The model codes and accessibility standards indicate the required mounting height range for operable hardware (there’s more about that in this Decoded article). The lever handle in today’s Wordless Wednesday photo posted by Richard Howard on the Crap Locksmithing Facebook page is outside of the allowable range – by a long shot!
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I recall seeing 36″ and 48″ down-set cylindrical locksets on many hospital pairs of doors in areas where hardware would become damaged by gurney’s or beds on their travels through the corridors.