HospitalInspections.org

Based on record review and interview, the hospital failed to provide radiology services according to the needs of three of four patients (Patients #7, #9, and #11) who were critically injured during a two vehicle car accident in that only one radiologist was available.

1) Patient #7 left the hospital for a higher level of care after a two hour ED stay. The physician ordered x-rays to evaluate for a possible right ankle fracture were not completed.
2) Patient #9 was evaluated for a blunt trauma to the abdomen and possible pelvic fracture. Physician ordered x-rays and CT scans were not completed when the patient left after a 78 minute stay in the ED
3) Patient #11 left the hospital after a 75 minute ED stay without the physician ordered CT scan and x-rays of his spinal cord, right arm, and left leg completed.


Findings included:

1) Patient #7's Emergency Nursing Record dated 05/02/14 noted the patient was evaluated for lacerations to her right forearm and right ankle. The physician's clinical impression dated 05/02/14 at 23:18 noted the patient's multiple contusions and possible right ankle fracture. X-rays were ordered at 23:30. There was no chart evidence of an x-ray report. Patient #7 left the hospital on 05/03/14 at 01:20.

2) Patient #9's Emergency Nursing Record dated 05/02/14 noted a patient triage time of 23:20. The patient was ED admitted on a backboard with a cervical collar applied. The patient was anxious, her heart rate was increased, and she had lacerations to her face. Clinical impressions included Multiple Contusions, possible Pelvic Fracture, and Blunt Trauma to Abdomen. A portable chest x-ray and computer tomography(CT) scans of Patient #9's head and pelvis were ordered. There was no chart evidence of x-ray or CT scan results. Patient #9 was transferred to a different hospital on 05/03/14 at 00:38.

3) Patient #11's Emergency Nursing Record dated 05/02/14 noted a triage time of 23:15. The physician clinical impression included the patient had fractured his right forearm and left knee. Physician orders for x-rays of the patient's chest, right forearm, left knee and lower leg, and a head CT scan were timed at 23:30. There was no chart evidence of x-ray or CT scan reports.

Hospital Personnel #7 was telephone interviewed on 08/22/14 at 15:25 and stated she was the only x-ray technician at the time the four patients came in after being involved in the motor vehicle accident. Multiple x-rays were ordered but the physician "decided to ship them [the patients] before I got to them." Hospital Personnel #7 stated it happened "quite a bit" that patients were transferred out without completion of x rays.

Hospital Personnel #1 stated on 08/22/14 at 12:10 that x-rays on Patient #7, #9, and #11 were not done. The orders were canceled because the patients were discharged.

The hospital's disaster plan dated 06/13/00 noted as first priority to treat patients with "...multiple or combined wounds and major fractures."