According to National Association of Insurance Commissioners, Medical Malpractice Closed Claims, July 1, 1975 - June 30, 1978, 10 percent of all claims paid for medical malpractice during the period reviewed related to falls; 87 percent of these occurred in hospitals.
2.
While some studies have shed light on the issue, a problem of this dimension deserves more industry focus. One major contribution is RubensteinH.S., Standards of Medical Care Based on Consensus Rather Than Evidence: The Case of Routine Bedrail Use for the Elderly, Law, Medicine & Health Care11(6): 271 (December 1983). See also RainvilleN., Effect of an Implemented Fall Prevention Program on the Frequency of Patient Falls, Quality Review Bulletin9: 287 (September 1984) (while the implementation of high-risk group classification reduced incidents within groups, it is clear that the classification system itself was neither adequate nor sufficiently broad).
3.
Grace v. Manhattan Eye, Ear and Throat Hospital, 301 N.Y. 660, 93 N.E.2d 926 (1950);Mossman v. Albany Medical Center Hospital, 34 App.Div.2d 263, 311 N.Y.S.2d 131 (1970).
4.
Haber v. Cross County Hospital, 37 N.Y.2d 888, 378 N.Y.S.2d 369 (1975).
5.
See GreenlawJ., Failure to Use Siderails: When Is It Negligence? Law, Medicine & Health Care10(3): 125 (June 1982).
6.
Bleiler v. Bodnar, 65 N.Y.2d 65, 69, 489 N.Y.S.2d 885, 889 (1985), citing LouisellWilliams, Medical Malpractice, 1: § 16A-2.
7.
Rubenstein, supra note 2, at 271.
8.
See ManM., Helplessness: On Depression, Development and Death (San Francisco, 1975), at 123–33.
9.
While it would be interesting to do a cost analysis weighing the expense of patient falls against that of preventive measures, regional variations in DRG (diagnosis-related group) weights and salaries for aides make such a calculation impractical. One could do such an analysis for a specific hospital by calculating the regional DRG rate for the specific fracture or injury under analysis to determine the nonreimbursed expense (under the prospective payment system, reimbursement is provided only for the principal diagnosis, the one that caused the original admission). One would then multiply that expense times the incidence of injury and compare the result with an average aide's salary plus 15 percent for benefits times 1.5 (to allow for weekends, vacation, and sick pay).
10.
The Chicago Hospital Risk Pooling Program seeks to educate patients to the risk of falls by distributing to them a card listing the most common causes of falls in the hospital and giving five guidelines on avoiding such falls. A recent study of the hospital fall problem and suggested solutions can be found in Aggressive Programs Lessen Frequency, Severity of Falls, Hospital Risk Management 7(7) (July 1985).
11.
Non-skid slippers currently cost about four times as much as their paper counterparts (approximately 48 cents for non-skid, as opposed to 12 cents for paper). The longer a patient stays, the smaller this gap becomes, since the paper slippers must be replaced periodically while the non-skid slipper is durable enough to survive most extended patient stays.
