Physical Restraints Endanger Physical and Psychological Health of Patients

Physical restraints, such as safety vests, wheelchair and lap belts, body holders, or ankle/wrist restraints, are commonly used in the United States. According to an article in STLToday.com, though widely used, studies show that physical restraints cause more harm than good, especially for older patients in nursing homes. The U.S. Food and Drug Administration (FDA) determined that approximately 100 patients die annually across the nation as the result of being physically restrained. Many of these deaths occur when the patient attempts to remove him or herself from the restraints for purposeful behavior, such as using the restroom, or to simply get out of the restraints. In the United Kingdom, physical restraints are seldom used, if ever, and no evidence suggests that the lack of restraints poses a safety threat. Many health professionals believe physical restraints will protect the patient from pulling out necessary medical equipment, such as IVs and breathing tubes, or falling, when, in fact, physical restraints actually increase the risk of those dangers. Studies in nursing homes have demonstrated that the number of falls actually decreases when the use of physical restraints is reduced. In addition, recent studies have shown that in intensive care units (ICU), physical restraints[…..]

Tube Feeding for Dementia Patients May Increase Restraint Injuries

Up to one-third of patients with severe dementia receive their daily meals via a tube. However, new research suggests that tube-feeding and the patient restraint that is necessary for its use might actually cause more harm than good. Dementia patients who receive tube-feeding are more likely to be placed in patient restraints in order to prevent them from accidentally or intentionally dislodging their feeding tubes. However, while in restraints, patients can easily be injured, according to a recent article released by Reuters. The study was performed at the Royal Free & University College Medical School in London, England and followed over 1,800 dementia patients, 409 of whom were tube-fed. The patients placed on feeding tubes had received them for conditions like losing weight, refusing to eat, not eating enough, or had difficulty swallowing. The research team discovered that the patients with feeding tubes were more likely to be placed in patient restraints and often developed bedsores as well as other sores, bruises and scrapes from the restraints themselves. Since patients with dementia often cannot communicate that their restraints are hurting them or are not necessary, these patients are far more likely than the general population to be restrained improperly or[…..]

Maryland Mental Hospital under Review after Patient Deaths

The Clifton T. Perkins Hospital Center in Jessup is facing inquiries after a patient died of strangulation in September, according to a recent article published by the Baltimore Sun. The deceased patient is the third to die at the hospital since 2008, raising serious questions about the psychiatric hospital’s staffing and procedures. Another resident in the same hall was charged with the murder of the most recently deceased patient. Last year, a patient was found dead after hospital staff had allowed him to lift his bed for exercise, which is a violation of hospital rules. A third patient died after complaining of leg pain, an indication of blood clots, but received no treatment from Perkins hospital staff, despite having a high risk for blood clots. Perkins Hospital is Maryland’s only maximum-security psychiatric hospital. It houses over 200 patients, many of whom have been charged with felonies or who would have been convicted of a felony but for their mental illness. The hospital is frequently understaffed, and employees report receiving pressure from administrators to move patients quickly through and out of the hospital, even if the patients are unable to live without supervision. Most hospitals strive to take good care of[…..]

FDA Urges Caution in Using Patient Restraint Devices

The U.S. Food and Drug Administration (FDA) has long warned hospitals, nursing homes, and other health care providers to use patient restraints with great caution. The FDA is concerned about the high rate of injuries to patients put in restraints, which includes safety vests, wheelchair belts, and similar devices. The FDA estimates that about 100 patients die or are injured per year in the U.S. while trying to get out of patient restraints. Often, the patient is attempting to do something as simple as getting up to use the bathroom when they become entangled or injured by the restraints. Often, patients are injured when restraints are put on incorrectly; the restraint is the wrong type of restraint for the patient’s needs; or when the patient is not monitored after the restraints are in use. To avoid patient restraint injury and death, the FDA recommends that all health care facilities use restraint alternatives whenever possible and communicate to the patient and their family what restraints are used and why. The restrained patient should always be under the direct care of a physician and should be restrained for the shortest time possible. All staff should know how to use restraints properly and[…..]

Federal Rules Provide Guidance for Hospitals Using Patient Restraints

In 2007, the federal Centers for Medicare and Medicaid Services (CMS) issued a final rule for hospitals on the use of patient restraints. The rule applies to any hospital or similar patient care facility that receives Medicare or Medicaid funds. Violating the rule can cause a facility to lose Medicare funding, as well as incite a civil or criminal investigation, particularly if violations cause injury or death. According to the National Council for Community Behavioral Healthcare, the rule defines a “patient restraint” as any method or device that prevents a patient from moving his or her limbs or head freely. Hospitals may use patient restraints to ensure a patient’s immediate physical safety. However, any restraint must be the least restrictive one that will still work and must only be used when other methods of keeping the patient safe have failed. Patient restraints must be removed as soon as possible once the patient is no longer in immediate physical danger. Physicians are responsible for ordering patient restraints and for reevaluating the patient frequently to determine when restraints can be removed. Hospital staff, including doctors, nurses, and emergency personnel, must receive regular training approved by the state in which they work. Under[…..]

Forced Medications, Physical Restraints Are a Reality of Psychiatric and Juvenile Institutions

Disability Rights New Jersey, a patient rights organization, has filed suit in federal court alleging that New Jersey psychiatric hospitals consistently medicate patients against their will. Believe it or not, New Jersey law only permits a psychiatric patient to appeal medication decisions to administrators at the hospital where they are confined. Most other states provide patients the right to appeal to the court system or decision- makers outside of the hospital. The lawsuit seeks to bring the state of New Jersey in the line with these other states. New Jersey’s law allowing psychiatric hospitals to forcibly medicate patients is just one example of the dangers that lurk inside psychiatric and juvenile facilities across the United States. Another common place practice inside mental and juvenile institutions and boot camps is forced physical restraints on patients. Forced physical restraints on individuals that are institutionalized often result in serious injury or death. Isaiah Simmons died on January 23, 2006 when the 17 year old was physically restrained by seven counselors for over three hours at a Maryland juvenile facility. Simmons was placed in a prone restraint and struggled to breathe before expiring due to cardiac arrest. Another youth, Martin Lee Anderson was killed[…..]

Use of Restraints Coming Under Fire in New Jersey

New Jersey, which allows both public and private schools to restrain unruly children with disabilities, is coming under fire. Last year, congressional investigators found hundreds of cases of abuse and at least 20 deaths related to seclusion and restraints since 1990 in United States schools. An app.com report mentions that the investigators found cases of disabled children as young as five being bound, held down on the floor or locked in rooms for hours at a time for small offenses. New Jersey is one of 19 states that does not have laws or regulations dealing with restraints or seclusion in schools. In addition, schools don’t have to report those incidents, maintain written policies on how to handle such problems, or even notify parents if their children are restrained. Employees of New Jersey schools are allowed to keep children confined in rooms until they settle down, and can use bear hugs and other physical moves to handle unruly children. School employees can also use techniques to control autistic children who injure themselves, including spraying water or chemicals at the children, putting hot sauce in their mouths, or snapping them with rubber bands. Some say these techniques are necessary as a last[…..]

Recovery for Estate of 17-Year-Old Killed in Youth Facility

Seventeen year old Manny Leach was choked to death in June of 2007 by an employee of the Chad Youth Enhancement Services Inc., a Youth Correctional facility in Philadelphia. According to a philly.com story, the facility paid the teen’s family $10.5 million to settle the matter in a federal lawsuit. The death was the second incident of juvenile detention center abuse at the facility resulting in a teen’s death. Had the City of Philadelphia shut down the facility after the first death, as was done by the State of Maryland after Isaiah Simmon died at Bowling Brook, this death may have never occurred. Another senseless death, in my opinion, due to the negligence of the City of Philadelphia. Manny’s case was previously thought to have been a homicide; however, further evidence supported by a photograph from a surveillance camera demonstrated otherwise. Based on the story, after Manny had been put in a restraint hold, a Chad mental-health technician had both hands gripped around the boy’s neck and had him pinned to the floor. Restraint is often used in some mental health facilities in Maryland and throughout the United States as a way to help prevent the patient or others from[…..]

Unlawful Restraint Methods Used in NY Juvenile Detention Centers

Juvenile detention centers are supposed to rehabilitate wayward youths, not harm them. However, a lawsuit recently filed against an agency that operates nine New York state juvenile detention centers is being accused of wrong doing, specifically the improper use of force and illegal methods of restraint used against detention center residents. A poughkeepsiejournal.com article discusses multiple instances where juvenile offenders were mistreated. In some of these cases, some individuals sustained physical injury as a result of negligent and unlawful care administered. One such mistreatment involved a young man who had his arm broken, and then later had that same arm pinned behind his back as he attempted to leave a room. What’s even more problematic is that the youth’s arm was not treated by facility staff, and remained untreated until the victim’s grandmother noticed the break during a visit. In another instance of juvenile facility abuse, it was determined by the Justice Department that staff members at four different detention centers “violently and unlawfully restrained (young people) and failed to provide legally required mental health services.” Nearly 1,600 juvenile offenders in New York are incarcerated in detention centers each year. However, just because these youths have been sentenced to detention[…..]