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Bed Safety: Preventing Fires Caused by Hospital Beds

August 1, 2006
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Knowing the causes of hospital-bed fires in nursing homes is the first step toward mitigating risk by Julie A. Braun, JD, LLM, and Mark E. Bruley, BS
BY JULIE A. BRAUN, JD, LLM, AND MARK E. BRULEY, BS Bed safety: Preventing fires caused by hospital beds
Hot tips for clinical staff and bed-maintenance personnel Flames in a resident's room trigger a heat detector, setting off a fire alarm. A member of the nursing home's housekeeping staff, alerted by the fire alarm, sprays a fire extinguisher into the resident's room, which is filled by a dense cloud of smoke. A senior staff member who had heard a "pop" sound emanate from the room yells "Is anybody in there?" No one answers. Most of the residents are evacuated from the building when firefighters arrive. The fire was held to the room of origin as a result of staff efforts at extinguishment. Smoke scars the walls of the damaged room.

The 73-year-old resident with Alzheimer's disease, Adele, had moved her nightstand as she lay in bed. It jostled the bed's power cord at the electrical outlet. Sparks shot out of the plug and outlet igniting a sheet at the head of the bed. Flames raced down the bedding and covered Adele's body. She sustains second- and third-degree burns over 98 percent of her body. Ambulance attendants report that her skin was peeling from her feet to her waist. Adele dies a few hours later at a nearby hospital. The medical examiner determines that the burns played a direct role in her death.

The fire marshal's investigation concludes that preexisting power cord plug damage caused the sparking when the cord was tugged. The resident's loved ones consult an attorney, the facility is slapped with a lawsuit, and the insurance impact from the fire is not yet clear.


Resident safety is integral to providing quality nursing home care. Fires pose true threats to nursing homes, as well as their residents and staff. To receive government reimbursement, nursing homes must comply with several telephone books' worth of federal regulations and guidance. One says facilities must have emergency plans and procedures to meet all potential emergencies and disasters, including fires. With lives and property at stake, take steps now to prevent bed fires in your facility.

The Food and Drug Administration (FDA) reported in a Public Health Notification (www.fda.gov/cdrh/safety/bedfires.html) that it had received 95 reports from 1993 to 2003 of fires involving electrically powered hospital beds. Seventy-five percent of the fires were associated with such causes as failed motor starting capacitors, overheated motors, arcing from ill-fitting or damaged plugs, missing ground pins, fluid leaks that damaged the circuit boards, missing components in the wiring, poor maintenance, or failure to heed manufacturers' warnings. At the authors' request, the FDA searched its Manufacturer and User Facility Device Experience (MAUDE) database (www.fda.gov/cdrh/maude.html) using the keywords "fire," "smoke," "spark," "burn," "flame," and "ignite," and reported another 34 such incidents from January 1, 2004, to April 1, 2006.

Awareness of fire risks and precautions related to electrically operated beds is important to protect nursing home residents and staff against the risk of injury or death and to prevent significant property damage. To prevent such incidents, the authors offer safety tips that apply to all electrically powered healthcare beds, but may be particularly useful for older bed models. The tips are directed toward clinical staff and staff responsible for bed maintenance. This discussion assumes that the nursing home already has fire-prevention and behavioral policies in place (e.g., smoking in bed; lighter, candle, and match use). Safety tips supplied do not address any fire risks posed by oxygen administration to a nursing home resident while in bed.

Safety Tips to Prevent Fires Caused by Hospital Beds
Clinical staff. When plugging in a bed, visually inspect the bed's power cord for damage from, among other possibilities, use, age, crushing, pinching, shearing, cutting, cleaning solutions, bed movement, human and equipment traffic, and furniture placement (e.g., positioning a nightstand too close to a bed's power cord). Cord insulation should be intact and without evidence of bulging, stretching, crimping, cracking, or discoloration, especially at the ends, where the cord is attached to the plug body and to the hospital bed.

After inspection, connect the power cord directly into a wall-mounted outlet that is in good working order and capable of accommodating a heavy-duty or hospital-grade plug. The plug body, wall outlet, and wall plate should not be cracked or chipped. The plug should fit tightly into the outlet. The plug blades should be securely retained in the plug body. Any ground pin should be intact and secure. Do not connect the bed's power cord to an extension cord or to a multiple-outlet strip because they are highly vulnerable to physical damage that can cause fires. If use of extension cords or multiple-outlet strips cannot be avoided, choose only heavy-duty or hospital-grade connectors approved by the facility's engineering department. Only properly trained electrical-maintenance personnel should install extension cords and multiple-outlet strips. Mount multiple outlet strips on a fixed object (e.g., an equipment cart) to reduce risk of liquid spills and physical damage. Also protect multiple-receptacle outlet boxes from the risk of liquids spills and physical damage. All extension cords and multiple-outlet strips should be tagged and inspected routinely.

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