Defective Assistive Device Involvement in Older Adult Emergency Department Visits.

Abstract

Many older adults adopt equipment to address physical limitations and reduce dependence on others to complete basic activities of daily living. Although a few prior studies have considered injuries associated with assistive devices for older adults, those studies focused on older adults' health and functional risks for injury. There is limited analysis of older adult injuries involving defective or malfunctioning assistive devices. Data from this study are from the National Electronic Surveillance System All Injury Program which collected data on consumer product-related injuries from a probability sample of 66 hospital Emergency Departments across the United States. Data from 30776 older adult Emergency Department (ED) injury narratives from 2016 to 2020 were coded according to the assistive device involved and whether malfunctioning led to the injury. The study team manually examined all narratives in which the assistive device was coded to have malfunctioned. A total of 10974 older adult ED cases were treated for 12488 injuries involving a defective device. Injuries included 4212 head and neck injuries (eg, concussion), 4317 trunk injuries (eg, hip fractures), and 3959 arm or leg injuries (eg, leg fracture). Of these patients, 4586 were admitted to a hospital ward for further evaluation and treatment. Seventy percent of these patients were injured while using a walker; in contrast, wheelchairs were implicated in only 4% of the above cases. Design flaws were identified in 8158 cases and part breakage/decoupling incidents in 2816 cases. Our findings provide evidence that assistive devices are actively involved in older adult injuries. Further research is needed to reduce injuries associated with assistive devices by educating patients and their careproviders about device use and assembly and developing effective methods for informing manufacturers about malfunctioning devices.