Nurses Did Not Breach Standard of Care in Failing to Prevent a Patient Fall

A federal appeals court has upheld dismissal of a medical malpractice claim and a wrongful-death claim against a hospital after a patient fell while using a bedside commode, leading to a spinal fracture approximately one month before he died.

The patient suffered from end-stage multiple myeloma and had exhausted all possible therapies when he was admitted to a Veterans Affairs hospital in Arkansas. In the year prior to his admission, he had declined to enter hospice. The patient was assessed as a high falls risk and was required to use a bedside commode with limited assistance from staff. Four days after admission, the patient needed to use the commode. The nurses testified that the patient did not appear dizzy, unstable, or unable to use a bedside commode. Two nurses attended him as he used the commode, conversed with him, and positioned themselves so that they were within arm's length of him but not touching him. Suddenly, he "folded over," hit his head on the floor, exhibited seizure-like activity, and became unresponsive. His heart stopped and he required cardiopulmonary resuscitation to regain a heartbeat. He was transferred to the intensive care unit, where it was discovered he had fractured his cervical spine. The patient underwent a successful repair of his spinal fracture, but his condition continued...