The most frequently reported safety incident within hospitals is falls. In some studies it is reported that 30 to 50% of falls result in some harm to the patient and even fractures occur in 1 to 3% of cases.
These statistics are very important from the point of view of civil liability because damage is one of the essential elements to prove in court and, in the case of falls, many even end in fractures, which makes it very easy to prove that there was damage. Let us also remember that in other countries there are precedents of cases won against hospitals for moral damage derived from a fall, even without the presence of fractures.
The medical literature describes the multiple risk factors and measures that must be taken to reduce the risk of falls, although it is recognized that the risk will never be zero. Therefore, in accordance with the medical lex artis and the standard of care required of doctors and hospitals so that civil liability is not updated, in the event that a patient falls, it must be proven that the risks and adequate and sufficient measures were taken to prevent said fall and it still happened.
Unfortunately, falls will never cease to occur inside hospitals, but from a legal point of view, a doctor or health institution has a chance of winning one of these cases if they prove that all necessary measures were taken to prevent the fall. fall and still showed up.
In our country, direct amparos 102/2021, 103/2021 and 104/2021, which were ruled by the Seventh Collegiate Court in Civil Matters of the First Circuit, deal with this particular issue. During her hospitalization, a patient received various medications that included analgesic, sedative and muscle relaxant. While under the influence of these drugs, he fell out of the hospital bed, causing fractures to both forearms. The patient claimed that the fall was due to the medications as the bed rails were not in place.
In said resolution, it was resolved that, according to the previous criteria of the Supreme Court, sedatives cannot be considered as dangerous substances to prove strict liability (SCJN CT 93/2011); This means that it must be proven that there was guilt, that is, an act contrary to the standard of care required or to the ad hoc medical lex artis on the part of the hospital or health personnel.
In the particular case, to accredit the due diligence of the health personnel, it seems to me that there must be an assessment of the risk factors of the patient of presenting falls, the handrails must remain elevated and the patient must also be informed and It is important for family members to keep the guardrails in place at all times. Of course, all these measures must be included in the clinical record.
The fact that a medical act is judged under the figure of subjective civil liability presents an interesting distribution of the burden of proof. In this type of case, the patient has to prove the damage and the causal link that relates the culpable action or omission of the health personnel with the damage. The defendant, on the other hand, is responsible for proving that he was diligent and complied with the standard of care and the ad hoc lex artis medica.
This case is illustrative, because every time we are going to see more civil liability procedures derived from hospital falls and the best defense will be to prove that sufficient care was taken to avoid the fall. It is impossible to avoid all falls, but when we are in these cases, the hospital and the doctor have the burden of proof regarding their due diligence.
These days, there should be no hospital or clinic in the country that does not assess the risk factors for falls in all its patients, that does not place the rails and does not inform the patient and relatives of the importance of not lowering the rails. It may seem like a lot of work, but a fall liability case is more work, more money, and it means that a person suffered harm that was many times preventable. Let’s not lose sight of the legal consequences of a hospital fall.
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