The state Medical Examining Board disciplined three doctors this week, including reprimanding a Waterbury obstetrician for failing to perform a timely Caesarean section in a case in which the infant died. Dr. John Kaczmarek also failed to assess the infant’s category III fetal heart monitors results on Aug. 10, 2014 at Waterbury Hospital, a consent order he signed with the board states. Category III results are considered abnormal and may indicate that the fetus is at risk of being deprived of oxygen. Kaczmarek also did not appropriately document his evaluation of the monitor results or his plan of care, the order said. The consent order does not detail what happened to the baby, but Christopher Stan, a spokesman for the state Department of Public Health (DPH), said Thursday that despite resuscitation efforts and a transfer to Yale New Haven Hospital, the baby died a day after delivery.
About half of Connecticut hospitals—15 out of 31—will lose part of their Medicare payments in 2018 as a penalty for having relatively high rates of patients who acquired preventable injuries and infections while hospitalized. The hospitals are among 751 nationwide that will lose 1 percent of their Medicare reimbursements in this fiscal year. The penalties are part of the Centers for Medicare and Medicaid Services’ (CMS) Hospital-Acquired Condition Reduction Program, which is part of the Affordable Care Act. The program penalizes hospitals with the highest rates of patients who got infections from hysterectomies, colon surgeries, urinary tract catheters and central line tubes. It also tallies those who suffered from blood clots, bed sores or falls while hospitalized.
Various violations that jeopardized patient safety, including several before and after a newborn died, have taken place in Connecticut hospitals, according to the most recent hospital inspection reports from the Department of Public Health (DPH). The reports, which can be found in C-HIT’s Data Mine section, cover inspections that took place at hospitals between 2016 and first few months of 2017. Some of the violations resulted in injuries to patients, while others showed lapses in infection control standards and other protocols. The Hospital of Central Connecticut in New Britain was cited for several violations that preceded a newborn’s death in 2016. DPH found several errors were made during and after the baby’s birth.
Officials at St. Mary’s Hospital and Waterbury Hospital began negotiations in 2011 to merge and join a Texas-owned company. But the state Permanent Commission on the Status of Women—with MergerWatch, a hospital watchdog group—successfully argued against the merger by making the case that since the new hospital would honor Catholic religious directives, a significant portion of patients would be left vulnerable—because God help you if you are a woman and need emergency reproductive services at a Roman Catholic hospital. Medical professionals at Catholic-owned or -sponsored hospitals operate under directives—known officially as the Ethical and Religious Directives for Catholic Health Care Services. These directives come from the United States Conference of Catholic Bishops and take 43 pages (plus footnotes) to describe what constitutes appropriate Catholic health care.
Eighteen Connecticut hospitals will lose 1 percent of their Medicare payments in 2016 as a penalty for comparatively high rates of avoidable infections and other complications, such as pressure sores and post-operative blood clots, according to new federal data. The Centers for Medicare & Medicaid Services (CMS) announced this month that 758 of the nation’s hospitals – about 23 percent of all eligible hospitals — would be penalized for patient safety lapses in the second year of the Hospital-Acquired Condition Reduction Program, which was mandated by federal health care reform. The penalties are based on rates of infections and other complications that occurred in hospitals between 2012 and 2014. The 18 hospitals in Connecticut include larger urban institutions, such as Yale-New Haven, Hartford and Bridgeport hospitals, and smaller hospitals, such as Manchester Memorial and Windham. They are among hospitals in the worst performing quartile nationally on patient-safety measures including the frequency of central-line and catheter-related infections, post-operative sepsis and accidental laceration.
Connecticut hospitals reported fewer numbers of patients killed or seriously injured by falls or perforations during surgery or suffering from severe pressure ulcers in 2014 than in 2013, but the incidence of such “adverse events” still remains higher than in 2012, a new state report shows. The report by the Department of Public Health (DPH) shows that the total number of hospital adverse events, or errors, dropped by 12 percent — from 534 in 2013, to 471 last year. Deaths or serious injuries from falls declined from 90 to 78; perforations during surgical procedures fell from 79 to 70; and life-threatening medication errors fell from six to one. The number of patients with serious pressure ulcers dropped from 277 to 245. Rates of all four of those incidents had climbed in 2013, in part because of an expansion of required reporting on pressure sores to include “unstageable” ulcers.
A prominent Waterbury gynecologist was fined $5,000 by the state Medical Examining Board Tuesday for mistakenly performing a laparoscopic hysterectomy on a patient who he did not know was pregnant, state records show. In January 2011, Dr. Jonathan Foster, who is also an obstetrician, failed to detect the patient’s pregnancy before the operation, according to a consent order he signed in July agreeing to the punishment. He also relied on the patient’s statement that she was not pregnant and failed to follow-up a urine pregnancy test with a blood test or ultrasound before operating, the order said. State records do not indicate how far along the pregnancy was. After the incident, Foster completed a course to maintain his certification in his specialty.
Mental disorders surpassed respiratory problems and all other ailments as the leading cause of hospitalization in Connecticut in 2012 for children ages 5 to 14, teenagers and younger adults, according to a new state health department report. The report shows that the number of days that patients with behavioral health problems were hospitalized surged 5.3 percent between 2011 and 2013, to nearly 260,000 patient days. Other categories of hospitalizations, including cardiac and cancer care, declined during that time. The data show five hospitals had increases of more than 12 percent in the number of days that patients with behavioral health problems were hospitalized. The biggest increases were at Yale-New Haven Hospital, which saw the number of patients rise 61 percent, and inpatient days jump 51 percent; and Waterbury Hospital, with 26 percent more patients and a 37 percent increase in inpatient days.
Starting Wednesday, a new state law requires Connecticut hospitals to tell all patients when they are being kept in the hospital for observation instead of being admitted and to warn them about the financial consequences. Anyone who goes to the hospital can be placed on observation status, so that doctors can determine what’s wrong, and decide whether the patient is sick enough to be admitted or well enough to go home. Observation patients may receive diagnostic tests, medications, some treatment, and other outpatient services. Depending on their insurance, they can be charged a share of the cost. “They are in a regular hospital bed in a hospital room, getting a hospital level of care, and they have no way of knowing they were not admitted,” said Rep. Susan Johnson, a sponsor of the legislation and co-chair of the General Assembly’s Public Health Committee.
As the state works to improve its mental health system, new federal data show that hospitals in Connecticut restrain psychiatric patients at more than double the average national rate, with elderly patients facing restraint at a rate seven times the national average. In addition, the state lags behind in providing adequate post-discharge continuing care plans for psychiatric patients, especially teens and the elderly. Connecticut’s 28 inpatient psychiatric units and hospitals developed continuing-care plans for fewer than 70 percent of patients they discharged from October 2012 to March 2013 – indicating that thousands of patients may have left facilities without adequate treatment and medication plans. A C-HIT analysis of the federal data, released by the Centers for Medicare & Medicaid Services for the first time, show that Connecticut ranks in the top fourth of states (11th highest) in the use of physical restraints in inpatient psychiatric facilities – and is the third highest state in restraining patients 65 and older. Two psychiatric units – at Bridgeport Hospital and Masonicare Health Center in Wallingford – have the 10th and 12th highest rates of restraint use, respectively, among the 1,753 psychiatric facilities nationwide that are included in the federal reports, which cover October 2012 through March 2013.