Sept. 20, 2017 -- The picture is meant to scare people into action.

In it, Clark Jacobs lies on a hospital bed, head wrapped in bandages, in a coma.

He remained like that for nearly 3 months after he fell out of his 7-foot-high loft bed in his fraternity's house at Georgia Tech in January 2015.

The bed had no safety rails.

“The thought of a world without Clark was not a place we wanted to live,” says his mother, Mariellen Jacobs. “It was just horrible to have to face that all because of a safety rail. It caused a lot of emotional fallout for our family.”

Since Clark’s accident, she has spoken out about the dangers of loft beds, especially to first-year students.

“They look at the picture of Clark in the hospital bed, and they can't believe that all of that ensued because of the lack of a safety rail.”

A Drop, A Bump and Emergency Surgery

Clark’s injury wasn’t that unusual. An average of 36,000 children are injured every year in the United States from accidents involving bunk beds. Half of them involve children younger than 6, according to a study by investigators at the Center for Injury Research and Policy of The Research Institute at Nationwide Children’s Hospital.

But 18- to 21-year-olds suffer twice as many injuries as other teens -- 2,500 a year -- which might be because many in this group use bunk beds in college or in the military, according to the study.

Study researcher Tracy Mehan says those numbers are likely underreported because the study only looked at injuries at hospitals or emergency departments.

Clark, who joins his mother when she talks about bed rail safety, has no memory of what happened the night of his accident.

He remembers that when he woke up early the next morning, he was on his knees, vomiting into a trash can. He had a stiff neck, pain in the back of his head, and a painful headache. He assumed he had the flu. When his symptoms persisted into the night, he and his family decided it was best for Clark to return to their family home in nearby Acworth so they could supervise him.

In the next few days, when he wasn’t feeling better, his mother took him to the emergency room.

CT scans revealed a large fracture at the base of Clark’s skull and a blood clot in his brain. Shortly after he was admitted to the ICU, another part of Clark’s brain began to bleed, and the Jacobs family got the news that he needed emergency brain surgery to live.

“The surgeon came to us and told us that if they didn't do surgery, then he wasn't going to make it, and even with the surgery, he still might not live,” Mariellen says. “We sat in operating room waiting room for 3.5 hours not knowing if he was going to die or not.”

On January 27, he was transferred to the Shepherd Center in Atlanta, a well-known spinal cord and brain injury rehabilitation hospital, where he remained in a coma for nearly 3 months. Eventually, Clark began showing signs of recovery.

“We were excited to see fingers move and a thumbs-up. At that point, he gradually learned how to walk, talk, swallow, and do everything all over again,” Mariellen says. “But it was a very slow process. After being in a hospital bed for so long, he had no muscle tone left, he was down to 130 pounds at 6-foot-5, and he had multiple infections …. it was just one thing after another.” 

Now, Mariellen and Clark Jacobs, through their nonprofit organization, Rail Against the Danger, are determined to spread awareness about the importance of safety rails on lofted and bunk beds and to change college dorm policies.

A Long Road To Recovery

He left the Shepherd Center in June 2015 to begin home therapy. Then, in August, he began a 4-month comprehensive outpatient rehabilitation program for people recovering from brain injury.

However, it was in January 2016 -- when he entered the Shepherd Center’s Beyond Therapy, a rigorous activity-based program to help patients become as independent as possible -- that he truly began to get his life back.

“They kicked my butt beyond belief for 3 hours a day, 3 days a week,” Clark says. “But the results were so real. In January, I hobbled in there with a cane, barely able to cover short distances. When I walked out in August, I was walking unassisted for a mile plus. It truly prepared me to go back to campus for school.”

Safety Standards Not Always Followed

The U.S. Consumer Product Safety Commission requires bunk beds have at least two upper-bunk guardrails, with at least one rail on each side. The tops of the guardrails must be at least 5 inches above the top of the mattress.

But, Mehan says, those rules don’t apply to college dorms.

“I see a lot of boards on Pinterest about how to decorate your dorm room, but you have to be careful about that because a lot of their recommendations don’t actually meet the safety standards required by the Consumer Product Safety Commission,” Mehan says. “Be sure to look at what the safety standards are and make sure you’re following them.”

Bunk bed safety tips recommended by Nationwide Children’s Hospital include:

  • Use guardrails on both sides of the top bunk. The gaps in the guardrails should be 3.5 inches or smaller to prevent strangulation.
  • Guardrails need to extend at least 5 inches above the mattress top to prevent kids from rolling off.
  • Check that the mattress foundation is strong and that the right mattress size is used.
  • Children younger than 6 are too young to sleep in the top bunk.
  • Never let kids play on the bunk or ladder.
  • Remove dangerous objects from around the bed.
  • Keep the top bunk away from ceiling fans.
  • Install a night light near the ladder.
  • Do not use the bunk bed or ladder if any parts are damaged or broken.
  • Teach kids how to carefully climb the ladder.
  • Do not allow children to attach belts, scarves, or ropes to the bunk bed. This can lead to strangulation.

“Some of the beds you see in colleges can be 6  to 7  feet in the air, so if you’re a college student, who are traditionally known for not getting enough sleep, and you fall from your bed, you might not wake up to brace yourself until you hit the floor,” Mehan says. “We are seeing broken bones, cuts, deep bruising, and things that can be serious.”

Clark says that after speaking with first-year students this summer, Georgia Tech had to order an additional 500 rails to keep up with requests.

Mariellen and Clark’s efforts have not gone unnoticed. In January 2016, the University System of Georgia passed a resolution that all public colleges and universities had to have rails available to students free of charge.

“I would love for every bunk to have a safety rail on it, or I want everyone to at least know the risks,” Mariellen Jacobs says. ”It's time to change the mentality. This isn't just a baby or toddler thing. This is a human thing.”

'He's Still Achieving His Life Goals'

Since his injury in 2015, Clark, now 23, has regained his ability to talk, walk, and even run, and he is back at Georgia Tech as a mechanical engineering major, taking three classes this semester. His greatest challenges, he says, are fatigue and memory issues.

“No brain injury or stroke patient is going to get back completely to where they were. He will never be the Clark that he was before,” Mariellen said. “Physically, he does have some challenges. He still experiences left side weakness and coordination issues due to the stroke, but he's still achieving his life goals and getting his education. He's my hero.” 

Clark says that he still does dexterity and enunciation exercises every day to improve his speech and coordination.

“My enunciation therapy is for my ability to speak clearly because I had to relearn to talk all over again,” he says. “The dexterity exercises are for the coordination of my left hand, because its coordination, even after therapy, is pretty abysmal.”

“Before I had my injury, I thought having a safety rail was so silly, but it’s such an easy, simple fix that can save so much trouble,” Clark says.