Defective assistive device involvement in older adult Emergency Department visits

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 (NEISS) 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 injury narratives from 2016 – 2020 were coded according to assistive device involved and whether malfunctioning led to injury. The study team manually examined all narratives in which the assistive device was coded to have malfunctioned. A total of 10,974 older adult Emergency Department cases were treated for 12,488 injuries involving a defective device. Injuries included 4,212 head and neck injuries (e.g., concussion), 4,317 trunk injuries (e.g., hip fractures), and 3,959 arm or leg injuries (e.g., 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 four percent of the above cases. Design flaws were identified in 8,158 cases and part breakage/decoupling incidents in 2,816 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 care providers about device use and assembly and developing effective methods for informing manufacturers about malfunctioning devices.