor resulting in him falling face first on the ground. He suffered abrasions on his forehead and nose, a hematoma on his forehead and neck tenderness. The next day the patient started complaining of pain in his head and neck. The patient was seen by the staff physician after the fall. A nurse noted he was moaning and indicated there was swelling and purple discoloration on his right eye as well as bleeding from his forehead abrasion. The following day the patient had a CT scan that showed a fracture at C2. The patient became tachypneic and tachycardic. He passed away shortly thereafter. It is alleged that the nursing home staff failed to adequately monitor the patient following his fall.
Question(s) For Expert Witness
- 1. Do you have knowledge of the safety protocols that should be followed when transporting elderly patients on a wheelchair?
- 2. Were you working as a nurse full time in August of 2012?
Expert Witness Response E-000779
Based on the case overview provided, when a footrest is present on a wheelchair, it should certainly be utilized – it serves a specific purpose. Every resident who resides in a facility must have a fall risk assessment done to see what their individual risk factors are and those risk factors need to be developed into a care plan for that individual. There is no mention that neurological status was monitored after the event.