Physical Restraints: Patient Who Fell Should Have Been Restrained, Court Rules

Legal Eagle Eye Newsletter for the Nursing Profession

   Quick Summary: The physician ordered restraints prn, and wrote a letter requesting the resident be restrained. 

   Not restraining this resident led to a negligence claim after she fell and required hospitalization for a head injury. 

   This confused ninety-eight year old resident often got up from her wheelchair and had fallen twice before.  The family, who visited frequently, asked for restraints.    COURT OF APPEALS OF NORTH CAROLINA, 1997.

   The Court of Appeals of North Carolina described the group living facility as a rest home rather than a nursing home. The group living facility provided the same type of care that might be found in an individual’s home, but did not provide direct, one-on-one personal care for its residents, according to the court.

   The resident's granddaughter visited regularly and was actively involved in the resident's care. As the resident's condition declined and her confusion worsened, the granddaughter asked the staff to restrain her grandmother, due to her tendency to try to stand up unassisted when unattended. When the granddaughter arrived and found her grandmother up and wandering unattended, she always brought this to the staff's attention, the court said.

   At the family's urging, the resident's physician wrote and signed an order for restraints prn, and wrote a separate letter to the management requesting the resident be restrained while unattended, the court pointed out.

   The resident finally did sustain a serious head injury in a fall, and required hospitalization. When the resident and her family sued the facility, it came out that the resident had in fact fallen twice before this, while up from her chair unassisted wandering unattended.

   The court ruled the resident should have been restrained in her chair when unattended. Since the facility knew of the danger of leaving this resident without restraints, there were grounds for a civil lawsuit claiming negligence for her head injury. Swann vs. Home, 490 S.E. 2d 572 (N.C. App., 1997).