Outrage of the Month: CPSC Drags Its Feet, Proposes Half Measures as Fatalities Caused by Adult Portable Bed Rails Mount
If you’re not outraged,
you’re not paying attention!
Read what Public Citizen has to say about the biggest blunders and outrageous offenses in the world of public health, published monthly in Health Letter.
In 2013, Public Citizen petitioned the Consumer Product Safety Commission (CPSC) to ban all adult portable bed rails because these products too often cause fatalities due to strangulation or asphyxiation of typically elderly or frail victims who become stuck or entrapped between the mattress and bed rail.
In our petition, we cited CPSC’s own data documenting 155 reports of fatalities linked to use of adult portable bed rails over a nine-year period from 2003 to 2012, 145 of which were related to entrapment. The CPSC had found that 94 of these fatalities (61%) took place at home, 25 (16%) in nursing homes, 15 (10%) in assisted living facilities and 3 (2%) in hospice care settings. In addition to posing an entrapment risk, we noted that individuals attempting to climb over bed rails placed on their beds also can be more susceptible to injury due to falls. Importantly, bed rails raise the height from which patients can fall, increasing the risk of severe injury.
We argued in 2013 that no feasible mandatory safety standard issued by the CPSC would sufficiently mitigate the risks of fatalities caused by adult portable bed rails. We also cited scientific literature describing safer alternatives to bed rails, including use of large body pillows, placement of floor mats on the side of the bed to minimize risk of injury if someone falls out of the bed, and lowering the height of the bed (such as placing the mattress on the floor). Finally, we noted that in contrast to clear evidence of fatal harm, there was no evidence that adult portable bed rails help prevent falls and injuries.
But rather than ban adult portable bed rails as we requested in 2013, the CPSC waited to see if an August 2017 voluntary safety standard issued by American Society for Testing and Materials (ASTM) — now called ASTM International, an organization that develops voluntary standards that, among other things, are intended to improve safety of consumer products and services — would stem the tide of fatal injuries caused by these dangerous products. Predictably, as shown in the table below, the number of fatalities due to adult portable bed rails have steadily mounted since our 2013 petition, with no evidence of any change in the frequency of these preventable deaths following issuance of the ASTM standard in 2017.
Reported Adult Portable-Bed-Rail–Related Fatalities by Year, 2013-2020
| Year | Number of Fatalities |
|---|---|
| 2013 | 17 |
| 2014 | 10 |
| 2015 | 12 |
| 2016 | 14 |
| 2017 | 32 |
| 2018 | 13 |
| 2019 | 28 |
| 2020 | 18 |
| Total | 144 |
Many more deaths due to adult portable bed rails likely occurred that were not identified by the CPSC.
On March 15, 2022, the CPSC voted unanimously to implement a regulation that would require adult portable bed rails to meet mandatory safety standards. Such action had been requested in a separate 2013 citizen petition submitted to the agency by consumer advocate Gloria Black, whose mother died from entrapment by a portable bed rail; Voice for Quality Long-Term Care; Consumer Federation of America; and 60 other organizations. (These organizations also had requested that the CPSC ban all currently marketed adult portable bed rails.)
In a statement commenting on his agency’s action, CPSC Chair Alexander Hoehn-Saric stated that:
It is unacceptable that so many Americans are harmed or killed when their head or neck becomes entrapped in bed rails. Consumers buy these products specifically to protect vulnerable adults who are in danger of falling or need assistance getting in and out of bed. Bed rails should increase safety and should never create new hazards for this at-risk population, yet CPSC staff has identified 300 deaths associated with bed rails since 2003.
CPSC Commissioner Rich Trumka Jr. likewise said the following:
Today, the Commission voted to begin rulemaking to address the risk posed by adult portable bedrails, which have trapped and strangled older adults at alarming rates. This was the right decision to protect older Americans. Over 60 public health groups had petitioned the Commission to take this action. In the time period between when the petition was submitted and the Commission granted it, at least 129 people were killed by adult portable bed rails.
CPSC’s half measures will not stem the tide of fatalities caused by adult portable bed rails. As long as these products remain on the market, frail, vulnerable adults will continue to die unnecessarily from strangulation or asphyxiation due to entrapment. These bed rails are inherently unsafe, and no feasible mandatory safety standards will eliminate this risk.
How many more American must die before the CPSC finally bans these products?