Defective Assistive Device Involvement in Older Adult Emergency Department Visits

Felipe Restrepo; Namrata Mali; Laura P Sands; Alan Abrahams; David M Goldberg; Richard Gruss; Nohel Zaman; Wendy Shields; Elise Omaki; Johnathon Ehsani; Peter Ractham; Laddawan Kaewkitipong

doi:10.1093/geroni/igad138

Defective Assistive Device Involvement in Older Adult Emergency Department Visits

Innov Aging. 2024 Jan 10;8(1):igad138. doi: 10.1093/geroni/igad138. eCollection 2024.

Authors

Affiliations

¹ Department of Industrial and Systems Engineering Information Technology, Virginia Tech, Blacksburg, Virginia, USA.
² Department of Computer Science, Virginia Tech, Blacksburg, Virginia, USA.
³ Center for Gerontology, Virginia Tech Carilion School of Medicine, Virginia Tech, Blacksburg, Virginia, USA.
⁴ Department of Business Information Technology, Virginia Tech, Blacksburg, Virginia, USA.
⁵ Department of Management Information Systems, San Diego State University, San Diego, California, USA.
⁶ Department of Management, Radford University, Radford, Virginia, USA.
⁷ Department of Management, Information Systems, and Quantitative Methods, University of Alabama at Birmingham, Birmingham, Alabama, USA.
⁸ Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁹ Center of Excellence in Operations and Information Management, Thammasat Business School, Thammasat University, Bangkok, Thailand.

Abstract

Background and objectives: 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.

Research design and methods: 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 30 776 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.

Results: A total of 10 974 older adult ED cases were treated for 12 488 injuries involving a defective device. Injuries included 4 212 head and neck injuries (eg, concussion), 4 317 trunk injuries (eg, hip fractures), and 3 959 arm or leg injuries (eg, leg fracture). Of these patients, 4 586 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 8 158 cases and part breakage/decoupling incidents in 2 816 cases.

Discussion and implications: 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.

Keywords: Injuries; Malfunctioning devices; Product design; Responsible production; Safety.