Various entities may be listed as a defendant in legal action regarding bed hazards. These entities span a chain of bed rail use, and include manufacturers, suppliers, facilities, and personnel. Each plays an important use in evaluating the use of a bed rail for the patient, and in watching to make sure that there is no foreseeable harm to patients or staff.
A diverse group of individuals and corporations may be considered defendants in legal action regarding entrapment in a bed rail, side rail, or other hazard on the bed. These individuals and companies can include manufacturing companies, hospital and nursing home supply companies, the facility itself, personnel who required that the restraint be used, or personnel who either used the rail or witnessed the usage.
Manufacturing companies are those companies who make the bed, bed rails, mattresses, or any combination of these products. The chain of bed rail usage starts with this sector. Manufacturers may make individual pieces, or may make the entire component. In situations where individual pieces are made, there may be production outsourced to a separate company who in turn funnels complete parts to the manufacturer. The onus for bed rail safety mainly lies with the manufacturer. The second most responsible party comes at the end of the chain, and includes the facility and its personnel.
Supply companies serve as a type of "middleman" between the manufacturer and the facility. The supply company has an obligation to ensure that the product they provide is safe and will not cause foreseeable harm - or harm that an average layperson could see as foreseeable - to patients and staff. According to the Centers for Medicare and Medicaid Services, suppliers have the obligation to carry "comprehensive liability insurance in the amount of at least $300,000 that covers both the supplier's place of business and all customers and employees of the supplier. If the supplier manufactures its own items, this insurance must also cover product liability and completed operations." This indicates that there would be some potential liability on the part of the supplier - and even more so if the supplier also served as a manufacturer.
Facilities and personnel are the sectors that provide direct patient care. Facilities may include hospitals, nursing homes, hospices, at-home-care providers, assisted living residences, and other locations that provide care either in or out of the location to patients. Personnel are the individuals in these facilities who make decisions to use bed rails and have them available in the facility. Facilities ultimately install the beds with the side rails, and are the units that create protocol for determining when use of side rails is appropriate. Facilities also are the units that determine what equipment and what visibility is available in patient care settings and rooms. It is the responsibility of the facility to make sure that the equipment is safe for patient use.
Personnel are the potential defendants who have the most access to patients and are the last individuals in the chain of decision making regarding the use of bed or side rails as a restraint with a patient. These personnel may be physicians, chief nursing officers, physician assistants, nurses, and certified nursing aides. Although these personnel may be guided by the use of protocol established by their facility or employer, they do have the ultimate say in determining whether the restraint is appropriate for the individual patient. Some personnel, such as a CAN, have no say in determining whether a patient should be using bed rails. Eventually, it is personnel who are responsible for watching the patient and catching any hazards before they turn into an entrapment.