Study finds falls from new, higher border wall causing complex fractures, hospital crowding, death

The falls caused 16 deaths and five times more admissions to San Diego trauma center already overloaded by COVID-19. Injuries included complex facial, pelvis and leg fractures. Patients included children and pregnant women.

A new section of border wall constructed in a remote expanse of desert outside Yuma, Arizona, under the Trump administration. Replacing the previous 6-to-17-foot border wall with a 30-foot barrier at the southern U.S. border was followed by a five-fold increase in wall-fall hospitalizations at a nearby level 1 trauma center in San Diego, according to a new study published in the journal JAMA Surgery.
Molly O'Toole / TNS
We are part of The Trust Project.

ROCHESTER, Minn. — Replacing the previous 6-to-17-foot border wall with a 30-foot barrier at the southern U.S. border was followed by a five-fold increase in wall-fall hospitalizations at a nearby level 1 trauma center in San Diego.

That is the finding of a study published April 29 in the journal JAMA Surgery .

The study found that with the higher fence — erected after a 2017 executive order from President Donald Trump — came millions in new medical expenses for the hospital and the expansion of a trauma unit to accommodate more patients for longer stays.

The study also noted "a new phenomenon" closely tied to the arrival of the wall: "the appearance of scene deaths," or fall-related fatalities at the base of the structure. It reported 14 such deaths during the period studied, joined by two other deaths recorded in the ER.

"Raising the U.S. border wall to 30 feet is associated with increased deaths, increased injury severity score, and increased health care costs," the authors of the research letter wrote. "It increased the burden of complex injured patients at a level 1 trauma center already dealing with a traumatic surge and respiratory surge during the COVID-19 pandemic."


Dr. Amy Liepert is the medical director of acute care surgery at the University of California, San Diego, and a coauthor of the study. She said the impetus for the study was that "whenever we start to see something happening clinically, we try to verify what we think we're seeing with the data."

"We were finding that more of our calls were being occupied with injuries in the border wall, and we were also finding that the injuries were more severe," Liepert said in an interview.

In response, Liepert and six colleagues carried out a retrospective comparison of hospital admissions at their medical center serving the southern border in California, assessing wall-related falls during two-year periods before and after the new barrier went up in 2019.

These are fractures not like you get from falling off your bike or tripping on the ground. These are bones broken in multiple places, sometimes coming through the skin.
Dr. Amy Liepert

To control for any increase in crossing attempts, the researchers calculated the rate of injuries treated per 100,000 immigrant apprehensions by Customs and Border Protection agents. There were just over 159,000 apprehensions in San Diego and Imperial counties during each of the periods studied.

Following the construction of the new wall, admissions for falls jumped five-fold, from 67 to 375 severely injured patients. The study further noted that the average injury severity score of these admissions jumped by 25%, the average length-of-stay jumped from four to six days, and that the average ICU visit jumped from a half day to two days.

Following adjustment for inflation, hospital costs for these visits jumped from $31,000 to $45,000, on average.

Liepert says that while they did not quantify the demographics of those who were injured, the hospital has seen children and pregnant women who needed care.

"We see a whole range of injuries," Liepert said, "the most severe of which are traumatic brain injuries ... More commonly we will see very complex fractures of the legs particularly, but sometimes the arms."


The new report, released this morning, showed a rise among the state's ninth-graders battling long-term mental and emotional problems
When you sprain your ankle or have an infection inflammation helps to heal tissues. But when inflammation is chronic, or long term, it can contribute to conditions such as heart disease and autoimmune diseases. Researchers have found a link between chronic inflammation and low levels of vitamin D. Viv Williams has details in this episode of NewsMD's "Health Fusion."
A discovery made in the lab sparked the creation of Anatomic Inc., which sells human stem cell-derived sensory neurons to pharmaceutical companies for the possible creation of new, nonaddictive painkillers.
Rural Americans, who die by suicide at a far higher rate than residents of urban areas, often have trouble accessing mental health services. While 988 can connect them to a call center close to home, they could end up being directed to far-away resources.

"These are fractures not like you get from falling off your bike or tripping on the ground," she said. "These are bones broken in multiple places, sometimes coming through the skin."

Liepert noted "facial fractures, rib fractures, pelvis fractures, other significant injuries," calling them "complex fractures that require multiple operations, often with external fixation devices, before a definitive operation or repair can even be done."

Liepert says that as an observation the injuries led to higher stress on doctors and the hospital, which had to expand into unused rooms to add more trauma beds.

"Clearly when there's more work to be done and we have the same amount of staff to do it ... That means there's longer wait lists, because more cases have to be done in a finite period of time."

The authors wrote that future border barrier policy decisions "should include assessment of the impact of increased injuries on local health care systems."

"We need to have the resources and the support," Liepert says, "however the policy is decided, to expand services as necessary if this type of injury continues to occur at these rates."

Paul John Scott is the health correspondent for NewsMD and the Forum News Service. He is a novelist and was an award winning magazine journalist for 15 years prior to joining the FNS in 2019.
What to read next
"Minding Our Elders" columnist Carol Bradley Bursack hears from a reader wondering how to respond when their spouse with dementia sees or talks with his long-deceased parents.
Blood pressure, body weight, cholesterol and blood glucose are some of the numbers that measure heart health. The American Heart Association has added sleep to that list. Why? Because research about how sleep effects those numbers keeps emerging. In this episode of NewsMD's "Health Fusion," Viv Williams talks to a Mayo Clinic cardiologist and sleep expert about why sleep is vital to your heart health.
The Minnesota Department of Health's first-ever such study finds high disparities among Indigenous, Black persons, with most deaths in the months following giving birth associated but not related to pregnancy.
Abortion pill reversal, a controversial and harmful practice intended to ‘reverse’ an abortion halfway through, is still being advertised by Rochester's First Care Pregnancy Center and other Minnesota anti-abortion crisis pregnancy centers. First Care Pregnancy Center does not receive state funds, but five centers that promote the practice do.