I can't figure out how this happened

Russians do it as no problem, but in America filming a patient in such position (and as he is trying to cover his face in shame) would be a gross violation of all written and unwritten rules.
 
XD Yowza. Could have been a few things that happened. He could have been trying to get it up his ass and he slipped, falling down onto it with his bodyweight.
He could have just fallen on something totally by accident and impaled him.

My guess, he was trying to get it up his ass.
 
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