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Today in Your Health we consider a simple device that's found on hospital beds, bed rails. They are supposed to help, but too often they can be deadly. Patients use the metal bars to pull themselves up and the bars prevent patients from rolling out of bed. But sometimes people, especially older ones with dementia or Alzheimer's, get trapped between the bedrail and the mattress, and that can cause injury, even death.
NPR's Joseph Shapiro explains.
JOSEPH SHAPIRO reporting:
The first phone call came from the nursing home. Bud Flynn's mother had died during the night.
Mr. BUD FLYNN: That's the way it was explained to me, that my mom passed away in the night. So I thought that she passed away normally.
SHAPIRO: The second call came a few days later.
Mr. FLYNN: The funeral director called my wife and said that the coroner's office needed to transfer my mom to do an autopsy, because her death wasn't a normal death, meaning that an accident had occurred.
SHAPIRO: That was the first time Flynn found out that his mother's death had not been peaceful, but instead gruesome. The official cause, according to the coroner in Sacramento, California, was death by sudden cardiac arrest, caused when Frances Flynn got her body stuck between her bedrail and the bed mattress, then panicked and died.
In the last year and a half, there have been 35 bedrail deaths reported to federal officials, some 350 deaths since 1995. Larry Kessler of the U.S. Food and Drug Administration has reviewed those deaths.
Mr. LARRY KESSLER (Director, FDA Office of Science and Engineering Laboratories): People shouldn't die this way. They're very serious and we believe they're largely preventable.
SHAPIRO: In March, the FDA issued new guidelines to reduce cases of people trapped in bedrails. The instructions tell hospitals and nursing homes how to make complex calculations to check that beds are put together correctly. Kessler led the group that came up with the new guidance.
Mr. KESSLER: Sometimes the problem is caused by people who have put together a hospital bed with disparate parts, so a bed from one company, a mattress from a second company and the rails from a third company. And that may cause gaps to occur, which are the dangerous spots. And a frail patient may slip his or her head or arm into one of those gaps and not be able to extricate it, and that's where injury or death occurs.
SHAPIRO: Kessler says when the beds are put together correctly, there's almost never a problem.
Mr. KESSLER: We don't believe hospital beds are killer beds. We don't believe that it's an unsafe environment on average. It's just that because a million or more people are in a hospital bed everyday in this country, it only takes a few of them who are frail, disoriented in a bed that's slightly dangerous to cause a problem. And that's what we're talking about. It's a rare event, but it's worth worrying about.
SHAPIRO: In 1995, Steven Miles at the University of Minnesota was one of the first to notice that people were dying after getting caught in bedrails. He thinks the new FDA guidelines don't go far enough and that patients can't rely on hospitals and nursing homes to catch dangerous beds.
Professor STEVEN MILES (University of Minnesota): It think right now it's patient and family beware.
SHAPIRO: Miles says if you've got a loved one in a hospital or a nursing home in a bed with a bedrail, you need to check if there is a gap between the mattress, the bed frame and the bedrail.
Mr. MILES: Personally look at the bed and see if by pushing the mattress to the far side of the bed they can make a gap that is big enough to put four fingers between that and the rail. If they can, that gap is too big.
SHAPIRO: Many hospitals and nursing homes have stopped using bedrails. Miles says one result is that older beds, the ones most likely to be unsafe, are winding up in the home care and hospice market and get sent into people's homes.
Mr. MILES: Rent a bed for your disabled loved one who is coming home and typically what happens is they will pull some rails off a rack, they will pull a mattress off a rack, they will throw it on a bed, and they will assemble it, and they don't do the testing of the size of these gaps. Then they ship it off to the end user without any labeling with regard to these hazards.
SHAPIRO: And again, that means it's up to family members to check that the mattress is tight against the bed frame and the bed rail.
Joseph Shapiro, NPR News.
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