210 results for “falls risk”
85y · Female·neck injury (cervical spine fracture) as a consequence of a fall
…ine fractures sustained when she fell from a toilet chair at her nursing home. She had multiple documented falls and explicit care plan instructions never to be left alone on the toilet due to high falls risk and dement…
82y · Male·closed head injury (subdural haematoma) sustained in a fall
…l while attempting to walk to the toilet unassisted after not being provided with a urinal bottle, despite falls risk assessment identifying he needed assistance with toileting. Initial examination appeared thorough wit…
83y · Female·Pneumonia complicating rib and pelvic fractures sustained in the setting of mult…
Margaret Barton, 83, died of pneumonia complicating rib and pelvic fractures from multiple falls. Critical clinical lessons: (1) The Oxazepam regimen directly contributed to her death. Dr C. tripled her …
80y · Female·terminal exacerbation of congestive cardiac failure due to a fracture of the rig…
…ater from terminal exacerbation of congestive cardiac failure secondary to the fracture. The coroner found falls risk assessment and prevention measures were appropriate, including call bell access, frequent checks, and…
70y · Female·pneumonia and post-surgical course following repair of neck of femur fracture, i…
… Mental Health Act Treatment Order. She sustained a neck of femur fracture from a fall despite appropriate falls prevention strategies in place. Following surgical fixation at hospital, her postoperative course was comp…
96y · Male·Traumatic closed head injuries sustained in a fall
… from which he died two days later. A coronial nursing consultant found no clinical red flags in his care. Falls risk assessment was appropriately completed on admission and he was assessed as high-risk. While the nursi…
84y · Female·pneumonia and fracture of the neck of right femur following a fall
…. She had advanced Alzheimer's disease, cognitive impairment, impulsive behaviour, and was assessed as high-risk for falls. A movement sensor alarm, which was part of her prescribed falls prevention strategy, was not in …
75y · Female·postoperative delirium/exacerbation of community acquired pneumonia following le…
…isease, anemia, and significant mobility impairment fell in her aged care facility despite documented high falls risk and appropriate preventive measures. She sustained a neck of femur fracture requiring hemiarthroplast…
98y · Male·comminuted pertrochanteric fracture of left hip sustained in mechanical fall
…t his residential aged care facility on 24 July 2023, dying four days later. He had experienced escalating falls in the prior year. The coroner found the care substandard, identifying critical failures: movement detecto…
82y · Male·end stage dementia
…Helping Hand Mawson Lakes for two years with progressive cognitive decline, mobility issues, and recurrent falls including one causing intracranial bleeding managed conservatively. In February 2016, he acutely deteriora…
73y · Male·Traumatic head, facial and chest injuries caused by fall down stairs at resident…
A 73-year-old man with Parkinson's disease and recent falls died from traumatic injuries after falling down six stairs while exiting a residential aged care facility …
84y · Male·acute aspiration complicating periprosthetic fractured right femur (operated) on…
…ryan Roocroft, 84 years old with severe dementia, suffered a periprosthetic right femur fracture after two falls at aged care on 24 December 2020 while on oxazepam. He underwent surgical repair on 25 December and was pl…
82y · Male·hypostatic pneumonia
…pression fracture from an unwitnessed bed fall on 1 April 2022. The facility had documented multiple prior falls but failed to implement standard fall prevention measures including bed alarms or bed rails, despite clear…
55y · Male·Multiple injuries sustained in a fall from a height
…rniation and died 9 days post-injury. The coroner identified a significant prevention gap: while workplace falls are regulated, domestic DIY falls from heights and roofs lack public education campaigns. The finding high…
77y · Male·Subarachnoid and subdural haemorrhage post head trauma secondary to a fall
Leslie Alexander, 77, died from subarachnoid and subdural haemorrhage following a fall at an aged care facility. He fell on 29 March and again on 30 March 2015, striking his head. Initial assessment by a locum GP found n…
75y · Male·pneumonia and head injury from fall
…sturbance and hyponatraemia (low serum sodium of 124 mmol/L). Initial clinical assessment did not identify falls risk. After 4 days, he fell backwards suddenly while standing in the corridor despite a care assistant bei…
52y · Female·Spinal injuries sustained in falls in a woman with multiple medical comorbiditie…
…ultiple comorbidities living in supported disability accommodation, died from spinal injuries sustained in falls. She fell in her bedroom on the afternoon of 7 May 2021 and appeared relatively well afterwards, walking u…
76y · Female·Immersion (with underlying cause undetermined in circumstances of a fall into a …
… failed to report the death to the coroner. Systemic failures included inadequate supervision despite high falls risk, poor communication between staff and GP, absence of incident reporting, and an apparent cover-up. Ke…
79y · Female·subdural haematoma following mechanical fall with head strike
…ematoma and died 11 days later. The coroner found the care provided was adequate and appropriate, with fall risk appropriately assessed at level two requiring one-staff assistance. While the patient's progressive instabi…
100y · Female·frailty and fracture of the right neck of femur
Nancy Muriel Hazell, aged 100, was a long-term resident of an aged care facility with appropriate falls prevention measures in place including bed/chair sensors, call bells, and physiotherapy. She sustained an …
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