Failure to Turn Off Power to Motorized Wheelchair During Transport Results in Resident Injury
Penalty
Summary
A deficiency occurred when staff failed to ensure that the power control to a resident's motorized wheelchair was turned off during van transport. The resident, who had diagnoses including quadriplegia, immobility, and a right foot fracture, was seated in a motorized scooter that was locked and secured with seat belts. However, the power to the scooter remained on, and while the van was in motion, the resident accidentally activated the forward button, causing the chair to move forward. This movement resulted in the scooter's foot board striking the chair in front, which then caused injury to the resident's right foot. The incident was identified when the resident reported pain in his right foot upon arrival at a clinic, leading to an x-ray that showed a healing fracture in the first metatarsal head. The facility's investigation confirmed that the van driver did not turn off the power to the motorized wheelchair before transport, which directly led to the accident and injury.