HospitalInspections.org

Intakes: TN00027276

1. Based on review of the Emergency Department (ED) log and interviews, it was determined the facility failed to ensure the central log was accurately completed to include 1 of 30 (Patient #1) sampled patients who presented to the ED for treatment.
Refer to A 2405.

2. Based on review of the ED log and interviews, it was determined the facility failed to ensure the ED provided an appropriate medical screening examination within the capability of the hospital's ED for 1 of 30 (Patient #1) sampled patients who presented to the ED for treatment.
Refer to A 2406.

Based on review of the Emergency Department (ED) log and interviews, it was determined the facility failed to ensure the central log was accurately completed to include 1 of 30 (Patient #1) sampled patients who presented to the ED for treatment.

The findings included:

1. Review of the ED log for 7/6/10 and 7/22/10 revealed no documentation on the ED log that Patient #1 was seen in the ED on either of those dates. The ED logs dated 7/22/10 revealed a total of 60 patients were seen on that date in the Medicine ED and a total of 25 patients were seen in the Trauma ED.

2. Closed medical record review from a children's hospital located near this facility revealed Pt #1 presented to the ED of that hospital 7/22/10 at 11:16 AM and received treatment for a closed fracture of the left radius on that date.

3. In an interview in a conference room 5/2/11 at 11:10 AM, the facility's Chief Legal Officer stated she was aware of an occurrence concerning a security guard who did not follow facility protocol in allowing a patient to enter the ED. She stated she spoke with the father of the patient on the telephone, then she and the ED nurse manager visited the patient and her parents in a nearby Children's hospital ED where the patient received treatment.
In an interview on 5/3/11 at 8:45 AM, the Chief Legal Officer stated the patient's father told her they never entered the hospital, the security guard stopped them on the steps outside the ED and instructed them they had to go to a nearby Children's hospital to receive treatment, then refused assistance for transporting the juvenile patient to the other facility.

Based on review of the ED log and interviews, it was determined the facility failed to ensure the ED provided an appropriate medical screening examination (MSE) within the capability of the hospital's ED for 1 of 30 (Patient #1) sampled patients who presented to the ED for treatment. The findings constituted an Immediate Jeopardy situation that began on July 22, 2010 when the facility failed to provide a MSE for a patient who presented to the ED.

The findings included:

Review of the ED logs/records dated 7/22/10 revealed that a total of 60 patients were registered in the facility's Medicine ED and 25 patients were registered in the facility's Trauma ED on that date. There was no documented records indicating that Patient #1 was seen at this facility on 7/22/10.

In an interview in a conference room on 5/2/11 at 11:10 AM, the facility's Chief Legal Officer stated she was aware of an occurrence concerning a security guard who did not follow facility protocol in allowing a patient to enter the ED for treatment. In a subsequent interview on 5/3/11 at 8:45 AM, the Chief Legal Officer stated the patient's father told her they never entered the hospital; that the security guard was on the steps outside the ED and instructed them to go to a nearby Children's hospital in order to receive treatment. By preventing the juvenile patient to enter the facility, the security guard refused to allow the patient to receive a MSE.