Patient Set Clothes on Fire : New Investigation at Hillcrest Hospital

State and county health authorities said Tuesday that they are investigating an incident at San Diego County’s Hillcrest mental health hospital in which a female patient set her clothes on fire with a cigarette during a hospital Christmas party.

The 31-year-old woman was admitted to UCSD Medical Center’s burn unit on Friday afternoon and was treated for a deep burn on a small area of her left leg. Hospital officials said the woman was in fair condition but was under constant observation because of her “psychiatric condition.”

Paul Keller, chief of the state Department of Health Service’s field operations branch, said the hospital notified the district licensing office here shortly after the incident occured Friday. Keller said the district office would review the circumstances surrounding the incident to determine if staff negligence was involved.

“The review would include the circumstances in which the incident occurred, the amount of staff in the area, who was there to supervise and any other factor that might be considered,” Keller said.

The outcome of the investigation could affect whether the hospital continues to receive state and federal certification, Keller said. The hospital had been warned by state and federal authorities that it could lose its license and certification to receive Medicare and Medi-Cal funds if conditions there did not improve. Health officials have charged Hillcrest with a pattern of poor patient care and bad management.

Keller said that if the hospital were found at fault in this instance, a refusal to recertify the facility “would warrant some consideration.”

Dr. Harold Mavritte, Hillcrest’s acting medical director, said he was unaware of the investigation and did not know the circumstances of Friday’s incident.

“I have not reviewed the incident report and would not be able to comment on what the investigation would entail,” Mavritte said.

Steve Harmon, assistant director of San Diego County’s Department of Mental Health Services, which is also reviewing the case, said he did not believe the incident would affect the hospital’s recertification. Harmon said there appeared to be “nothing technically or clinically wrong” in the way the hospital’s staff responded to the incident.

“There appeared to be an adequate, quick response to the situation,” Harmon said. “These kinds of things happen in such a facility, but the county is reviewing the case to find ways to prevent this kind of thing from happening again.”

Harmon said the woman, who had smoking privileges, apparently slipped away from the Christmas party about 3 p.m. and entered an unused room where she held the cigarette to her pants leg until it caught fire. The woman’s screams were heard by staff members about 10 minutes later and she was admitted to the UCSD Medical Center’s burn unit at 3:15 p.m., Harmon said.

Harmon said that no matches were found with the woman, but that some may have been slipped in by a visitor during the Christmas party. Patients at Hillcrest are not allowed to have matches, but can utilize lighters--similar to automobile cigarette lighters--installed on the walls. Harmon said it was uncertain how the woman had lit the cigarette.

Hillcrest was investigated by state health departments in May after a psychiatrist at the hospital alleged that “poor judgment” on the part of some doctors had caused the deaths of four patients who had been treated there. The investigation by the departments of Health and Mental Health concluded that two of the deaths could have been prevented.