How Safety Is Compromised When Hospital Equipment Is a Poor Fit for Patients Who Are Obese


  • Elizabeth Kukielka Patient Safety Authority



obesity, abdominal girth, BMI, patient safety, imaging, equipment, hospital infrastructure


Obesity is common, serious, and costly, and according to recent data, its prevalence is on the rise in the United States. Event reports submitted to the Pennsylvania Patient Safety Reporting System (PA-PSRS) indicate that some healthcare facilities do not have the necessary equipment to monitor and care for some individuals in this patient population, leading to embarrassment for patients, delays in care, and injuries to patients. An analysis of 107 events related to monitoring and patient care for patients who are obese submitted to PA-PSRS from 2009 through 2018 showed that imaging equipment, especially MRI and CT scanners, was most often implicated in event reports (49.5%; 53 events); other equipment included stretchers (24.3%; 26 events) and wheelchairs (11.2%; 12 events). Events most often occurred in an imaging department (30.8%; 33 events) or a medical/surgical unit (21.5%; 23 events). Analysts determined that 80 events (74.8%) resulted in a delay in care and that 44 events (41.1%) resulted in temporary harm to the patient, including skin tears and abrasions. Healthcare providers may not be able to prevent delays in care resulting from the unavailability of adequate equipment for patients who are obese, but they may be able to prevent harm and embarrassment for patients through proactive assessment.

Author Biography

Elizabeth Kukielka, Patient Safety Authority

Elizabeth Kukielka ( is a patient safety analyst on the Data Science and Research team at the Patient Safety Authority. Before joining the PSA, she was a promotional medical writer for numerous publications, including Pharmacy Times and The American Journal of Managed Care. Kukielka also worked for a decade as a community pharmacist and pharmacy manager, with expertise in immunization delivery, diabetes management, medication therapy management, and pharmacy compounding.


Adult obesity facts. Centers for Disease Control and Prevention website. [updated August 13, 2018; accessed November 6, 2019]. Available from:

Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity among adults and youth: United States, 2015-2016. NCHS Data Brief. 2017(288):1-8. Epub 2017/11/21. PubMed PMID: 29155689.

Musich S, MacLeod S, Bhattarai GR, Wang SS, Hawkins K, Bottone FG, Jr., et al. The impact of obesity on health care utilization and ex-penditures in a Medicare supplement population. Gerontol Geriatr Med. 2016;2:2333721415622004. Epub 2017/02/01. doi: 10.1177/2333721415622004. PubMed PMID: 28138482; PubMed Central PMCID: PMCPMC5119873.

Bertakis KD, Azari R. Obesity and the use of health care services. Obes Res. 2005;13(2):372-9. Epub 2005/04/01. doi: 10.1038/oby.2005.49. PubMed PMID: 15800296.

Medical Care Availability and Reduction of Error (MCARE) Act, Pub. L. No. 154 Stat. 13 (2002).

Ortiz VE, Ottolino RJ, Matz MW, Uppot RN, Winters B. Infrastructure design: a critical element in the care of the patient with obesity. J Patient Saf. 2018. Epub 2018/10/12. doi: 10.1097/PTS.0000000000000537. PubMed PMID: 30308591.

Uppot RN. Technical challenges of imaging & image-guided in-terventions in obese patients. Br J Radiol. 2018;91(1089):20170931. Epub 2018/06/06. doi: 10.1259/bjr.20170931. PubMed PMID: 29869898; PubMed Central PMCID: PMCPMC6223172.

Carucci LR. Imaging obese patients: problems and solutions. Abdom Imaging. 2013;38(4):630-46. Epub 2012/09/26. doi: 10.1007/s00261-012-9959-2. PubMed PMID: 23008055.

Muir M, Heese GA, McLean D, Bodnar S, Rock BL. Handling of the bariatric patient in critical care: a case study of lessons learned. Crit Care Nurs Clin North Am. 2007;19(2):223-40. Epub 2007/05/22.

doi: 10.1016/j.ccell.2007.02.010. PubMed PMID: 17512478.

Scale on background w/ title.



How to Cite

Kukielka, E. (2020). How Safety Is Compromised When Hospital Equipment Is a Poor Fit for Patients Who Are Obese. Patient Safety, 2(1), 48–56.



Original Research and Articles
Bookmark and Share

Most read articles by the same author(s)

1 2 > >>