Legal Review & Commentary: No time for a wheelchair; an $85,000 verdict made
Legal Review & Commentary: No time for a wheelchair; an $85,000 verdict made
News: A 72-year-old woman was admitted to the hospital to rule out the occurrence of a stroke. After being discharged, she went unescorted to the hospital lobby where she tripped, fell, and fractured her left arm. She brought suit against the hospital for not providing her with wheelchair transportation from her room to the hospital exit. The jury awarded her $85,000.
Background: The woman was admitted to the hospital for dementia and to rule out the possibility of her having experienced a stroke. After being hospitalized for several days, she was discharged. At the time of discharge, the patient was attended to by her children. The floor nurse went to find a wheelchair, but the patient and her family did not wish to wait. They escorted themselves to the hospital lobby, where the patient tripped and fell over a stanchion — a ceiling support post — in the hospital lobby. She fractured her left, nondominant humerus in the fall. Her pre-existing left shoulder prosthesis did not require replacement from the incident.
The plaintiff sued the hospital for negligence by failing to provide her with a wheelchair, even though she admitted that a nurse had gone for one and that she and her family did not wait for it. The patient also claimed that there should not have been a stanchion in the lobby. She claimed the incident exacerbated her dementia.
The hospital maintained that the plaintiff left the floor against the nurse’s discharge instructions with her children before the unit nurse was able to bring a wheelchair. The defendant also denied that there was any defect in the arrangement or design of the lobby.
A jury awarded the plaintiff $85,000.
What this means to you: Standard hospital policies generally provide that all patients should be escorted to the facility’s exit.
"This case illustrates the classic example for the rationale for policies requiring all patients to be taken to the exit whether by wheelchair, stretcher, or simply accompanied by hospital personnel. And in light of the policy and attempt by the floor nurse to abide by the policy, but for the actions of the patient and her children, one wonders why the plaintiff in this case was awarded anything," says Leilani Kicklighter, RN, ARM, MBA, CPHRM, director, corporate risk management, Miami Jewish Home & Hospital for the Aged.
"By nature, patients are persons who have received or are waiting to receive medical care. They have experienced some illness or malady that requires some kind of medical treatment. Such an experience, generally leaves one in a weakened state of being or at a minimum not accustomed to being on one’s feet. Therefore, unless a patient leaves the hospital against medical advice or runs out the door, as seems to have been the case in this scenario, patients are always escorted to the exit and more often than not such transportation is provided by a wheelchair. About the only defenses to such a claim of negligence for failing to provide exit transport are the hospital’s policy against such unescorted exits and documentation of the facts surrounding the patient’s exit tactics. Ideally, the documentation would need to be done prior to the incident, but that is virtually impossible under the facts of this case, given the time it takes to get from the unit to the door. And, regrettably for the facility, the plaintiff prevailed under such a fact pattern.
"Perhaps, in anticipation of discharges, wheel-chairs should be gathered prior to advising a patient they have been discharged. Another thought is to conduct a study to attempt to determine whether there are an adequate number of wheelchairs to handle all the types of transports on a daily basis. Trying to find a wheelchair or the length of time it might take to find a wheelchair can test the patience of patients and family members who are anxious to leave the hospital after they’ve been discharged," adds Kicklighter.
"As to the stanchion in the lobby, risk managers should evaluate the entrances and lobbies in their facilities with a critical eye to determine if there are potential areas that are risks for infirm visitors or patients to trip. Sometimes, a barrier to divert pedestrians from the hazardous area is all that is needed as a preventive measure," concludes Kicklighter.
Reference
• Rose Friedman vs. Presbyterian Hospital, Kings County (NY) Supreme Court, Index No. 13794/99.
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