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Despite federal safety regulations and an increased awareness of the dangers of using bedrails at long-term care facilities and hospitals, patients continue to die from suffocation, strangulation or asphyxiation.

How do these tragedies occur?

One way is when patients slip through a gap between the mattress and the bottom of the raised bedrail, their heads get stuck, and they strangle to death. Sometimes their bodies are compressed causing asphyxiation. Or patients suffocate when they get wedged between the bedrail and the side of the mattress, with their faces pressed against the mattress. These hideous entrapment deaths usually occur with elderly patients. As long ago as 1995, the U.S. Food and Drug Administration issued a Safety Alert to hospitals and nursing homes warning about entrapment hazards and safety concerns that accompany the use of bed rails.

I’m currently handling a case involving the strangulation death of an 87-year-old Massachusetts woman in 2006. The woman slid off her nursing home bed, and caught her chin on the raised bedrail. Her head became wedged between the bed rail, mattress and bed frame, with the rest of her body in a sitting position toward the floor, causing asphyxiation.

The Massachusetts Department of Public Health concluded that the woman’s mattress pad alarm and personal safety alarm had not sounded to alert the nursing staff that the woman was in distress. Nonetheless, the woman’s tragic death could have been prevented if the nursing home had taken the proper steps to identify and eliminate the risk of entrapment hazards associated with bedrails.

Compounding these tragedies is the fact that they could have been easily avoided. Long-term care facilities and hospitals can take relatively easy and inexpensive steps to protect patients from these dangers.

For example, they can install cushions to fill the gap between mattress and bedrail, much like bumpers used in a baby crib. As an alternative, they can install see-through netting to fill the gap, which provides patients better visibility from their beds. Another safeguard is to simply use thicker mattresses to eliminate the gap.

Nursing homes and hospitals have used bedrails for decades with the intention of restraining patients from falling out of bed and suffering injuries. However, medical studies actually show that bedrails can increase the likelihood of falls as elderly patients try to crawl over or around them. A safer option is to simply place a patient in a bed low to the floor with safety mats next to the bed, and avoid using bedrails altogether.

Some long-term care facilities and hospitals increase the potential for injuries and death by “mixing and matching” beds, mattresses and bedrails from different manufacturers, causing unsafe integration of bed parts. Not only that, nurses and nursing assistants often receive inadequate training on the proper use of bedrails, and effective monitoring of patients.

A related problem is that the cause of death is often misdiagnosed because the suffocation can result from a gentle compression of the body or covering of the nose and mouth. The trauma often associated with strangulation, such as bruising of the neck or a fractured hyoid bone, which lay at the base of the tongue, is not always present or may not be identified.

An even larger potential problem is that long-term care facilities and hospitals either destroy or alter their medical records (more often than you’d like to believe), which makes it harder to prove their negligence in the use of bedrails and monitoring of patients.

The sad truth remains that bedrails can cause more problems than they solve. There’s often no need to use them, yet they are continuing to be used, and people are dying or suffering serious injuries as a result.

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