Revealed death by improper belt fixation

Researchers reveal: Death due to improper belt fixation

18/01/2012

According to a study by the Ludwig Maximilian University of Munich and the Medical University of Vienna, incorrect positioning of patients in bed or in the chair can lead to death, for example due to unintentional strangulation. In at least 22 cases, patients died because the forceps were incorrectly attached.

Belt fixations require a medical order
Scientists evaluated 27,000 autopsies at the forensic institute in Munich from 1997 to 2010. The coroners found out that in 26 cases death occurred during a so-called belt fixation. In 22 cases, the deaths of those not requiring long-term care could be exclusively attributed to fixation, as reported in Deutsches Ärzteblatt.

Belt fixings are among the so-called „Deprivation of liberty“ (FEM). These include, for example, the attachment of bed rails, straps, straitjackets and the sheaf of sedating medications. These measures are in contrast to the state guarantee of freedom, which is enshrined in the fundamental rights of the constitution, if there is no justification. Both for criminal and ethical reasons, a possible indication for fixation should be thoroughly examined by the physician. As a rule, affected patients are those with dementia who are in need of care, who could fall out of bed or seriously mentally ill or suicidal subjects. In recent years, more and more reports of cases of abuse from nursing homes are reported in which older people are unnecessarily fixed with straps or sedated with medication. If this can be proven, it is a criminal offense.

Of 22 deaths by girdle fixation was detected at every other strangulation
The scientists found that among the 26 deaths, only three were due to a natural cause and one patient committed suicide. The remaining 22 deaths can be traced back to belt fixations. Strangulation was detected every second. In eight belted patients, the rib cage was squeezed together and in three cases a so-called head loss occurred due to fixation.

The sad result of the study: In 19 cases belt fixations were made incorrectly. The experts were able to prove in two cases that the fixation was provisionally carried out only with belt and bed sheets. In another case, a patient was strangled despite a correctly performed fixation with a gut, as she was above average articulation.

The scientists commented on their result: „To prevent such deaths, it is strongly recommended from a forensic point of view to exploit all possibilities of alternatives to FEM.“ Should a fixation be unavoidable, according to the scientists, it would not only have to be laid out in accordance with the regulations. Affected persons would also have to be increasingly monitored by the nursing staff. (Ag)

Picture: Gerd Altmann