Penningtons Manches LLP has settled a claim against St George’s University Hospitals NHS Foundation Trust for a woman who suffered a fall from her bed while she was recovering from brain surgery for a stroke.

The claimant was in her 60s at the time of these events in July 2012. She was diagnosed with a stroke (an intracerebral bleed) and underwent surgical evacuation of the haematoma under the care of the neurosurgical team at St George’s Hospital.

She was cared for on the neuro-intensive care unit. She was unable to mobilise independently and remained in bed on a continuous cardiac monitor. She was also catheterised as she was not well enough to mobilise to the lavatory. Occupational therapy (OT) and physiotherapy assessments noted that she was weak and that transfers, even with the assistance of two, were extremely difficult because of left sided weakness in her body. 

In the middle of the night a couple of days after surgery, the claimant was found on the floor by her bed after the nurses heard a loud bang. A CT scan showed that she had suffered a head injury in the form of a subdural haematoma. She had also suffered a fractured clavicle which was not diagnosed for several days due to delays in X-raying. Treatment for both injuries was conservative. The claimant suffered a worsening in her neurological condition as a result of the head injury and continues to suffer ongoing headaches. 

The normal procedure on a ward which cares for vulnerable post-surgical patients is to have the bed rails raised to protect patient safety during the night and to prevent a patient from rolling out of bed in their sleep. 

Initially the claim was disputed by the Trust, represented by the NHS Litigation Authority. It argued that as the fall was unwitnessed and the bed rails would usually have been up, the claimant had somehow managed to climb over the rails and cause herself injury. Legal proceedings were brought which alleged that the Trust was negligent for failing to raise the bed rails on the claimant’s bed during the night. The only explanation for the fall was that the bed rails had been left down as the claimant lacked the physical capability to climb over the rails in her post-surgery state following her stroke. The matter was subsequently concluded by an exchange of offers to settle. 

Lucie Prothero, a member of the clinical negligence team at Penningtons Manches who specialises in hospital falls cases, comments: “We deal with a variety of clinical negligence cases relating to avoidable hospital falls. There are NICE guidelines for the prevention of hospital falls and the safe use of bed rails for in-patients as the problem of patients falling in hospital is a serious one that all hospitals must work to prevent. We see instances where basic failures to provide a safe environment for patients at high risk of falls, such as ensuring that bed rails are used appropriately or the use of lowered beds or crash mats, can result in preventable injuries which can have devastating consequences for patients and their families.”