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Protecting Long-Term Care Consumers from the Dangers of Bed Rails

What are Bed Rails?

Bed rails are metal or plastic bars positioned along the side of a bed, also commonly known as side rails. The rails may extend the length of the bed or less, such as a quarter or half length. Some people use bed rails to help pull themselves up, turn in bed, or to get out of bed. Others may use a bed rail thinking it will prevent an older adult from falling out of bed or keep an individual with dementia from getting out of bed and wandering.

Some bed rails are attached to the bed as part of a “bed system.” Bed rails that are part of a bed system are found on hospital beds, in most nursing homes and in medical supply companies that rent hospital beds for use at home. There are also portable bed rails that can be purchased by consumers directly and attached to a bed. 

Why are Bed Rails Dangerous? 

Bed rails are frequently used in homes or long-term care facilities because they are believed to keep people safe. In reality, bed rails can be extremely harmful. Bed rails can cause:

Strangulation or asphyxiation: Older adults can get trapped in the gap between the bed rail and the mattress. The individual can roll into that gap and be too weak, frail or confused to change position. The mattress may press against the person’s chest, preventing the individual from breathing. This can quickly result in death. Older adults can also get trapped between the rails and suffocate.

Severe injury: When individuals who are confused or have dementia want to get out of bed and bed rails block their way, they frequently try to climb over the rails. This can lead to a fall, hitting their heads, and a serious injury. Injuries such as cuts, abrasions and bruises can also result when an older adult becomes entrapped.

Reports of Bed Rail Injuries and Deaths: From January 2003 through September 2012, 155 deaths involving bed rails were reported to the Consumer Product Safety Commission (CPSC). In October 2012, the CPSC released a memorandum on reports of adult bed rail-related deaths, injuries and potential injuries the agency received, which can be read here. The report reveals that over a nine-year period, there were roughly 36,900 visits to hospital emergency wards resulting from bed rail-related injuries.

In addition to the number of deaths reported to the CPSC, by 2012 the Food and Drug Administration (FDA) had received approximately 550 reports of alleged bed rail deaths. The FDA maintains a database of adverse event reports it receives (called the MAUDE reports).These reports include multiple incidents of death and injury associated with bed rail products, including multiple reports of deaths and injuries associated with the same product over a period of time and multiple reports of deaths and injuries from bed rail products produced by the same manufacturer.

What Can be Done to Protect the Elderly from Dangerous Bed Rails?

  • Create safety standards. Both the Food and Drug Administration (FDA) and the Consumer Product Safety Commission (CPSC) have received hundreds of reports of injuries and deaths related to bed rails, yet there are no mandatory standards for adult bed rails.
  • Recall dangerous devices. Bed rails that have injured or killed older adults remain on the market. These bed rails continue to cause harm or death, yet no action is taken. The FDA and CPSC must exercise their product recall authority in order to remove from the market dangerous bed rails that have shown risks of entrapment, asphyxiation or other failures.

  • Resolve jurisdictional issues. The FDA and the CPSC disagree about which agency has authority over the different types of bed rails. These agencies must work together to resolve any jurisdictional issues so vulnerable older adults will be protected.

How to File A Report to the CPSC or FDA Concerning a Bed Rail Product

Individuals can file a report concerning a bed rail product that is responsible for an injury or death, or required intervention to prevent injury or death, through the Food and Drug Administration's MedWatch website. Individuals should report any adverse incidents involving bed rail products used for medical purposes, purchased from a medical supply store or used in a medical setting to the FDA (which regulates such bed rails as medical devices). 

For bed rail products purchased in retail stores or online and not used in a medical setting or for medical purposes, individuals should report any incidents of injury or death, or incidents that required intervention to prevent injury or death, to the Consumer Product Safety Commission.  

Alternatives to Bed Rails  

There are safer ways to reduce the risk of injury from falls. These include:

  • Lowering the bed as near to the floor as possible. An adjustable height bed can go very low to the floor for sleeping and be raised for transfers and care.

  • Placing non-slip mattress pads or other cushioning by the side of the bed to cushion any fall that might occur.

  • Using a secured vertical pole to assist in getting in and out of bed.

  • Using a bed trapeze to help reposition while in bed and to get in and out of bed.