A Case Report of a Severe Musculoskeletal Injury in a Wheelchair User Caused by an Incorrect Wheelchair Ramp Design

Edlich, Richard F.; Kelley, Angela R.; Morton, Karrie; Gellman, Richard E.; Berkey, Richard; Greene, Jill Amanda; Hill, Larry; Mears, Roy; Long, William B.

doi:10.1016/j.jemermed.2007.07.067

« Previous Next »The Journal of Emergency Medicine
Volume 38, Issue 2 , Pages 150-154, February 2010

A Case Report of a Severe Musculoskeletal Injury in a Wheelchair User Caused by an Incorrect Wheelchair Ramp Design

Richard F. Edlich, MD, PHD
- Distinguished Professor Plastic Surgery, and Emergency Medicine, University of Virginia Health System, Director of Trauma Prevention, Education, and Research, Trauma Specialists LLP, Legacy Emanuel Hospital, Portland, Oregon
- Reprint Address: Richard F. Edlich, md, phd, Director of Trauma Prevention, Education, and Research, Trauma Specialists LLP, Legacy Emanuel Hospital, 22500 N.E. 128th Circle, Brush Prairie, WA 98606
Angela R. Kelley
- Information Specialist, Legacy Emanuel Hospital, Portland, Oregon
Karrie Morton
- Research Assistant, Legacy Emanuel Hospital, Portland, Oregon
Richard E. Gellman, MD, FAAOS
- Orthopedic Specialist for Skeletal Trauma, Summit Orthopedic, LLP, Legacy Emanuel Hospital, Portland, Oregon
Richard Berkey, MD, FACEP
- Emergency Physician, Department of Emergency Medicine, Legacy Emanuel Hospital, Portland, Oregon
Jill Amanda Greene
- Information Specialist, Legacy Emanuel Hospital, Portland, Oregon
Larry Hill
- Director of Corporate Real Estate, Properties and Facilities, Legacy Health Systems, Portland, Oregon
Roy Mears, BS
- Third year medical student, Western University College of Osteopathic Medicine of the Pacific, Pomona, California
William B. Long III, MD, FACS
- President and Medical Director of Trauma Specialists, LLP, Legacy Emanuel Hospital, Portland, Oregon

Received 2 November 2006; received in revised form 27 February 2007; accepted 14 July 2007. published online 18 February 2008.

Abstract

The Americans with Disabilities Act (ADA) gives all Americans with disabilities a chance to achieve the same quality of life that individuals without disabilities enjoy. In this case report, we will be discussing the consequences of having inaccessible ramps to persons with disabilities that can result in severe musculoskeletal injuries in a wheelchair user. While going down an inaccessible ramp in the garage of a hospital, a wheelchair tipped over, causing a fracture to the user's right femur. The injured patient was taken to the Emergency Department, where the diagnosis of a fracture of the right femur was made. The fracture then had to be repaired with an intramedullary rod under general anesthesia in the hospital. It was discovered that the ramps in the hospital garage did not comply with the guidelines of the ADA. The wheelchair ramps had a ramp run with a rise > 6 inches (150 mm) and a horizontal projection > 72 inches (1830 mm). This led to the redesign and construction of safe ramps for individuals using wheelchairs as well as for pedestrians using canes, within 1 month after the patient's injury, making it safe for wheelchair users as well as pedestrians using the parking facilities. The ADA specifies guidelines for safe ramps for patients with disabilities. It is important to ensure that hospital ramps comply with these guidelines.

Keywords: ADA, accessible parking ramps, handrails, femoral fracture