State officials have fined 12 California hospitals for medical errors that in some cases killed or seriously injured patients, according to a report made public Friday.
California Department of Public Health officials have required all facilities — which may appeal the fines — to submit plans to correct the problems. Among the facilities fined are eight in Southern California.
USC University Hospital, east of downtown Los Angeles, was fined $50,000 after pharmacists and staff gave a female patient with cystic fibrosis five overdoses of medication in February, causing kidney failure and seizures and requiring dialysis.
The hospital has since retrained nurses to verify prescription orders, created a new pilot program to ensure medications are administered correctly and started randomly auditing medication orders, according to a plan of correction submitted to the state. It was the first time the hospital had been fined.
Citrus Valley Medical Center in Covina was fined $25,000 after state investigators found that a metal piece of a surgical sealing device was left inside an 80-year-old woman during bypass surgery in August 2008. The woman needed a second surgery to have the device removed.
Hospital officials notified the device’s manufacturer, who replaced it with an upgraded model and retrained staff on how to use it, according to the hospital’s plan of correction. It was the first time the hospital had been fined. It does not plan to appeal, a spokeswoman said.
Southwest Healthcare System in Murrieta, which includes Inland Valley and Rancho Springs Medical Centers, received its seventh fine, $25,000. Investigators found that surgeons left a retractor in a 22-year-old woman during exploratory surgery after she delivered a baby at the hospital in May 2008. The woman had to undergo a second surgery to remove the retractor.
Southwest has received more fines than any other hospital in the state. In April, it received three, including the largest fine ever issued, $100,000, after investigators determined that doctors performed caesarean sections using electrical cauterizing instruments in a delivery room with dangerously low humidity, which could have sparked a fire. A day later, federal officials said they planned to cut the hospital’s Medicare funding, but they reached a settlement agreement in May that required the hospital to make improvements.
The latest fine will not jeopardize that agreement, state regulators said Friday.
Ken Rivers, Southwest’s chief executive, said it does not plan to appeal the latest fine. “Since this incident, Southwest enhanced its processes, practices and training relating to surgical counts, which has resulted in 100% accuracy,” he said in a Friday statement.
Western Medical Center-Santa Ana was fined $75,000, its third fine, after state inspectors found that the staff had used potentially ineffective vaccines to inoculate an adult against tetanus and 1,641 newborns against Hepatitis B, including some born to mothers who tested positive for the virus.
An investigator found that hospital pharmacists had stored the vaccines at temperatures below freezing, against manufacturers’ recommendations. The hospital later notified the babies’ parents and 661 patients who received tetanus vaccines, created a vaccine hotline and held a re-vaccination clinic.
Shelle Malm, a spokeswoman for the hospital, said it is “committed to ensuring quality patient care and patient safety” and that administrators have worked with state regulators and “have set up new policies and procedures as well as staff training and rectified the findings.”
Kindred Hospital Westminster was fined $25,000 after an obese patient developed 11 bed sores and lost 64 pounds within four months of being admitted in April 2008.
Placentia-Linda Hospital was fined $25,000 after surgeons replacing a patient’s left knee in February 2008 used a part designed for the right knee. The patient returned to the hospital five months later complaining of knee pain and had to undergo a second surgery to fix the knee, according to the state investigator’s report. The hospital has since created a new policy for double-checking orthopedic implants during surgery, and it retrained staff and suppliers.
The state also fined two hospitals in San Diego County and four hospitals in Northern California.
Scripps Memorial Hospital La Jolla was fined $50,000 after a surgical towel was left in an 80-year-old man for four months after surgery, and Palomar Medical Center in Escondido was fined $50,000 after a woman in intensive care fell out of bed, became disconnected from her oxygen and IV, and later died.
The state issued two fines to UC San Francisco Medical Center for a total of $50,000; two fines to California Pacific Medical Center in San Francisco for a total of $125,000; a $25,000 fine to Hanford Community Medical Center and a $50,000 fine to Petaluma Valley Hospital.
The state has issued 170 fines since they were first required by law in January 2007, a spokeswoman said. In all, 112 hospitals have been fined and the state has collected $3.65 million. Of those fined, 39 hospitals have appealed, she said.