Failure to Secure Resident During Transport Results in Injury
Penalty
Summary
A Transportation Aid failed to ensure the safe transport of a resident by not securing the shoulder harness strap and seat belt during a van ride to a medical appointment. The resident, who had a history of multiple fractures including a left distal femur fracture that was not healing well, was loaded into the van with the wheelchair secured, but the seatbelt system was not fastened because it was not functioning. The Transportation Aid was aware that the safety belts were not working but did not report the issue to maintenance staff, who were present at the facility at the time. Instead, the Transportation Aid proceeded with the transport, believing the short distance would not pose a problem. During the transport, the resident slid from the wheelchair onto the floor of the van, resulting in a comminuted fracture of the left femur. The facility's policy required that safety belts be worn at all times, and a visible sign to that effect was supposed to be present in the van, but no such sign was observed during the survey. The Transportation Aid had only recently begun driving the van and had received training through videos and orientation from the Maintenance Director. The failure to secure the resident and to report the malfunctioning safety equipment directly led to the resident's injury.