Slips and Falls: What to do and safe practice tips

My patient has fallen in my clinic. Am I at fault?

As a treating health professional, you owe a duty of care to your patient. It is therefore crucial for you to have a thorough understanding of your professional obligations as a health professional.

This article discusses a clinical scenario where a complementary therapist has not taken appropriate precautions to ensure that no harm comes to a patient in their care and provides some safeguards to prevent this from happening to you.

This blog is part of the Don’t risk it series facilitated by IICT’s trusted insurance partner BMS and written by Lauren Rickersey and Annaliese Williams of Barry.Nilsson. Lawyers

What are your obligations as a complementary therapist?

The health, safety, and care of the patient is the primary concern for health professionals in clinical practice. In accordance with the International Institute for Complementary Therapists’ Code of Ethics and the National Law (in some circumstances), complementary therapists have to practice safely and effectively, and to minimise any risks to a patient’s safety – specifically, to give due consideration to the foreseeable consequences of their actions. This is also the therapist’s legal obligation under federal, state and territory legislation – complementary therapists are required to take precautions to avoid a risk of harm to patients for whom they are responsible. If a therapist fails to take appropriate precautions, they will likely be liable for any injury suffered if a patient injures themselves at the clinic.

To better understand what this means, let’s examine it in a clinical scenario.

Clinical scenario

Larisa attends for a consultation with complementary therapist, Tanith, for complementary therapy to support and enhance her wellbeing during chemotherapy. Larisa is weaker on one side of her body due to a previous injury. Tanith directs Larisa to move onto the massage table so as to continue part of the therapy. Tanith looks away for a moment to speak with one of her colleagues. Larisa falls as the table was not secure. Tanith’s colleague runs over to help Tanith lift Larisa back up. Larisa reports feeling wrist pain and decides to drive herself home rather than continue with the treatment that day. Tanith tells Larisa to ice her wrist. In her notes of the day’s appointments, Tanith writes ‘RFA: hip. Tx: massage. NB - L fell, complained of wrist pain. Tx: ice. NV – 1/52’.

Tanith calls Larisa a few days later to follow up and see how she is going. Larisa tells Tanith that she went to her GP for the pain in her wrist and was referred for an x-ray which confirmed that she had sustained a fracture. Larisa blames Tanith for the fall and her wrist injury and makes a complaint against Tanith and the clinic.

Tanith has breached her professional obligations by:

1. failing to be fully appraised of Larisa’s medical history and considering the proper safety precautions and treatment to be provided given Larisa’s original injury before providing the treatment;
2. failing to ensure that there was a safe environment and equipment for Larisa’s treatment before and during the provision of treatment;
3. failing to properly assist, refer and ensure continuous and ongoing care of Larisa after her fall; and
4. failing to adequately record the treatment and incident in Larisa’s clinical notes.

Learnings and safeguards

The scenario of Larisa and Tanith displays a number of common errors that occur before and after an incident in which a patient falls at a clinic.

Here are some simple strategies to help you avoid breaching your professional obligations regarding a patient’s safety and being found at fault if a patient falls:

• make sure that there is a safe environment when providing treatment to the patient;
• follow proper safety procedures as outlined by the clinic and in accordance with your training;
• make sure that any supportive equipment is stabilised and in proper working order;
• do not leave the patient unsupervised during the course of treatment;
• be aware of a patient’s medical history at all times; and
• if your patient does fall, follow appropriate procedures for rendering aid.

Safeguards for clinics to ensure that all complementary therapists are practicing effective risk-management may include training for all new staff on clinic policies and professional obligations relating to patient safety and risk management. Clinics can also organise regular meetings with staff to discuss case studies and ongoing training regarding risk-management.

In order to limit your risk of being found to be fully responsible for any injury suffered if a patient does fall, we suggest that you:

• offer ice or treatment to help the patient in the short-term – but make sure that this is within the scope of your clinical expertise and it is appropriate to do so;
• arrange transport for the patient, either to their home or to a hospital – making sure that someone comes to pick up the patient from the clinic;
• refer the patient for examination with a general practitioner or call an ambulance depending on the seriousness of the patient’s fall/injury;
• ask the patient to update you as to their progress;
• make sure to record the incident in detail in your clinical notes; and
• notify your insurer in case the patient decides to make a claim.

What to do if a slip or fall happens?

You should seek assistance including from a senior colleague and make sure to notify your insurer as soon as possible if a patient does slip or fall while in your care.

Learn more about IICT’s trusted insurance partner BMS or IICT’s insurance program.

Barry.Nilsson. Lawyers communications are intended to provide commentary and general information. They should not be relied upon as legal advice. Formal legal advice should be sought in particular transactions or on matters of interest arising from this communication.

BMS Risk Solutions Pty Ltd (BMS) AFSL 461594, ABN 45 161 187 980 is the official and exclusive insurance broker for the IICT member insurance program and is part of the BMS group.

Article written by: Lauren Rickersey and Annaliese Williams of Barry.Nilsson. Lawyers

About the Authors:

	Barry.Nilsson. is a national firm specialising in Insurance & Health Law, Family Law and Wills & Estates.
	The BMS group provides cover to more than 700,000 healthcare and regulated professionals through 100+ associations across Australia, Canada, Europe and New Zealand. This experience gives BMS the ability to create and deliver significantly continuously evolving member centric insurance programs. This includes ensuring broad, market-leading coverage, evidence-based risk management and exceptional member service.