A fall inside a hospital room can do a lot of damage to an already frail or sick patient.

Sometimes the victim of the fall ends up with nothing more than a couple bruises and a wounded pride. Other times, the outcomes are undeniably tragic -- patients break bones, sink into unconsciousness with concussions and comas, develop new neurological problems from brain damage caused by the fall, or die. 

Is a fall just a patient's bad luck or is it malpractice? The answer depends on a number of factors. This is what you should know.

1. The hospital you're in may have a lot to do with whether or not you fall. Research on Veteran's hospitals showed that the range of falls per facility could be anywhere from 1.3 falls per 1000 patient days (essentially treating each day that a patient stays in the hospital as a new patient for the purpose of statistics) to as high as 8.9 falls per 1000 patient days. That's a disparity that cannot be accounted for easily. Hospitals on the higher end of that spectrum are clearly doing something wrong.

2. Experts have broken falls down into four categories -- two of them entirely preventable. Accidental and anticipated physiological falls are generally considered "never events." They should never happen. When they do, they indicate a real problem that should have been addressed. The remaining two reasons, unanticipated physiological and behavioral (intentional) falls, are far harder to prevent -- but not impossible (even if all falls can't be prevented).

3. A great deal of prevention starts with anticipation. Many falls are allowed to happen because hospitals make the same mistakes over and over again:

• Nurses rush through initial assessments. Intake nurses are tasked with getting proper wristbands on a patient. Most hospitals use a color-coded system so staff can instantly tell if someone is on narcotics, allergic to latex or certain drugs, or is a known fall risk (like someone who uses a walker or cane).
• Staff members fail to communicate well with each other. Even if an initial assessment didn't show a risk of falling, any patient that complains of dizziness at a later date should be considered a fall risk from that point forward. That change needs to be communicated to staff coming on duty at every shift change. 
• If a patient is identified as having a psychological disorder that puts him or her at risk for an intentional fall, the issue needs to be communicated clearly to all staff members and treated just as seriously and carefully as patients with other types of all risks

4. The next level of fall prevention has to do with proper adherence to safety protocols and staffing. There are simple steps can be taken to prevent falls:

• Hospitals can lower beds so that if a patient decides to get out of bed despite being instructed not to do so without help, there's only a short drop.
• Bed and chair alarms need to be activated. Nurses and other aides should never leave a room without making sure that alarms and monitor are active.
• Good sense is important when it comes to fall prevention. If a patient puts his or her call light on because he or she needs to go to the bathroom, but nobody responds for 30 minutes, the odds are good the patient is going to get up and try to go to the bathroom anyhow -- fall risk or not!
• Any time a patient is recovering from anesthesia, give a narcotic or another new drug, he or she needs to be treated as a fall risk until the effects have either been assessed or worn off.

Can these procedures work? Absolutely. Experiments using just some of these methods in a hospital ward in Fargo, North Dakota, reduced patient falls from 7 for every 1000 patient days to only 2.4 falls per 1000 patient days in just 9 months! 

If you or a loved one fell inside a hospital and ended up seriously injured, there's every possibility that malpractice was involved. Malpractice is not just actively doing something wrong -- it's also negligently failing to do what should be done to protect a patient from harm. Contact an attorney like those at Shaevitz Shaevitz & Kotzamanis for more information if you think the hospital failed along any of the points covered in this article.