Injury Causation in Care Facility Disputes Expert Article

In cases involving an injury to a resident in a long-term care facility, a combination of co-existing medical/health conditions, the level of supervision, and the resident’s ability to communicate can make it challenging to determine the cause of the injury.

In this article, Biomechanical Engineer, Dr. Carolyne Albert discusses how a qualified biomechanics expert can investigate whether an adverse event took place, and shares two case examples.

Long Term Care Injury Causation Expert Witness

Care Facility Injury Causation Disputes

Residents of long-term care facilities often require substantial skilled nursing and medical assistance for their activities of daily living. Many residents of such facilities are diagnosed with medical conditions that require specialized care.

Examples of such medical conditions can include:

  • Bone fragility conditions, such as osteoporosis, which can compromise bone strength
  • Prolonged immobility due to injury or illness, which can result in loss of muscle tone and bone mass
  • Joint contractures, which hinder the motion of affected joints
  • Paralysis, which impairs the ability to effectuate certain movements and may be accompanied by sensory loss and bone and muscle atrophy

In some residents, the presence of mental health conditions affect interaction with other individuals, which may lead to injurious altercations. Some long-term care facility residents also have cognitive and/or communication impairments that may render them unable to explain how they were injured.

Injury Causation Analysis

The following examples outline scenarios where a biomechanical investigation determined the mechanical cause of diagnosed acute traumatic injuries in residents of long-term care facilities.

Biomechanics is comprised of bio, meaning living tissue, and mechanics, the classic engineering study of forces. Biomechanics is the science that deals with the response of the body to imposed internal or external forces.

A qualified biomechanical engineering expert can apply fundamental principles of physics and engineering to the evidence of cases such as these to answer questions about the forces and/or motions involved in causing diagnosed injuries.

Sample Case #1

While residing at a stroke rehabilitation facility, an elderly male resident was diagnosed with multiple acute bilateral leg and arm fractures. He was a non-ambulatory and non-verbal resident and was unable to explain how his injuries occurred. Facility staff did not report an incident, and his injuries were unexplained.

Did he fall? Was he dropped from his bed?

In this case, upon completing a biomechanical investigation, our biomechanical expert determined that the mechanisms of injury (i.e., the types and directions of forces necessary to cause the man’s diagnosed bilateral leg and arm fractures) were not consistent with a single fall event.

According to his medical records, the resident was also diagnosed with underlying osteoporosis, severe joint contractures, and spasticity, i.e., a condition involving abnormal muscle contractions and tightness following a brain and/or nerve injury.

Our biomechanical expert determined that the forces and motions necessary to cause the resident’s diagnosed multiple bilateral leg and arm fractures were generated by the residential facility staff’s handling of the resident during daily care activities such as washing, dressing, and repositioning.

Sample Case #2

A female resident with partial paralysis of her lower limbs, residing at a rehabilitation facility, was diagnosed with an acute fracture of her right femur.

The resident’s emergency room records indicated that the resident heard a pop when she twisted her right leg while transferring herself from the bed to the wheelchair.

The resident, however, testified that the aide caused her to fall backwards onto the ground and that she heard a pop when she landed on her buttocks. The aide denied that such a fall incident took place.

Was the loading necessary to cause the diagnosed femur fracture generated in the event as testified by the plaintiff?

In this case, our biomechanical expert determined that a backward fall landing on her buttocks, as testified by the plaintiff, did not generate the type and direction of force necessary to cause her diagnosed right femur fracture.

Our expert also determined that the biomechanical mechanism of injury for the resident’s diagnosed fracture pattern was torsion, which was generated when the plaintiff twisted her right leg when transferring herself from the bed to the wheelchair, as indicated in the emergency room records.

Investigating Injury Causation Disputes

In both case examples, a biomechanical investigation conducted by applying the scientific method and fundamental principles of physics and engineering to the evidence determined the mechanical cause of diagnosed acute injuries in healthcare settings.

Robson Forensic also has health care experts who are qualified to investigate various issues relevant to long term care facilities, including but not limited to, medication incidents, falls, recertifications, and advance directive challenges.

To connect with the appropriate expert for your case, submit an inquiry or call us at 800.813.6736.

Featured Expert

Carolyne I. Albert, Mechanical Engineer & Biomechanics Expert

Carolyne I. Albert, Ph.D.

Mechanical Engineer & Biomechanics Expert
Dr. Albert is an expert in mechanical engineering with specific expertise in orthopaedic biomechanics. She applies principles of biomechanics, dynamics, and mechanics of materials to determine the… read more.


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