Bed Rail Injuries in Nursing Homes and Hospitals

As we age, danger doesn’t always announce itself.

We still see the world the same way, but it begins to respond differently—especially when it comes to movement, balance, and physical limits. Staircases become harder to navigate. Certain foods are avoided because of choking risks. And in care settings, even something as small as the space between a mattress and a bed rail can carry consequences no one intended.

That gap isn’t obvious. It can form slowly as a mattress compresses or shifts, or when equipment that once fit no longer does. But when it goes unnoticed, it can turn a safety measure into a source of serious injury.

7 Places a Bed Can Become a Trap

Bed rails are a common safety measure in nursing homes and hospitals, used to help prevent falls and provide stability for patients who have trouble moving on their own. 

In theory, they add safety. In practice, that safety depends entirely on proper assessment, fit, installation, and ongoing monitoring.

Federal investigators have identified predictable points where bed rails can become dangerous. These areas, often referred to as entrapment zones, are places where parts of a person’s body can become caught between the mattress, the rail, or the frame.

Common danger zones include:

1. The space between the mattress and the bed rail
2. Gaps beneath the rail or between rail segments
3. Openings near the head or foot of the bed
4. Areas created when rails loosen, bend, or collapse
5. Spaces that widen when a mattress shifts or compresses over time
6. Gaps between the mattress and the bed frame at the head or foot
7. Openings created when a rail is only partially raised or improperly locked

Nursing home staff are trained to monitor for these hazards and, more importantly, resolve them before anyone is at risk of injury. But, unfortunately, that isn’t always the case.

Common Injuries Linked to Bed Rails

When bed rail injuries do happen, they tend to follow consistent patterns, as documented for decades by federal safety agencies and public health researchers.

Data from the Consumer Product Safety Commission (CPSC) estimates about 79,500 adult bed rail–related injuries treated in U.S. emergency departments from 2003–2021, and identifies 284 entrapment deaths involving adult portable bed rails during the same period. 

Other common injuries:

• Entrapment of the head, neck, or chest, which can restrict breathing and lead to suffocation or strangulation
• Asphyxiation-related injuries, sometimes occurring without visible external trauma
• Cardiac distress, often associated with prolonged panic, exertion, or oxygen deprivation
• Head and neck injuries caused by sustained pressure or awkward positioning
• Falls resulting from attempts to climb over rails or from rail failure

What makes bedrails especially scary is that, with a wrong move, someone can quickly find themselves trapped, unable to call for help. If these are in place, it’s truly up to nursing home staff to closely monitor anyone under their care, so long as they’re at risk of injury.

When a Bed Rail Injury Points to Negligence

Not every bed rail injury is the result of negligence. But when a preventable injury happens in a questionable way, it’s worth slowing down and looking at what was within human control.

When the Equipment Itself Creates Risk

Sometimes the problem is built into the setup itself, where a rail doesn’t actually match the bed and mattress it’s paired with, or when it’s installed once and treated as “done.” Familiar equipment can create a false sense of security, even as small changes in fit and wear quietly increase the risk.

These failures sit quietly in the background until a shift in weight, a change in position, or a passing moment turns them into something dangerous. Families rarely see these details, but investigators often do.

When Care and Oversight Fall Short

Other cases have less to do with hardware and more to do with human decisions. 

Bed rails aren’t meant to be one-size-fits-all. They require judgment about who actually benefits from them, who may be harmed by them, and how closely a resident needs to be watched. And when they’re applied haphazardly, they often do more harm than good.

Concerns arise when no one goes back to check the work: when staff stop reassessing whether the rail still fits, when routine checks are skipped or shortened, and when earlier close calls are brushed off because nothing serious happened at the time. This oversight, or negligence, can make a nursing home facility liable for any damage it causes. 

When It’s Time to Ask Questions

When answers are vague or don’t add up, it’s time to start asking for the truth. Some questions families can ask include:

• Was a bed rail truly appropriate for this resident, given how they moved, thought, and behaved day to day?
• Who made that decision, and was it ever revisited as conditions changed?
• Were the bed, rail, and mattress actually designed to work together, or simply paired because they were available?
• How closely was the resident monitored, especially during overnight hours or known periods of confusion?
• Were there earlier incidents or close calls that should have prompted a reassessment?

Some facilities may get offended or close up after questioning, but know their behavior isn’t your fault. The right questions reveal whether the injury grew out of a preventable breakdown in care, and whether the nursing home is liable for exposing your loved one to unsafe conditions.

Justice After Bed Rail Injuries in Nursing Homes and Hospitals

When nursing homes betray our trust and cross legal boundaries, Morgan & Morgan helps families find the truth, seek justice, and hold them accountable to the fullest extent of the law.

Our team is here to help, with offices from coast to coast. Get started today with a free, no-risk case evaluation.

Frequently Asked Questions

1. What are the most common bed rail injuries in nursing homes?

The most serious bed rail injuries usually involve entrapment, where a resident’s head, neck, or chest becomes caught between the mattress, rail, or bed frame. Suffocation, cardiac distress, head and neck trauma, and falls from climbing over rails are also common.

2. Are bed rails considered restraints in nursing homes?

They can be. A bed rail may function as a restraint if it limits a resident’s ability to get out of bed independently or restricts normal movement. Whether it qualifies depends on how it’s used and the resident’s individual condition.

3. Why does bed rail entrapment happen?

Entrapment usually develops over time, not all at once. Mattresses compress, equipment from different manufacturers may not align perfectly, and routine re-checks are sometimes missed, allowing dangerous gaps to form.

4. Are bed rail injuries preventable?

Many are. Prevention depends on assessing whether a bed rail is appropriate, ensuring equipment fits properly, and continuing to reassess safety as a resident’s condition or the equipment changes.

5. Are bed rails allowed in nursing homes?

Yes, but their use requires careful assessment and ongoing monitoring. Bed rails shouldn’t be used simply because they’re available or familiar, as improper use can increase the risk of injury.

6. Is a bed rail injury always a sign of negligence?

Not always. However, when an injury follows missed reassessments, poor equipment fit, lack of monitoring, or ignored warning signs, it may point to a preventable breakdown in care.