Analyzing falls, especially in hospitals and nursing homes, can make up a big part of a legal nurse consultant’s work. Unreported falls have significant liability issues.
One of the things that I have seen in quite a few cases is certified nursing assistants who saw a patient fall; they were afraid to tell anybody. The impact of delay and diagnosis of an injury is enormous on the patient.
Death by Delay
I recall a patient’s fall that ended up being fatal. She died from her head injury one week after the fall. Had the appropriate personnel known about this earlier and had they evaluated her, they would have found her subdural hematoma when there was enough time to treat it.
The patient was an elderly woman with dementia, in her 80s. She fell. Because she had breast cancer, she was being evaluated for hospice services.
The RN from Hospice came into the facility to do a palliative care assessment. As part of that assessment, she tried to interview the patient, and she also examined her. On examination, she found that the patient had a large ecchymotic area on her forehead and was disoriented and barely awake.
When the RN discovered this, she communicated with the woman’s physician, who ordered a transfer to the hospital, where a neurosurgeon took over.
No one had documented on any medical record that the woman had fallen.
This lack of documentation put both the entire professional staff at a high risk for liability, and it also placed liability on the facility. It became clear that the patient died as a result of the undiagnosed, untreated and unreported fall.
What Can Be Done about Unreported Falls
In practical terms, facilities can do more frequent rounds and surveillance. Some facilities may allow types of video surveillance.
The value of this kind of surveillance will depend on where the falls are occurring. Typically, long term care facilities have cameras at entrance and exits of the facility. You can’t have them in patient’s rooms or bathrooms obviously, and this is where a large number of falls occur, especially if an CNA is inadequately assisting a patient from bed to wheelchair or from wheelchair to toilet.
The legal nurse consultant’s analysis of the fall may result in a conversation with the attorney about obtaining incident reports, notes from an internal investigation, employee files, background screening checks of the employees, and other documents that would be helpful In determining what occurred.
CNAs who are worried about losing their jobs because of a patient fall need to understand the importance of immediately reporting any falls. Fall injuries will eventually be discovered, and the longer falls go unreported, the worse the effects for everyone.
Falls Course: The Impact of Head Injury
Falls are common reasons for lawsuits. Whether they occur in the community and within healthcare facilities, legal nurse consultants are essential for helping attorneys to understand the medical issues.
What can this six hour long course do for you?
You’ll learn and retain more in the course than you can imagine. Gain insight and practical tools about how to analyze a head trauma case. You will gain skill in reviewing facts of a fall case and learn from expert witnesses who have reviewed hundreds of cases.
Falls Course: The Impact of Head Injury is designed to learn skills and techniques you can use immediately. The course is not full of dry theory; it is a fast paced, comprehensive way to learn practical, useful information.