Unattended Elderly Patient Is Injured During Physical Therapy Session

Case Overview

This case involves a 76-year-old female patient who suffered an injury during a physical therapy session. The patient was in the midst of recovering from a hip replacement surgery and was required to use a treadmill as part of her physical therapy regimen. While she was on the treadmill, the patient was monitored by her physical therapist or an assistant. The staff member monitoring her would start and stop the machine for the patient and would remain within a 2-3 feet distance while the patient was in motion. The patient had never stopped the machine herself during the course of her physical therapy and had never been taught how to do so by the defendant physical therapist. During one session, the patient was left unattended on the treadmill. When she became tired and needed to stop, she reached for the stop button leaving only one hand to steady herself. The patient then lost control and fell when the treadmill jolted to a halt causing her to break her leg and her collarbone. The patient required several painful corrective surgeries following the incident.

Questions to the Physical Therapy expert and their responses

Do you routinely work with elderly patients in a physical therapy center?

I have treated 100+ patients and study participants in my time as a physical therapist. My background and research are specifically in the area of hip fracture and hip replacement. I am currently employed as a full-time faculty researcher, so I do see research participants who have had a hip replacement.

Can you describe the standard of care for monitoring patients when they are using equipment such as a treadmill?

The standard of care for monitoring patients on any equipment is 1) the patient to be taught how to use the equipment by the physical therapist or physical therapy assistant - not the aide 2) after the patient is familiar with the treadmill, 'sufficient monitoring' depends on the patient's level of cognition and level of functional status. For example, an individual who is cognitively impaired may need constant supervision. The same is true of an individual who requires moderate or maximum assistance for most functional activities. It is not uncommon to have a patient, as you describe, unattended with the physical therapist checking in on them every 5-10 minutes. This would really depend on the specifics of the case.

What precautions should be observed in order to prevent injuries while using such equipment?

Precautions of treadmill include any severe cardiac disease (CHF), severe balance disorders (if using Berg Balance scale below 42/56), vertigo, impaired cognitive function (moderate to severe), documented poor functional status that requires the assistance of 1 or 2 people at a moderate level.

About the expert

This qualified expert earned her BS and MS at Nazareth College, a PhD at the University of Rochester, and her DPT at the MGH Institute of Health Professions. She is active in her field as a member of the American Physical Therapy Association and in research within her field. Formerly, this expert has held positions as a physical therapist at several hospitals and outpatient clinics. Currently, she is an assistant professor at a top-ranked health professions school in New England.