Bed rails are a form of restraint but are meant to keep residents from falling out of bed and being injured. Nursing home facilities cannot use bed rails without documentation and justification. Bed rails are intended to be used as a safety precaution, however there have been cases where bed rails were the cause of injuries, some fatal. Many families are unaware of how dangerous bed rails can be and assume they are safe to use. The U.S. Food and Drug Administration (FDA) and the U.S. Consumer Product Safety Commission (CPSC) have received numerous reports of death and injury that are associated with bed rails. Between the years of 1985 and 2009, 803 reports of patients being trapped, entangled, or strangled in beds with rails were reported to the FDA.
Families of residents who have suffered nursing home bed rail injuries in Maryland can file a claim against the nursing home for negligence and failing to provide a safe living environment.
Why Are Bed Rails Used?
While bed rails do result in injuries, there are positive benefits from this medical device that necessitates their use in many cases. Nursing home residents may be assessed with a high risk of falling out of bed. They can try to get out of bed on their own when they are not able to walk or move about. Residents may also be at risk of falling when they are being transferred from their beds. Some residents with dementia who become easily agitated may feel comforted by the security that the bed rail provides. However, bed rails must be used with the proper supervision and attention to whether the device functions properly.
What Are Bed Rails?
To understand how bed rail injuries occur, it is important to understand the construction of them. They are a set of several rails that go on one or both sides of the bed. There is a gap between both the rails and the bed as well as between each of the rails. The rails will generally be a foot or so high off the mattress, such that the top of the bed rail is at least four feet off the ground. The bed rails are made of metal and they are portable, meaning that they do not move unless they are raised or lowered either manually or by machine.
Bed Rail Injuries
There are safety issues that result from the use of bed rails. These problems occur not just in nursing homes, but in hospitals and private homes as well. The Consumer Products Safety Commission collects reports of serious injury and death that result from the use of bed rails. According to the CSPC, 155 deaths and 5 injuries were caused by bed rails between January 2003 and September 2012.
- 129 of these fatalities were people over the age of 60
- 143 of the incidents occurred because victims became entangled in bed rails
- 11 of the incidents were related to falling on bed rails
- 1 victim hit his head on the bed rail
There are many different types of injuries that can occur from the use of bed rails. These injuries tend to be more severe and have a higher fatality rate than other types of nursing home injuries. By the time a bed rail injury victim is found by staff, they have either already died or suffered irreversible injuries. Here are some of the ways nursing home residents in Maryland can suffer a bed rail injury:
- The most common cause of injury is when a resident’s neck becomes trapped between the rails and is asphyxiated.
- Residents may try to climb out of bed over the bed rails and end up falling. Due to their fragile bodies, seniors will often suffer fractures, broken bones, and fatal head injuries.
- Seniors can slip into the gap between the bed rail and the mattress and become asphyxiated or their chest cavity can be compressed.
Other potential risks of bed rails may include:
- Residents may display agitated behavior when bed rails are used as a restraint
- Residents may feel trapped or unnecessarily restricted
- Bed rails may prevent residents from being able to get out of bed to use the restroom
Why Are Bed Rails Dangerous?
The lack of rules and regulations on the use of bed rails are one of the main reasons why bed rails pose such a high risk to seniors. Injuries and deaths related to bed rails have been reported to federal agencies for decades, but there are still no significant safety warnings or guidelines for the manufacturing of bed rails.
Bed rails can be safe for residents when used in the proper way and with the right type of mattress, however negligent nursing homes don’t always use the correct combination. There needs to be a raised edge around the mattress as well as little to no gaps between the mattress and the bed rail. Nursing homes often move beds around, take them apart and put them back together. Issues arise when beds are not reassembled correctly or are paired with the wrong mattress. According to one study, many bed rail injuries are the result of improper assembly and outdated equipment.
Replacing outdated bed rails and mattresses means thousands of dollars in costs that many nursing homes are not be willing to pay. An alarming number of nursing homes have been reported for purposely understaffing to save money.
New CMS Bed Rail Regulations
In the nursing home setting, bed rails are viewed as a restraint and in order to use restraints on residents, the nursing home must have a reason and it must be done pursuant to a plan. In other words, nursing homes cannot simply place bed rails on every resident’s bed. They must selectively do this with legitimate cause and it must be supervised. In the event that the nursing home uses restraints without adequate documentation, it will face scrutiny from the federal and state authorities who oversee the nursing home.
Because of the potential danger associated with bed rails, the Centers for Medicare Services (CMS) issued guidelines governing their use in 2018. The CMS is a federal entity that regulates nursing homes and in order to continue to participate in the Medicare program, these nursing homes must follow all issued regulations. Here are some of the rules that are in the CMS regulations:
- Bed rails cannot be used as a form of restraint or because they are convenient
- Nursing homes must always review whether bed rails serve a purpose
- Nursing homes can consider alternatives to bed rails that may be safer before deciding to use bed rails
How to Prevent Bed Rail Injuries
According to the FDA, most residents will be able to stay in a bed without bed rails. To help create a safe environment for the elderly, nursing homes and families should make sure nursing homes in Maryland are doing the following:
- Using beds that can be raised and lowered for easier access to the floor
- Keeping the resident’s bed as low as possible and lock the wheels
- Placing cushioned mats near a resident who is at risk of falling
- Using mobility and transfer aids
- Always monitoring residents and are anticipating the reasons why residents need to leave their bed such as using the restroom, getting food or water, restlessness, or pain.
- Providing assistance to residents when necessary
If bed rails are absolutely needed, then families will want nursing homes to do the following:
- Frequently monitor a resident’s physical and mental health
- Lower one or more parts of the bed rail
- Use the correct sized mattress that has raised foam edges to prevent residents from getting entangled between the bed rail and mattress
- Minimize the gap between the bed rail and mattress
Successful Bed Rail Injury Lawsuits
When a resident is injured in a bed rail accident, the family has the ability to sue the nursing home where the accident happened. In many cases, the fact that the accident happened was a direct result of an oversight or error by the nursing home. Here are a few examples of situations where the nursing home paid financial compensation to families of those who were injured or killed in a bed rail accident.
Settlement for $190,000 in 2010 – The senior was a resident in a New York nursing home. She had end-stage dementia and was asleep in her bed at night. She slid down in her bed and became trapped between her bed rail and mattress, with her face pressed down against the mattress. The resident’s family said that the bed rails should not have been on the bed any longer since there was no need for them. In addition, they argued that the nursing home should have had monitors and alarms on the bed to make the bed rails safer.
Settlement for $115,000 in 2001 – This incident happened in a Michigan nursing home. The resident caught her lower leg on the bed rail. This caused an injury to her lower leg which ultimately resulted in her death. The family claimed the woman pressed her call button to alert staff that she was trapped, but nobody answered within a reasonable period of time, worsening her injury. The lawsuit claimed that the nursing home did not provide a safe environment for the deceased resident.
Settlement for $600,000 in 2009 – The plaintiffs were the family of a woman who died in a New Jersey nursing home. While her treatment plan did call for the placement of side rails on her bed, there was the possibility that she could intentionally bang her head on the rails. The care plan called for the nursing home to place pads on her bed rails to keep her safe, yet the nursing home failed to do so. While she was injured from this and it was part of the settlement, the ultimate cause of death was sepsis from bedsores.
Speak With a Nursing Home Bed Rail Injury Attorney in Maryland
The lawyers at KBA Attorneys have experience in all types of nursing home abuse cases. Our legal team can help families throughout the entire process, including drafting a complaint, negotiating a settlement, or litigating the case all the way through the court system if necessary. We offer free case evaluations to help you determine whether you have a viable claim for compensation due to nursing home bed rail injuries in Maryland.
- FDA. “A Guide to Bed Safety Bed Rails in Hospitals, Nursing Homes and Home Health Care: The Facts”, U.S. Food & Drug Administration, https://www.fda.gov/medical-devices/hospital-beds/guide-bed-safety-bed-rails-hospitals-nursing-homes-and-home-health-care-facts. Accessed August 1, 2019.
- FDA. “Safety Concerns about Bed Rails”, U.S. Food & Drug Administration, https://www.fda.gov/medical-devices/bed-rail-safety/safety-concerns-about-bed-rails. Accessed August 1, 2019.
- National Consumer Voice for Quality Long-Term Care. “Protecting Long-Term Care Consumers from the Dangers of Bed Rails”, National Consumer Voice for Quality Long-Term Care, https://theconsumervoice.org/issues/other-issues-and-resources/dangers-of-bed-rails. Accessed August 1, 2019.
- Ron Nixon. “After Dozens of Deaths, Inquiry Into Bed Rails”, The New York Times, https://www.nytimes.com/2012/11/26/health/after-dozens-of-deaths-inquiry-into-bed-rails.html. Accessed August 1, 2019.
- Julie Deardorff. “Bed rails for elderly, their risks long known, face relative lack of scrutiny”, Chicago Tribune, https://www.chicagotribune.com/news/ct-xpm-2013-07-11-ct-met-bed-rail-safety-20130707-story.html. Accessed August 1, 2019.