Well, like most tasks, there really is quite a bit more to it than is originally apparent.  In order for patients to be safely transported in wheelchairs staff need to take precautions to make sure that the patient arrives where they need to be in a safe manner.

Though not a well-publicized topic, injuries resulting from faulty wheelchairs and staff negligence in pushing the wheelchairs, are responsible for a steady stream of needless injuries to especially vulnerable people.  Just recently, I read about a patient at a Minnesota nursing home who broke three toes when a staff member sloppily pushed the wheelchair and knocked her foot into a wall.

While the incident itself may seem like not much of a deal, the fact that that patient was forced to live with a broken bone due to the inattention of a staff member pushing their wheelchair is inexcusable. At facilities where patients are regularly transported via wheelchairs, the facility needs to train staff on the basics of wheelchair use including:

• Securing immobile or spastic patients
• Transferring patients into and out of the wheelchair
• Use of wheel locks
• Wheelchair lifts between floors and on vans
• Loading patients into elevators
• Use of braces and other propping devices for patients who may already have an injury 
• Parking patients in level areas and away from ramps and stairways

As an injury lawyer, who has represented people who have suffered a variety of wheelchair related injuries, I frequently find little attention paid by facilities or staff to this essential--- albeit somewhat mundane task.  As more disabled patients begin to demand to live full and active lives--- not just in the confines of their room--- facilities need to make sure that their facilities and staff are equipped to safely care for patients in wheelchairs.

Related Nursing Homes Abuse Blog Entries:

Investigation Into Nursing Home Resident's Death In Van Accident Begins

Another Example Of Nursing Home Negligence: Disabled Patient Falls Down Unsecured Stairway

Nursing Home Aide Fired After She Forgets To Secure Paralyzed Patient In Wheelchair

Medical Facilities Must Use Wheel-Locks & Supervision To Protect Patients In Wheelchairs

Apparently the women-- who were both in wheelchairs-- only had their wheelchairs attached to the floor of the van. The driver never used a seat belt to secure them within the wheelchair. 

As the driver of the van applied the brakes the force of the stopping caused the women to be thrown from their wheelchairs causing them to sustain injuries.

In Iowa, as in some other states, there is no requirement that passengers in wheelchair be secured via seat-belt.  However, many handicapped drivers feel that common sense would dictate the use of some type of restraining device for the person in the wheelchair-- as do I!

I think the key to safely transporting the physically disabled patient is to use any type of securing method available to make sure they are snug.  Too often I have worked on injury and death cases where the patient was secured to the vehicle only by the wheels of the chair-- thereby allowing the straps to move though the spokes at the van moved.

Certainly, physically disabled passengers should be able to expect that the driver of the vehicle is experienced enough to properly secure them and assure them they they get to and from their destination safely.

In situations where a person does sustain an injury during transport on a van operated by a nursing home or other medical transport company, most situations are covered under the automobile insurance policy for the vehicle owner.  Generally, the injured person can recover for:

• Medical expenses
• Pain and suffering
• Disability
• Death

Related:

Inadequate Training Of Medi-Car Staff Exposes Seniors To Unnecessary Risk During Non-Emergency Transportation

Dropping Patients, Failing To Secure Wheelchairs & Dangerous Driving Put Elderly Patients At Risk Of Further Harm During Ambulance Transport

Transportation In & Out Of Nursing Homes: Ambulance Responsibility.

Nursing home resident's death raises questions, Quad-City Times by Tory Brecht and Brian Wellner, December 2, 2010

The young man was admitted to the Texas nursing home for rehabilitation following a car accident that left him with a traumatic brain injury (tbi) and multiple facial fractures.  On September 14th, a CNA called a nurse at the facility after she noticed that Evan was not breathing.

Rather than initiate CPR, the nurse scrambled to locate Evan's medical chart to determine what his families were with respect to resuscitation. 

In fact, seven minutes went by between the time the condition was recognized and chest compressions were initiated-- missing a crucial 5-minute window to initiate CPR.

By the time paramedics got Evan to a nearby hospital, he was dead.

This incident was investigated by The Texas Department Of Aging and Disability Services when it was discovered the facility was in disarray and had many problems that threatened the safety of patients.  Amongst the findings:

• 7 nurses lacked current CPR certifications
• Medical charts of 43 of the facilities patients contained no information regarding resuscitation wishes of the patient
• In other cases where resuscitation wishes were noted on the patient rooms, most of the time they were incorrect
• The facilities 'crash cart' contained inadequate medical equipment such as a missing blood pressure cuff, stethoscope and a working flashlight

Nursing homes need to be aware of their residents wishes-- to be resuscitated-- or not.  Certainly, when CPR is requested, it should be initiated as quickly as feasible by staff that are properly trained in the procedure. 

While I have no idea of this young-man's prognosis at the time he was admitted to this facility, it is tragic that the caregivers who were responsible for caring for him lacked the basic training to at least position him for the best outcome possible.

Related:

'Neglect' cited in death of Fort Worth patient November 15, 2010 Star-Telegram by Darren Barbee

A short delay from out of hospital cardiac arrest to call for ambulance increases survival (PDF) Johan Herlitza*, Johan Engdahla, Leif Svenssonb, Marie Youngc, Karl-Axel A¨ ngquistd, Stig Holmberga, European Heart Journal

Nursing Home Injury Laws: Texas

Not surprisingly, the allegations surrounding Crestwood Terrace stem from an economic incentive on the part of the facility to keep facility fully occupied and in receipt of governmental funding.  "They don't make things easy for the residents when they say they want to leave.  They want to keep the beds filled," says John Jansa program director at Progress Center.

Certainly, if the allegations asserted against Crestwood Terrace are accurate, they are particularly disturbing considering the fact that nursing home patients are entitled to select a facility on their own free will.  

Crestwood Terrace is owned by a limited liability company that has an ownership interest in the following facilities in Illinois:

• Bourbonnais Terrace
• Burnham Healthcare
• Southview Manor
• Community Care
• Joliet Terrace
• Kankakee Terrace
• Sycamore
• Woodside Extended Care
• The Terrace Nursing Home
• West Chicago Terrace

Related:

Forest Park activists protest Crestwood nursing home Forest Park Review August 24, 2010 

Apparently the man was chaperoned to a local amusement park with staff from the Woods Services.  When the group returned to the facility, one of the staff members escorted some of the other residents back to the living quarters while the other staff member parked the van.  The staff member who parked the van forgot that the autistic man remained in the back seat.

By the time the staff located the autistic man in the van he was dead.  According to the medical examiner, the man died from hyperthermia. The staff involved in the event have been suspended pending the results of the investigation in the incident currently underway by multiple investigative agencies.

Hyperthermia Deaths

Sadly, hyperthermia deaths related to people left in vehicles is more common than you think. Even relatively mild temperatures and bright sunlight can allow temperatures in vehicle to reach dangerous levels with short periods of time.

Hyperthermia can occur when the body is exposed to high temperatures and produces more heat than it can dissipate. The increased heat raises the body temperature disrupting normal body functioning. If not treated quickly after the initial onset, hyperthermia can result in disability and death.

Related:

Hyperthermia Deaths of Children in Vehicles

Autistic man dies at Langhorne center after five hours in parked van, philly.com July 28, 2010

Second suspension in Woods Services death, phillyburbs.com July 28, 2010