Agency Issues Penalties to 12 California Hospitals

One of them, Dominican Hospital in Santa Cruz, received its third administrative penalty, the California Department of Public Health announced.

The California Department of Public Health announced Sept. 7 that it has issued administrative penalties to 12 California hospitals after determining their non-compliance with licensing requirements caused, or was likely to cause, serious injury or death to patients. Ten of the hospitals received $50,000 penalties, while two were penalized $75,000 each.

The $75,000 penalties went to Dominican Hospital in Santa Cruz and Emanuel Medical Center Inc. in Turlock.

CDPH said this is the third administrative penalty issued to Dominican Hospital, a Catholic Healthcare West facility located in Santa Cruz. It was penalized $75,000 for failing to develop and implement written policies and procedures to ensure medication was administered safely and effectively. The department investigated after Dominican reported that a testicular cancer patient received five times more cisplatin, a chemotherapy drug, than intended for four consecutive days because his primary oncologist had transposed two numbers in calculating the dosage. Two pharmacists reviewed the cisplatin order and realized the dose was appropriate for only one day of treatment, but they overlooked the part of the order saying the dose would be administered for five consecutive days, according to CDPH's statement of deficiencies. The patient suffered acute kidney failure and hearing loss because of the overdose, it states. Dominican implemented a new administrative policy and assigned a full-time clinical pharmacist to its oncology unit, according to the statement.

Emanuel Medical Center failed to follow its surgical policies and procedures, according to the department. The statement of deficiencies in this case says a guidewire was inadvertently left inside a patient who received a central link catheter while in the facility's emergency department in September 2010. X-rays then showed the guidewire, which is used to guide the placement of a catheter, had traveled from the patient's groin to the heart, according to the statement. CDPH said this is Emanuel Medical Center's second administrative penalty.

The other hospitals receiving penalties are:

  • Alameda Hospital, Alameda: The hospital failed to develop and implement written policies and procedures to ensure the safe and effective administration of medication. This is the first administrative penalty issued to this hospital.
  • Brotman Medical Center, Culver City: The hospital failed to ensure the health and safety of a patient when it failed to follow its policies and procedures for fall prevention. This is the second administrative penalty issued to this hospital.
  • California Men's Colony, San Luis Obispo: The hospital failed to implement written policies and procedures to ensure the safe and effective administration of medication. This is the first administrative penalty issued to this hospital.
  • Kaiser Foundation Hospital & Rehabilitation Center – Vallejo, Vallejo: The hospital failed to ensure the health and safety of a patient when it did not follow its surgical policies and procedures. This is the second administrative penalty issued to this hospital.
  • LAC+USC Medical Center, Los Angeles: The hospital failed to ensure the health and safety of a patient when it failed to implement written policies and procedures to ensure the safe and effective administration of medication. This is the fourth administrative penalty issued to this hospital.
  • Riverside Community Hospital, Riverside: The hospital failed to ensure the health and safety of a patient when it did not follow its surgical policies and procedures. This is the first administrative penalty issued to this hospital.
  • Stanislaus Surgical Hospital, Modesto: The hospital failed to ensure the health and safety of a patient when it did not follow its surgical policies and procedures. This is the first administrative penalty issued to this hospital.
  • Sutter Delta Medical Center, Antioch: The hospital failed to ensure the health and safety of its patient when it failed to follow its policies and procedures related to ongoing patient monitoring and assessment and provision of patient care. This is the first administrative penalty issued to this hospital.
  • Torrance Memorial Medical Center, Torrance: The hospital failed to ensure the health and safety of a patient when it did not follow its surgical policies and procedures. This is the first administrative penalty issued to this hospital.
  • UCSF Medical Center, San Francisco: The hospital failed to ensure the health and safety of a patient when it did not follow its surgical policies and procedures. This is the fifth administrative penalty issued to this hospital.

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