In a report released Thursday, Jan. 21, federal investigators found UC Irvine Medical Center to be operating out of compliance with health policies necessary to receive Medicare funding. In a surprise inspection in fall 2009, investigators found numerous lapses in policy and procedures in nursing and pharmaceutical services. The 85-page report details how nurses, doctors and pharmacists failed to provide care in compliance with health standards needed to receive Medicare funding. Such problems include the misadministration and improper handling of narcotics.
An 82-year-old male patient was mistakenly given a narcotic patch by a doctor, leading to a severe overdose that may have contributed to his death a week later. This mistake was attributed to a failure in pharmaceutical procedure and inattention to his medical record. Nurses were also found to have carried narcotics in their pockets, which is out of compliance of proper protocol. Other problems include issues of oversight. An on-call resident did not respond to emergency pages from the neurological intensive care unit. Another patient fell twice in three days and suffered a head injury from a third fall the following week.
UCI Medical Center filed their latest corrective action plan on Jan. 21. The plan incorporates daily audits, random audits and reeducation of staff on policies and procedures. The plan also includes corrections in the keeping of medical records and evaluation of patient falls and their fall risks. A second unannounced inspection will occur in the future to check on the implementation of the plan. The Center for Medicare & Medicaid Services (CMS) would revoke their funding for Medicare and Medicaid if UCI Medical Center does not pass this second inspection.
John Murray, the Media Relations Manager for the UCI Medical Center says this possibility is unlikely. “CMS does not want to shut down hospitals. They want to make sure their patients are receiving quality care as guaranteed by their plan,” Murray said. UCI Medical Center anticipates that CMS will fully accept their corrective plan of action. “Human error is inevitable,” Murray said, “What we can do is try to better implement the system to minimize that error.” Other commentators cite more than human error as the source of problems. The LA Times reported that Beth Keans, Assistant Director for UC nurses, attributed the problems to understaffing and cut funding. Meanwhile, Murray claims that UCI Med Center upholds its mandated staff ratios for nurses and health personnel.
In July, state investigators investigated a claim by UC nurses that faulty drug pumps were used to administer accidental overdoses. They found that the pumps were functional, but UC nurses administered incorrect dosages. The hospital was put in a state of “immediate jeopardy” until an immediate correction plan was created and implemented. UCI has been affiliated with a series of medical controversies since the 1990s. In 2005 the hospital’s liver transplant program was placed on probation due to a low survival rate, and University of California paid $7.5 million to settle ensuing lawsuits. UCI Medical Center also had the Willed Body Program scandal in the late 1990s during which body parts donated for educational purposes and research were sold for profit. Furthermore, there were cases of alleged fertility fraud in the Center for Reproductive Health in 1995 where fertility doctors were accused of taking eggs and embryos from patients without consent to be replanted elsewhere. While all these issues have been corrected and UCI Medical Center has continued to keep its doors open, the true test in its next step will be to pass the CMS’ second inspection.
UPDATE 2/9: The original article printed 2/2 stated that the “UCI Medical Center also had the Willed Body Program scandal…” The program was run out of the university and not affiliated with the UCI Medical Center. The article also stated that “The Center for Medicare & Medicaid Services (CMS) would revoke their funding…” The Center for Medicare and Medicaid Services reserves the revocation of funding as one of several options, not a foregone consequence. The article further stated that the UCI Medical Center was out of compliance with health policies: to be specific, the UCI Medical Center was out of compliance with three out of 23.