Hospital administration expert witness opines on a high fall risk patient who falls and fractures his hip

A hospital administration/risk management expert witness discusses a case that involves an eighty-four-year-old male patient with a past medical history of hypertension, dementia and prostate cancer. The patient was a resident of a nursing home and had been known to have suffered falls in the past. The patient was taken to the emergency room by one of his carers complaining of a three day history of nausea and vomiting alongside diarrhea and abdominal pain. The patient’s symptoms were thought to be caused by gastroenteritis and the decision was made to admit him for intravenous fluids and antibiotic therapy. On admission it was noted in the patient’s medical notes that he was an individual who was at high risk for falling. Due to his symptoms of dementia and past medical history of falls, the hospital took the precaution of placing a wristband on him as well as placing a sign on the door of his hospital room indicating that the patient was a high risk for falls and that he was not to be left unattended. The patient was left unattended in a chair next to his bed by a nurse who had come to record the patient’s vital signs. The patient attempted to get up from the chair by himself to change his dentures adhesives, but unfortunately suffered a fall. The impact of the fall caused the patient to fracture his head and femur. The patient required emergency surgery and subsequently passed away in the post-operative period due to natural causes.

Question(s) For Expert Witness

Is it a departure from the standard of care to allow a patient like the one described above to be left unattended in a hospital chair, given her status as at risk for falling?

Expert Witness Response E-000736

It falls below the standard of care to have left the patient unattended. If it was documented that he was at high risk for falls and could not be left unattended, then - regardless of whether she was in bed or in a chair- someone needed to be in attendance. A review of the medical records & the hospital policies regarding fall risk would verify this. In that case, the liability lies with the nurse who ignored the protocols put in place to protect this patient from injury especially as it seems that the hospital had put in place adequate measures to prevent this from happening.

This qualified expert is board certified and actively practices as a hospital administrator at among the finest medical institutions in the country, specializing in geriatric hip fractures. He is also extensively published and pursues research in the field of geriatrics, making him highly capable of reviewing the case at hand.