FALL & INJURY ANALYSIS WORKSHEET
A structured tool for evaluating fall events, identifying preventability, and uncovering failures in assessment, monitoring, and safety interventions.
Falls are among the most common—and most preventable—sources of injury in healthcare settings. This worksheet helps attorneys analyze the circumstances surrounding a fall, identify deviations from standards of care, and determine whether the event was preventable.
Use this tool during case screening, breach analysis, deposition preparation, and expert review.
PATIENT BASELINE & RISK FACTORS
✔ Establish Baseline
• Cognitive status
• Functional status
• Mobility level
• Assistive devices
• Medication profile
• Vision/hearing impairments
• History of falls
• Behavioral symptoms
• Safety awareness
✔ Identify Risk Factors
• Sedating medications
• Orthostatic hypotension
• Incontinence
• Weakness or deconditioning
• Confusion or delirium
• Recent illness or hospitalization
SAFETY INTERVENTIONS & PREVENTION MEASURES
✔ Required Interventions
• Bed/chair alarms
• Non‑skid footwear
• Toileting schedule
• Frequent rounding
• Mobility assistance
• Environmental safety checks
• Low bed / mats
• Call light within reach
✔ Identify Failures
• Interventions not implemented
• Interventions removed or turned off
• No documentation of monitoring
• No reassessment of effectiveness
• Inconsistent implementation across shifts
FALL EVENT RECONSTRUCTION
✔ Document Key Details
• Date and time of fall
• Location
• Activity at time of fall
• Staff present or nearb
• Witness statements
• Environmental conditions
• Assistive devices in use
• Alarms active or inactive
✔ Identify Red Flags
• Unwitnessed fall
• Conflicting accounts
• No documentation of circumstances
• Alarms not functioning or not in use
POST‑FALL ASSESSMENT & RESPONSE
✔ Required Steps
• Immediate assessment
• Neurological checks
• Vital signs
• Pain assessment
• Provider notification
• Family notification
• Incident report
• Safety plan update
✔ Identify Failures
• No post‑fall assessment
• Delayed provider notification
• No neurological checks
• No documentation of family notification
• No update to safety plan
INJURY ANALYSIS
✔ Document Injuries
• Bruising
• Lacerations
• Fractures
• Head injury
• Internal injury
• Pain or functional decline
✔ Identify Contributing Factors
• Unsafe environment
• Missed interventions
• Delayed response
• Medication effects
• Inadequate supervision
CHANGE IN CONDITION AFTER FALL
✔ Track Post‑Fall Deterioration
• New symptoms
• Decline in mobility
• Increased confusion
• Pain escalation
• New abnormal vitals
• New abnormal labs
✔ Identify Failures
• No reassessment
• No provider follow‑up
• No escalation despite deterioration
GLOBAL FALL‑RELATED BREACH INDICATORS
• No fall risk assessment
• No reassessment after change in condition
• Missing or ineffective interventions
• Alarms not used or not functioning
• No supervision despite high risk
• Unsafe environment
• No post‑fall assessment
• No neurological checks
• Delayed provider notification
• No update to safety plan
• Contradictory documentation
These are some of the strongest breach indicators in fall‑related negligence cases.