Trip over vacuum cord leads to a $150K award
Trip over vacuum cord leads to a $150K award
News: A patient tripped and fell over a vacuum cord after he had been discharged from the hospital, dressed, and was walking toward the nursing station to retrieve his valuables. He was readmitted for surgery to repair his torn medial meniscus. He sued the hospital and its cleaning service and was awarded $150,000 in damages.
Background: A 52-year-old retiree had been an inpatient in the hospital for six days to receive treatment and observation for severe abdominal pain. He had been given his discharge papers, was dressed in regular street clothes and waiting for his ride home. While waiting, he remembered that $300 in cash and his wristwatch had been taken from him at the time of admission. He inquired about his belongings at the information desk and was told that they were being held at the nursing station.
As he approached the nursing station, he noticed that a cleaning service employee was vacuuming the hallway. The person vacuuming had plugged the vacuum cord into an outlet near a corner of the hallway. He was vacuuming at the other end and so the cord was lying on the carpet across the hallway. The former patient claimed that the worker was vacuuming approximately 25 feet away from the outlet and had his back to the hallway down. The patient reported that just as he stepped over the cord, the worker pulled the cord off the floor, causing him to trip, fall, and injure his knee.
After the injury, the discharge from the hospital was canceled and he was readmitted to undergo surgery to repair the torn medial meniscus in his knee. Once discharged for the second time, the patient brought suit against the hospital and its cleaning service alleging premises liability and negligence.
The plaintiff contended that the defendants were negligent in creating a dangerous condition for patients as well as former patients, employees, and visitors. He argued that the worker who had been vacuuming admitted that he felt a pull on the cord of the vacuum he was handling and then turned around and saw the patient on the floor. However, the defendants contended that the patient tripped on purpose and/or had faked the fall and that the fall could not have happened as the patient described. The hospital and cleaning service also claimed that the patient only suffered a knee bruise. Despite these allegations, the patient maintained that he suffered multiple tears of the left medial meniscus, which required arthroscopic surgery and three months of intensive outpatient physical therapy. He also claimed that the injury worsened to the point that he was forced to use a cane and wear a knee brace to walk. His orthopedic surgeon testified that the fall caused the injury requiring surgery.
The jury awarded the plaintiff $150,000. The cleaning service was found to be 30% liable and the hospital 70%.
What this means to you: Several risk exposures are evident in this scenario that should concern the risk manager of any organization.
"The first is to remember that while the facility might contract for a service such as housekeeping, all the risks and responsibilities of that contract entity are not transferred and the facility may remain ultimately responsible for the contracted services," says Leilani Kicklighter, RN, ARM, MBA, CPHRM, CHT, past president of the American Society of Healthcare Risk Management, and director of risk management services for the Miami Jewish Home and Hospital for the Aged in Miami.
"It would be my argument that there are standards of practice even related to housekeeping tasks. For instance, it is a standard of practice that when mopping or buffing a floor, only one side is to be mopped or buffed at a time, and caution cones are to be placed along the center of the hallway to keep traffic off the freshly mopped side. Such standards relate to the use of extension cords and would apply to vacuum cleaner or other equipment cords as well," she notes.
"Another question comes to mind as to the method of transportation of this patient out of the hospital. Was the patient transported by wheelchair to his ride home? That is the usual practice. Does staff usually wait until the ride arrives or wait until the ride is there to even take the patient to the front door? This might be an area risk management should explore to verify the policy against the practice regarding the mode of transportation of discharged patients.
If this patient was being transported by wheel-chair, where in the continuum to the front door did he remember his belongings and why was he allowed to go back to the unit on his own power?" Kicklighter asks.
The risk manager might also want to look into the policy compared to actual practice as it relates to the steps of the discharge process," she adds. "In particular, it would seem that to check for and return all personal items and valuables that have been secured for a patient on admission would be a standard component of the discharge process. Had that been done in this situation, the need for the patient to return to the unit to retrieve his personal belongings and valuables would have been avoided. In some facilities, the personal valuables and monies are logged into, maintained by and released by the cashier rather than put this burden on the nursing unit staff. The facility may want to consider transferring this function to another area if it is assigned to the nursing unit.
"Even though the hospital has contracted with a third party to do the housekeeping tasks, the organization is still responsible for oversight. The oversight provisions should be contained in the contract; specifically the requirement should read that all contractor’s staff will be educated in safe practices including equipment power cords. We must remember, while a facility doesn’t directly and actually do certain things, those things are done within the confines of the building, and the organization has the obligation to see that standards are met. The principle is the same for as relates to agency staff or private duty staff; the organization is still ultimately responsible for the care of the patient," adds Kicklighter.
"While it sounds like this call might have been an accident, a person moving a power cord just as someone was stepping over it, the issue here is that it is in a hospital. Risk management should meet with the housekeeping supervisor to review policies and practices, whether written or not, especially as it relates to power cords. For instance, common sense would dictate that one should not extend a cord across a corridor; in the event it is absolutely necessary, a caution cone should be placed over the cord. Hospitals have many electrical outlets along the hallways, and right inside the patient rooms, therefore there should not be a need to run an electrical cord down a hallway. The practice should be to vacuum in segments and move the cord to coordinate with that segment where vacuuming," she notes.
"This type of situation is a recognized potential safety hazard. This is one that staff should be sensitive to when observed and be empowered to correct on the spot. This is an area that risk management might wish to explore with the patient safety officer and safety officer in that this hazard could be a potential accident for an employee, visitor or another patient. The use of extension cords is a recognized hazard; equipment power cords pose the same hazard and should be recognized as a hazard and addressed. A hazard for one stakeholder is a likely hazard for any other stakeholder or client," concludes Kicklighter.
Reference
- Los Angeles County (CA) Superior Court, Case No. BC238434.
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