The California Department of Public Health has fined Saint Agnes Medical Center and Clovis Community Medical Center for violating patient-care rules after a death at each hospital.
The administrative penalties were among 14 issued against 13 California hospitals, the state announced Wednesday.
The violations included errors in administering medications, second surgeries that were required to remove objects left inside patients and failure to prevent a fall.
Saint Agnes received a fine in connection with a woman's death Aug. 28. The state found a nurse at Saint Agnes delayed calling doctors and her nursing supervisors for hours when the woman's health began to deteriorate following a hysterectomy. The woman died of cardio-respiratory arrest and internal bleeding, the state said.
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Saint Agnes has appealed the penalty, a state health official said.
At Clovis Community, state investigators said, a patient admitted last October for shortness of breath received a blood-thinning drug for 11 days without tests being done to monitor the thinness of the patient's blood.
Two doctors failed to order the tests, and nurses did not check for test results in the patient's chart, the state said. Those failures "contributed to the death" of the patient, who suffered massive bleeding into her brain, the state said.
This was Clovis Community's first administrative penalty.
Clovis Community and Saint Agnes were assessed the maximum $25,000 fine each for the violations, which happened in 2008. Violations that occur in 2009 will cost a hospital $50,000. A second violation will be $75,000, and a third or subsequent violation will be $100,000.
Dr. Tom Utecht, senior vice president and chief quality officer for Community Medical Centers, which operates the Clovis hospital, said in a written statement that the hospital "immediately implemented corrective actions to ensure that physician medication orders are clarified by hospital clinical staff whenever the orders involve 'high alert' medications that might contribute to adverse events."
The correction plan was approved by the state.
Kelley Sanchez, a Saint Agnes spokeswoman, said the hospital reviewed policies and procedures following the death there. "We developed a corrective action plan immediately and implemented that action plan, and it was approved by the state, and it has been executed," she said.
Wednesday's penalty was the third assessed against Saint Agnes in the two years since the state began levying fines for violations that present an "immediate jeopardy to a patient's health and safety."
Saint Agnes faced a penalty in June after the state investigated a spike in cardiac infections that may have resulted in the deaths of two, possibly three, patients in 2007. The hospital developed a correction plan that the state approved.
The hospital faced a penalty in July 2007 for not having written policies and procedures for the distribution and dispensing of intravenous drugs. The hospital developed a patient safety action plan and bought equipment to reduce errors.
The state has issued 87 penalties to 59 hospitals for $2.175 million since it began assessing the fines, said Kathleen Billingsley, deputy director of the Center for Healthcare Quality in the California Department of Public Health. Twenty-three penalties have been appealed. Three settlements are pending, and two appeals have been settled and paid.
Billingsley said the state has collected $1.2 million. The money goes into a hospital quality improvement fund and not to the state general fund, she said.