An April 2014 incident in which a surgeon had to leave a hysterectomy to perform an emergency Cesarean section has resulted in a $40,000 fine for St. Joseph Hospital from the California Department of Public Health. In its press release, the CDPH stated "the hospital failed to ensure the health and safety of a patient when it did not follow established policies and procedures." This is the hospital’s second "Immediate Jeopardy" administrative penalty.
According to state documents, the incident occurred on April 29, 2014, when a physician performing a hysterectomy on a patient was called out to perform an emergency C-section and had to leave the operating room, "as no other obstetrician could be found." The doctor left "after the arteries to the uterus had been clamped, cut, and tied off." The incident report does not say how long it took, but both surgeries were successful.
In an interview conducted June 10, 2014, the physician stated "there were not enough
obstetrician gynecologists on the medical staff at the hospital to do the work" and he "was
on call as laborist 12-16 days per month."
The CDPH reviewed the hospital's bylaws and found that the rules stated that "when practitioners plan to be unavailable to cover their patients' hospital needs, arrangements must be made with another hospital-privileged practitioner." The hospital's failure to enforce these rules led to a fine.
According to the CDPH report, the hospital established a goal of monitoring whether the Medical Staff Services Office has verified on-duty laborists do not have elective surgeries scheduled and/or they have back-ups to cover them, and has met that goal.
David Southerland, interim chief executive for the hospital, responded to a request for comment on the afternoon of August 31, saying that the hospital "took appropriate and immediate action to prevent any such event from happening again. This includes submitting a plan of correction that was approved by CDPH."
Finding sufficient medical personnel has been an ongoing challenge for St. Joseph and other local health providers for several years.
Editor's note: This story was updated to include a statement from St. Joseph Hospital that was unavailable at the time of first publication. That statement can be found in full below.
From St. Joseph Hospital:
August 31, 2017 – St. Joseph Hospital Eureka released the following statement from David Southerland, Interim Chief Executive, with regard to the California Department of Public Health (CDPH) penalty:
St. Joseph Hospital is committed to providing high quality patient care and patient safety. This is a top priority.
The California Department of Public Health (CDPH) penalty notification recently received is related to an event that took place in April 2014. During their investigation, CDPH identified an area of improvement in our OB Laborist on-call program. We immediately implemented improvements to strengthen our program.
In keeping with our commitment to a culture of integrity, active compliance and the delivery of the highest standard of patient care, we took appropriate and immediate action to prevent any such event from happening again. This includes submitting a plan of correction that was approved by CDPH.
We deeply regret that this incident occurred. Ensuring patient safety and delivering extraordinary care is fundamental to our hospital’s mission and values. We perform rigorous internal reviews of our quality and safety on a regular basis. We are confident that our focus on continuous improvement will uphold our commitment to providing a safe environment for our patients.