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Monitor Alarm Fatigue In Hospitals

Posted by David P. McCormack

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When sick or injured people receive inpatient treatment at a hospital, both they and their families expect attentive care from the medical staff and careful monitoring of their condition and health. Although hospitals would ideally be able to provide close personal supervision and monitoring to all patients, the realities of staffing make this goal impractical, if not impossible. Instead, hospitals are increasingly relying on a series of electronic medical monitoring systems and computers to monitor patients and their health. These monitors can assess a patient's status and condition on a continuous basis while the patient rests in bed, when the patient is out of bed in a chair or even when the patient is walking. Some examples include monitors that check a patient's cardiac condition on a second to second basis and monitors that check a patient's breathing rate or vital signs. When these monitors are in use, they generally emit an electronic beep. When a patient has experienced or is about to experience a significant change in his or her condition, the monitors have built-in alarms that sound, usually via a change in the frequency, tone or volume of the monitor's normal electronic beeping. These alarms are intended to draw the attention of nurses or doctors to a patient who is need of critical care.  The alarms will also sound if there is a mechanical problem with the monitor itself that requires attention.

Ideally, this system would allow hospitals to effectively use the resources they have to provide optimal care to all of their inpatients. But as reliance on patient monitors has grown and as the use of medical monitors and alarms has become standard for almost every inpatient, a disturbing systemic problem has emerged - "alarm fatigue". Alarm fatigue is the term coined to describe situations in which medical providers become so desensitized to the constant beeps emitting from these monitors that they fail to respond (or fail to respond quickly enough) to potentially life-threatening alarms or even intentionally disarm them due to constant false alarms, resulting in a situation where a patient's condition is not being properly monitored at all. The Boston Globe recently investigated this growing problem and the tragic effects that local patients and their families have experienced as a result. The articles may be accessed through  Part One and Part Two.

Alarm fatigue is caused by a number of factors. Reliance on medical monitors has become so prevalent that a single patient may have six or more monitors, all performing different tasks and all with alarms that vary in pitch, tone and volume. The alarms sounded from monitors and other patient devices can vary in importance from the alarm of a cardiac monitor signaling an impending heart attack to an alarm activated by a patient to call the nursing staff for non-emergency attention, such as the need for help to the restroom. The alarms cannot only signal a significant change in a patient's condition, but they can also signal that a cable from the monitor is disconnected or that the monitor's battery is running low and needs to be replaced. Due to the almost constant barrage of alarms and electronic beeping, medical providers are sometimes unable to discern what is a critical or life-threatening alarm and what is a routine non-emergent one. This can lead to failures by the medical staff to respond or failures to respond quickly to critical alarms until it is too late for the patient. In short, these monitors and alarms create excessive "noise" that can leave a hospital's medical staff unable to determine which beeps are normal and which beeps require immediate attention.

Alarm fatigue also occurs because medical monitors have been made to be so sensitive that even an innocuous event such as a patient rolling over or repositioning himself in bed can cause an alarm to sound. These false alarms are so numerous that medical providers can "learn" to simply ignore the alarms or dismiss them as being false when in fact they are not. In extreme cases, these constant false alarms can even lead to medical providers disarming the alarms, thus defeating the ability of the patient's monitors to effectively inform the medical staff of significant medical information.

Medical device designers, health care consulting firms and researchers have found that a startling number of patient deaths occur as a result of alarm fatigue. One study revealed that alarm fatigue caused 216 hospital deaths nationwide from 2005 to mid-2010 - an average of 39 deaths per year. The same study determined that hospitals fail to report many of these accidents properly (or fail to recognize that alarm fatigue played a role in a patient's death), suggesting that the actual risk to patients may be much greater. Medical organizations have begun to study this problem in order to determine how it happens and how it can be prevented without the elimination of patient monitors and alarms. There are also efforts by manufacturers to improve monitor technology to drastically reduce the number of false alarms. Some hospitals have taken it upon themselves to hire extra staff whose sole job is to monitor patient alarms. Although some steps are now being taken, any solution to the problem is still in the early stages of understanding exactly how and why medical providers become desensitized and whether or not the problem can be prevented. Until the medical community adequately studies this problem and finds solutions to eliminate alarm fatigue or decrease hospitals' reliance on monitors and alarms to care for patients, alarm fatigue will continue to be a health risk for any inpatient in a hospital.

The reports on alarm fatigue demonstrate that serious medical errors by healthcare providers are occurring with surprising frequency, raising obvious concerns for patient safety. If alarm fatigue leads to a patient's death or significant injury to a patient, a medical malpractice claim may be appropriate. Because of the complexity of this issue, a patient or the family of a patient who suffers or tragically dies as a result of alarm fatigue should consult an experienced personal injury law firm. The attorneys at SUGARMAN have a long history of pursuing complex and challenging medical malpractice claims and are available to assist in any way.

For more information or assistance with alarm fatigue and medical malpractice claims call SUGARMAN at 617-542-1000 or email