Some of the most worrisome reports about Select Medical's hospitals are largely hidden from the public. Inspectors from state health departments regularly visit hospitals on behalf of Medicare to make sure that the hospitals are meeting the requirements to participate in the program. In their visits, often after complaints from patients, family members, nurses and physicians, the inspectors talk to patients and staff members and review medical reports and other evidence. The reports do not identify patients or staff members, but they offer detailed descriptions of what inspectors have found to be a problem, ranging from minor violations, like poor record-keeping, to much more serious issues.
A handful of states, including Florida and Pennsylvania, make the reports public on state health department Web sites. Most do not. The New York Times received the reports directly from Medicare under a Freedom of Information Act request that asked for reports of Select Medical Corporation hospitals citing "condition level" violations - problems so serious that Medicare could bar the hospitals from the program if they were not corrected. In all, Medicare turned over 22 condition-level reports for 2007, 2008 and 2009. In addition, several "standard level" reports from Florida and Pennsylvania describe very serious incidents.
In May 2008, inspectors in Ohio reported that family members of a patient at a Select hospital in Cincinnati had called 911 - from inside the hospital - at 9:30 p.m. on Feb. 15 to complain "that they couldn't get any nurses or doctors to help the patient," who had been short of breath for more than an hour. The patient's condition continued to worsen, but no doctor affiliated with Select Specialty arrived, according to the medical records. At 11:55 p.m., a medical resident from the host hospital, Good Samaritan Hospital, decided to admit the patient to Good Samaritan's intensive care unit. But under Good Samaritan's policies, a more senior physician needed to be consulted before the patient could be transferred. While the resident tried to get approval, the patient's heart stopped and he died. In a statement, Select said that its staff had responded properly and consistently to the patient's complaints. Nurses, a respiratory therapist and physicians all saw the patient during the night, according to the company. Good Samaritan declined to comment.
In January 2008, inspectors in North Carolina reported that a 68-year-old patient at a Select hospital in Durham had died after his heart stopped despite wearing a telemetry monitor that set off an alarm, because the clerk watching the monitor did not know what the alarm meant and a nurse did not visit the patient for 17 minutes. In the same report, inspectors reported finding a patient who had soiled himself and had not been cleaned for seven hours. Another patient told inspectors that he had on repeated occasions waited more than an hour to be cleaned after soiling himself. In a statement about the 68-year-old, Select said that the clerk had acted appropriately and that the patient would have died in any case. "Changes were made in hospital leadership and improved staff competency after this incident," the company said. A year later, inspectors returned to the hospital and again found an untrained person watching the heart monitors. In the same report, they noted that a patient had not been evaluated for nearly seven hours after falling out of bed. The patient later died.
In March 2009, inspectors in Kansas and Pennsylvania found problems with heart-monitoring in separate incidents. At the Select hospital in Topeka, monitors went unwatched, inspectors reported. In Pittsburgh, inspectors found a broken heart-monitor being used on a patient. In a statement, Select said that the incidents had not put patients at risk.
In October 2009, state inspectors in Florida found that a Select hospital in Palm Beach had put a bedridden patient on a feeding tube that provided only 600 calories a day, causing her to lose 8 percent of her weight in three weeks. "The registered dietician could not explain the nutritional care being provided to the resident," the inspectors wrote. Another patient at the same hospital weighed 146 pounds; the hospital had reported the patient's weight as 182 pounds and could not explain the discrepancy. In a statement, Select said that the hospital was trying to move the first patient from tube feeding to mouth feeding, and that the transition had caused temporary weight loss. In the case of the second patient, the weight was inaccurately recorded, but the patient was not malnourished, the company said.
http://www.nytimes.com/2010/02/10/health/policy/10careside.html
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A Jefferson County jury has found Christus St. Mary Hospital negligent in its treatment of a 41-year-old woman who died of a heart attack within hours of an emergency room visit.
In the verdict, filed Jan. 21, the jury found that the Port Arthur hospital along with Dr. Michael Peterson committed "willful or wanton negligence," in their treatment of Stacy Meaux.
The jury awarded a combined $1.3 million in damages to Meaux; her mother, Mary Ann, Licatino; and her two children.
Limitations on the amount of money that can be awarded for mental anguish pain and medical malpractice will limit this to $250,000 per defendant.
http://www.beaumontenterprise.com/community-%20news/mcc/local/St_Marys_found_negligent_in_death.html
According to the Institute of Medicine, 98000 people die every year from PREVENTABLE medical errors, such as the one described above. That number does not reflect the number of people seriously injured. Preventable medical errors are the sixth leading cause of death in the US, the equivalent of two 737s crashing every day.
Rather than putting limitations on the amount of money that can be sought from the families of these victims of those errors, which 30 states have done, would it not be more beneficial for everyone to reduce the number of medical malpractice lawsuit cases by reducing the number of medical errors? We need to be making strides in patient safety, not limiting the rights of patients who have been injured through no fault of their own. Tort law changes clearly won't fix health care.
Please visit http://www.98000reasons.org/ for information on how you too can stand up for patient rights.
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AAJ's New Campaign Focuses on Patient Safety
According to the Institute of Medicine, 98,000 people die every year from preventable medical errors. When tort "reform" became an issue in the health care debate, AAJ initiated the "98,000 Reasons" campaign to educate the public and tell Congress to put patients first. The key message: Tort law changes that limit injured patients' rights won't fix health care.
The campaign launched a new Web site (http://www.98000reasons.org/); ran broadcast, print, and online advertising; and released a series of video tributes to some of the lives cut short by medical negligence. The campaign featured patients who were harmed through no fault of their own and emphasized the need to make patient safely a top priority.
One of these patients was 19-year old Blake Fought, who had been treated in a hospoital for an illness that required a central intravenous (IV) line. He had recovered and was being prepared for discharge.
Unfortunately, the nurse had never been trained to remove the IV and did not follow proper procedures, causing bubbles to enter Blake's blood vessels and travel to his brain and heart. He died in front of the nurses and his parents, who had come to the hospital to take their son home. Blake is just one example of why tort law changes will not fix America's broken health care system.
98000Reasons.org also highlights the role played by trial attorneys - who see firsthand the effects of medical errors on patients and their families - in protection patients and ensuring a strong civil justice system.
For a closer look at the campaign, visit http://www.98000reasons.org/.
Justice In Motion, inside the American Association for Justice; Trial January 2010.
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