How a Hospital Falls Risk Expert Witness Reassessed a Case After New Evidence Emerged

When new witness evidence changes a falls risk assessment

In this reviewed case, a hospitalised patient sustained a fall that later became the subject of a legal claim. Initial clinical records suggested a moderate falls risk based on routine assessments and standard blood-work. However, following the receipt of a revised family witness statement, an Apex hospital falls risk expert witness reviewed the full context again and increased the risk score to reflect the patient's deteriorating condition at the time.

The new evidence, alongside abnormal blood results and ambiguities around mental state, shifted the picture from moderate to high risk. The expert’s re-analysis was not only clinically robust, but also legally significant.

The value of retrospective reassessment by a hospital falls risk expert witness

Several days after admission, the patient’s observations and biochemistry revealed deteriorating clinical signs that had not been accounted for in the original risk assessment. The updated family statement also raised valid concerns around cognitive confusion on arrival, an issue not clearly documented in the hospital notes.

A hospital falls risk expert witness reviewing this type of scenario expects:

• A clear mental state assessment on admission

• Thorough documentation of cognition if confusion is suspected

• Alignment between abnormal test results and risk stratification

• Nursing escalation or monitoring in response to deterioration

• Flexibility in risk reassessment when new concerns arise

“The original falls risk score did not reflect the whole clinical picture. When abnormal labs and possible cognitive changes are considered, the patient clearly fell into a high-risk category.”— Apex Hospital Falls Risk Expert Witness

Why evolving evidence is critical in medico-legal nursing reviews

This case highlights the importance of expert flexibility when presented with evolving case materials. As new information emerged, the expert:

1. Recalculated the falls risk score to reflect clinical deterioration

2. Reviewed ambulance reports and compared them to the hospital’s admission documentation

3. Noted the absence of a formal mental state entry in the medical and nursing records

4. Openly invited solicitors to provide further clarification if needed

5. Finalised the updated report with the new context fully considered

The expert’s approach demonstrated due diligence and professional openness, qualities essential to defensible expert testimony.

What solicitors and clinicians can learn from this review

Falls risk assessments are not static; they must adapt to:

• Changes in physiology

• Witness accounts

• Ambiguous documentation

• Clinical deterioration over time

This review shows that even in the absence of explicit entries in medical records, clinical inference and expert analysis can provide meaningful insight particularly when family observations bridge gaps in formal documentation.