Baby Mix-Up Wasn’t Hospital’s First

Officials at St. Joseph Hospital, which sent a newborn home with the wrong parents last Sunday, disclosed Friday three other incidents of infants being mixed up, including one in which a mother breast-fed the wrong baby for 30 minutes.

Though none of the babies in the newly revealed cases left the hospital with the wrong parents, the mix-ups may complicate matters for the hospital, which fired two nurses involved in last Sunday’s incident.

The hospital also is under scrutiny by the California Department of Health Services. It has asked the Joint Commission on Accreditation of Healthcare Organizations to look into Sunday’s incident, in which the hospital released an infant to the wrong couple, who took the child home. The couple was notified about 90 minutes later and returned to the hospital with the infant.

After that incident, hospital spokeswoman Valerie Orleans said it was the first time in the hospital’s 70-year history that a baby had been released to the wrong parents.

One couple involved in a mix-up last June, who declined to be identified, said St. Joseph assured them last summer that new policies were adopted to prevent such switches. But, said the 30-year-old father, “first of all, they didn’t correct their actions. And second, when this thing happened [Sunday], they didn’t admit they had had problems in the past.”

While confirming the June incident, a hospital official took pains Friday to distinguish between the two situations.

“I can understand their being upset, absolutely,” Katie Skelton, vice president of patient care services, said about the June switch. “What’s different [about the most recent incident] is that it wasn’t one error, it was a series of errors and the baby got discharged. That, clearly, we’ve never had any exposure to.”

But since June, she said, changes have been enacted, including a ban on nurses taking two babies at a time to a shared room. In addition, nurses must not only read the wrist identification numbers for a match, they also must examine the bracelets to ensure a mother-infant match, she said.

Those changes, however, did not prevent two minor mix-ups later, Skelton acknowledged. In August, an infant was placed in the wrong bassinet for a while. Several weeks ago, an infant was brought to the wrong mother but a nurse caught the error and corrected it before the baby was brought to his mother’s room.

In last June’s incident, a nurse brought two babies into a room shared by two women, according to a hospital official and the parents of one of the infants. A nurse, momentarily distracted, gave the wrong babies, both boys, to the women.

One of the mothers breast-fed the wrong baby for 30 minutes, realizing the switch only when she stopped to change the infant.

Neither set of parents wants to be identified, but the mother whose son was mistakenly breast-fed was reluctant to criticize the hospital, which she lauded for its all-around care.

However, she said, the early-morning mix-up greatly upset her because of the exchange of bodily fluids from another woman to her son. Even hospital officials acknowledged the seriousness of the switch, the boy’s mother, 28, said.

“The doctor came in and said, ‘This could have been a train wreck, and it ended up being a a minor fender-bender.’ ”

The couple said they met with a number of hospital administrators after the mix-up and were assured that steps would be taken to ensure it never happened again.

The mother said she does not see a great distinction between mistakenly breast-feeding the wrong baby and leaving the hospital with the wrong baby.

“To me, going home with the wrong baby and being switched in the hospital, it’s all the same,” she said. “The doctors tried to tell me, ‘There used to be wet nurses.’ I said, ‘Fine, if that’s what they picked. That’s not what I picked.’ ”

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Times staff writer Liz Seymour contributed to this story.