Assessing Standard Care in Elderly Patient Transportation Resulting in Fatal Injury

This case study examines a fatal incident involving an elderly patient during transportation to a dialysis appointment, focusing on whether there was a breach in the standard of care provided by the EMTs.

ByWendy Ketner, M.D.


Updated onNovember 17, 2023

Case Study: Assessing Breach of Standard Care in Elderly Patient Transportation Resulting in Fatal Injury

Case Overview

This case study covers an unfortunate incident involving an elderly patient residing in a skilled nursing facility. The patient was being transported to a dialysis appointment when the gurney they were strapped into was tipped over by the Emergency Medical Technicians (EMTs).

This resulted in the patient striking their head, leading to their demise 24 hours later. The central issue of this case is determining whether there was a breach in the standard of care provided by the EMTs.

Questions to the expert and their responses


How often do you transport elderly patients at risk for falls?

In my extensive career spanning over thirty years in EMS, I have regularly been involved in the treatment and transportation of elderly patients who are at risk for falls. This forms a routine part of both Interfacility Transports and 9-1-1 calls.


What are some methods that help minimize the risk of injury when transporting elderly patients at risk for falls?

The safety measures during transportation largely hinge on the type of equipment used and how it’s utilized. For instance, it’s crucial to understand what type of gurney is being used, how many straps or seatbelts are available, their positioning, and if they were used appropriately.


Have you reviewed a case similar to the one described above? If so, please briefly describe.

While each case has its unique circumstances, I have encountered situations where proper use of equipment could have prevented injuries. In this particular scenario, my initial thought is that if the equipment was used correctly, this incident should not have occurred.

About the expert

This expert boasts over three decades of experience in emergency medical services, holding a BS in Emergency Medical Services and an MS in Emergency Health Services. They are a licensed paramedic and certified EMS educator and coordinator, with memberships in national associations for both Emergency Medicine Technicians and EMS Educators. Their extensive career includes roles as a paramedic, training officer, program director, president of an EMS Training Institute, manager of EMS training at a Fire Protection District. Currently, they serve as a field paramedic and the director of emergency medical services for a safety training company.

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About the author

Wendy Ketner, M.D.

Wendy Ketner, M.D.

Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.

Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.

Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.

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