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April 17, 1987

Accidental Strangulation From Vest Restraints

Author Affiliations

Health and Welfare Canada Ottawa

Health and Welfare Canada Ottawa

JAMA. 1987;257(15):2032-2033. doi:10.1001/jama.1987.03390150048018

To the Editor.—  In a recent article in JAMA, Dube and Mitchell1 present two case reports of strangulation by vest restraints. Their investigation revealed that the deaths were largely the result of nursing and procedural errors, not due to design or labeling shortcomings in the restraint vest.It is true that some manufacturers have made significant improvements in the design of these products since we first published our recommendation.2-4 The changes include color coding by size, front and back identification labels sewn on the vest, full directions for use in plain English and French, improved ties, and quick-release fasteners. However, in spite of these improvements, serious incidents associated with these medical devices continue to occur: four cases of death by strangulation in vest restraints are currently under investigation in the province of Quebec. We suspect that a large number of such incidents go unreported. Manufacturers and health care