HospitalInspections.org

Intakes: TN00027629

Based on review of the hospital call schedules, facility document review, medical record review and interview, it was determined the facility failed to ensure a physician was on call for thoracic emergencies.
Refer to A2404.

Based on review of facility documents and interview, it was determined the facility that had specialized capabilities failed to accept from a referring hospital a transfer of a patient who required specialized services.
Refer to A2411.

Based on review of the call schedule and interview, it was determined the facility failed to ensure a physician was on call for thoracic emergencies.

The findings included:

1. Review of the Call Schedule for July - December, 2010 documented "...July 3, 4, 5 [named physician] ...10, 11 [named physician] ...17, 18 [named physician] ...24, 25 [named physician] ...31, 1 [named physician] ..." There was only weekend on-call physicians scheduled for thoracic emergencies.

2. During an interview in the administrative conference room on 4/4/11 at 2:15 PM, the Director of Quality and Performance Improvement stated "...there's no published thoracic call list during the week...they just call one of the physicians, talk to them, and get what they need...we only have a weekend call schedule..."

During an interview in the administrative conference room on 4/4/11 at 3:20 PM, MD #2 stated "...we have a call schedule in our office that rotates around the week before or the week after weekend call. My office has the call list and our doctors' answering service has it too..."

Based on facility document review and interview, it was determined this facility having specialized capabilities, failed to accept a patient from a referring hospital, who required the specialized services offered by this facility.

The findings included:

1. Review of the facility "Prior to Arrival Form" documented "...Date: 7/14/10...Time: 7:12 PM...[named patient] ...Age 61...Diagnosis or Problem: Refused by [MD #2]...Pertinent Lab/Information/Meds Given: Asc [Ascending]& desc [descending] aortic dissection...Declining MD [MD #2]..."

2. During a telephone interview on 4/4/11 at 8:05 AM, the transferring physician stated "...spoke with the ER physician who told [her] their thoracic surgeon would not take the patient because he was covering [named hospital] and another hospital. That was too many hospitals at that time and couldn't get tied up..."

During an interview in the administrative conference room on 4/4/11 at 12:35 PM when the Clinical Director of the Emergency Room was asked how do you handle transfers of patients requiring a higher level of care, she stated "...we just take them ...can't think of a time when we did not take a transfer..."

During an interview in the administrative conference room on 4/4/11 at 3:20 PM, MD #2, who refused to accept a patient (Patient #21) who requested transfer on 7/14/10 , stated "...I don't remember the specifics of this case [referred to patient who requested transfer]...I don't see patients from [named city where the patient who requested transfer was located]. It's not fair to send cases here, they can send them closer...I have an obligation to this hospital. It's not fair to send someone to me just because they don't want them..."