Community Regional Medical Center has been fined $175,000 by state regulators for two cases in which patients were harmed -- including one in which a surgeon walked out of the hospital in the middle of an open-heart procedure, leaving a physician's assistant in charge.
With these latest cases, which both occurred last year, Community Regional has been fined three times in the last two years for patient-care lapses.
Thomas Utecht, senior vice president of Community Medical Centers, said the hospital has instituted improved safeguards, which the state has approved.
He added: "Community continually trains and searches for ways we can improve our patient care and safety."
In the most recent cases, the hospital was fined $75,000 after a patient undergoing open-heart surgery suffered massive blood loss, cardiac arrest and loss of oxygen to the brain after the surgeon walked out of the operating room -- and the hospital -- before closing the chest, the state said Thursday. A physician's assistant was left in charge, the state said.
The physician's assistant and a medical doctor stitched the patient's chest closed, but the patient continued to bleed, and then went into cardiac arrest.
The physician's assistant was called back to the operating room, where she reopened the patient's chest and began manually massaging the heart. The cardiovascular surgeon was summoned back to the hospital and eventually, with the help of another surgeon, stopped the bleeding.
The patient was placed on life support. The report did not say whether the patient ever recovered.
The state report said investigators were tipped off to the case by an anonymous caller in early April 2012. The hospital, in a written response to the state's investigation, said it had been conducting its own investigation into the case. The hospital said the surgeon was suspended from the medical staff for 14 days and ordered to under go additional training.
In another case, the hospital was fined $100,000 for a medical lapse in which a physician ordered a physician's assistant to remove a spinal catheter from a patient who was on a blood thinner.
The patient developed bleeding near the spinal cord and required surgery to repair the damage, resulting in the patient becoming paralyzed, according to the state investigation.
Neither the physician nor the physician's assistant was authorized to remove the catheter. In addition, the medication directions specifically state epidural catheters are not to be removed when the patient in on blood thinners because of the risk of uncontrolled bleeding. The state report says the incident happened in late 2012, although the precise date was redacted.
According to the hospital's response to the state, the physician was suspended for seven days and ordered to undergo additional training. The physician's assistant was fired. The hospital also said it changed its procedures to prevent such problems in the future.
The two fines against Community Regional were among 10 levied against nine California hospitals. Also sanctioned was Mercy Medical Center in Merced, which was fined $50,000.
In 2012, Community Regional was fined $50,000 by the state for a 2010 incident in which a woman was given a lethal overdose of a blood-thinning drug.
Fine amounts are $50,000 for a first violation, $75,000 for a second and $100,000 for a third. After three years, the penalty count starts over.
Under a 2007 law, hospitals are required to self-report errors in cases that could cause serious injury or death.
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