December 2009
Patients and Families Should Obey Rules to Prevent Choking Deaths


Patients who are in the hospital often may ask a loved one to bring them some food or a milkshake to make them feel better. The Patient Safety Authority has received reports that show patients have died from choking because family members have given their loved ones food when the patient was not supposed to have it. Patients and their families need to be aware of what or if their loved one can eat or drink while in the hospital and obey the rules. Dysphagia, or difficulty swallowing, can be a problem for many patients for many different reasons including but not limited to: stroke, head injuries, old age, medication side effects, surgery and infections. Fifty percent of adult patients in hospitals are reported to have problems swallowing, while 66 percent of residents in long-term care facilities have the same difficulty. It is important for patients and their families to know if they have problems swallowing. Reports to the Authority show patients are not always screened properly to know if a patient is more at risk for choking. Therefore, while the hospitals must look at their screening processes to better determine at-risk patients, patients and their loved ones must be sure to follow the rules while in the hospital or nursing home facility.

Real Life Pennsylvania Cases

A patient had moderate to severe dysphagia [problems swallowing] following stroke. Family [members] brought in solid food, which the patient ate and [immediately began] to choke. Despite immediate resuscitation efforts, the patient expired [died].

A patient with recent history of stroke was placed on pureed dysphagia diet after nutrition and speech evaluations. After being fed [a meal] by [a family member], the patient became [short of breath]. Suctioning [the patient] produced the [meal] contents. The patient was intubated, transferred to the cardiac care unit, [and died as a result] of aspiration [choking].

Some Examples of Patients Who Are More At Risk for Having Problems Swallowing:
  • People who have suffered a stroke, head injuries, have had cervical spine surgery and infections may have trouble swallowing. Old age and certain medications can also cause a person to have more trouble swallowing and thus make that person more at risk for choking.
  • Some signs that you or a loved one may have trouble swallowing include the following: coughing when swallowing, delay in swallowing and drooling. People who have problems breathing (e.g., persons with sleep apnea) should also be aware that they may also have trouble swallowing properly. For sleep apnea signs, go to the Authority’s web site at and click on “News and Information: Patients and Consumers," Sleep Apnea.
Talk to Your Healthcare Provider:
  • If you’re in the hospital and are told you cannot have solid foods, do not ask a family member to bring you something to eat. If you are a family member and your loved one in the hospital asks you to bring in food, check with a nurse or doctor before giving your loved one anything to eat or drink to be sure it is safe to give.
  • If a hospital worker brings you something to swallow that doesn’t seem right (e.g., solid food, wrong medication) don’t be afraid to ask a nurse if you will be able to swallow it.
For more information on dysphagia (trouble swallowing) go to the 2009 December Pennsylvania Patient Safety Advisory article “Does Your Admission Screening Adequately Predict Aspiration Risk?” at For more consumer tips, go to the same web site.

©2018 Pennsylvania Patient Safety Authority