County Geriatric Hospital Fined in Woman’s Death

State health officials have fined the county-run Edgemoor Geriatric Hospital in Santee $5,000 for negligence in the death of a 66-year-old paralyzed patient who was left unattended in a bathtub and fell face down in the water.

The county health department and coroner’s office are still investigating the case. Edgemoor officials have suspended the nursing assistant who left the patient, Josephine Noonan, unattended in a tub of water on the morning of Dec. 10.

Later the nursing assistant, whom county officials would not identify, returned and discovered Noonan--whose legs were paralyzed--with the top of her head and part of her face underwater. Noonan, who was a ward of the county, died later the same morning.

As a result of the death, nurses at the 323-bed convalescent hospital are being required to undergo renewed training in the handling of such patients, an Edgemoor official said in a document submitted Thursday to state health officials. Edgemoor administrators refused all comment Monday, saying they had been ordered not to talk to reporters by county counsel.

State officials levied a “Class A” fine on Edgemoor Thursday. The fine is the most severe punishment possible under California law.

“The facility’s failure to identify the patient’s health and safety needs, including a need for direct supervision while she was helpless in a tub filled with water, caused a substantial probability that death or serious physical harm would occur to the patient,” state investigator Ardyce Moyer said in a report filed Thursday at the state Health Facilities Licensing Division in San Diego.

According to Moyer’s report, the unidentified nursing assistant placed the paralyzed Noonan in a hydraulic lift and transported her to a “tub room” for a bath.

“After the bathing had been completed, and while the patient remained seated in the lift support apparatus, still immersed in the tub of water up to mid-chest, the nurse assistant left the room leaving the patient alone and unattended,” Moyer’s report continued.

Leaving her alone “was in violation of the facility’s own policy,” the report said.

The nursing assistant had left the room to find a comb for the patient’s hair, Moyer’s document says.

Probe by Coroner

The county coroner’s office is still studying tissue samples from Noonan in an effort to determine the exact cause of death, deputy coroner Max Murphy said.

County employees have been instructed not to discuss the case and to refer all press inquiries to Paul Bruce, a deputy county counsel.

The county health services department is in the process of deciding whether to appeal the fine, Bruce said. Although technically the fine is levied against Edgemoor, San Diego County is responsible for paying it.

The county could appeal the fine through an administrative hearing, Bruce said.

Meanwhile, “there is a coordinated investigation (by the county) that is going into numerous facts and aspects of this particular incident. I’m not at liberty to indicate what particular points we’re looking into,” Bruce said.

Not First Fine

The latest citation is not Edgemoor’s first Class A violation, according to county health services director Jim Forde. “We’ve had one or more that we’ve contested and one or more that we have not contested.” He declined further comment on the advice of county counsel.

Forde also said he was unaware of the $5,000 fine until contacted by a reporter Monday. He declined comment on the fine.

Edgemoor received one other Class A fine during the last year, Health Facilities Licensing spokeswoman Donna Loza said late Monday. But she said she was unable to give further details.