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ANAHEIM GENERAL HOSPITAL
MEDICAL STAFF BYLAWS
Tag No.: A0353
Based on interview and medical record review, the hospital failed to ensure the physician on call for OB (obstetric) emergencies in the ED (Emergency Department) responded by phone within the timeframe dictated by the General Medical Staff Rules and Regulations for one of 31 sampled patients (Patient 12). This resulted in the potential for a delay in treatment to prevent a premature birth and potential maternal complications.
Findings:
Review of the hospital's General Medical Staff Rules and Regulations, ED On-Call Panel Requirements, #4, showed a physician scheduled to take ED call must respond to all calls from the ED by telephone or in person within 30 minutes of a call or page from the ED.
The medical record for Patient 12 was reviewed on 7/7/10. The patient presented to the hospital's ED on 6/24/10 at 1913 hours. The patient, who stated she was six months pregnant, was complaining of severe left lower abdominal pain and vaginal bleeding.
The physician's dictated report of Patient 12's ED visit, dated 6/25/10, showed MD F examined the patient on 6/24/10, and ordered an OB ultrasound. MD F received the results of the ultrasound at 2100 hours. The ultrasound showed the the patient was pregnant with a 26 week fetus (full term is 38-40 weeks) in the breech position (feet presenting first) and the placenta was abrupting (tearing away from the uterine wall). MD F documented he ordered the on call OB physician, MD G, be called immediately. At 2107, not having received a return call from MD G, MD F documented he was able to contact another OB physician on the call panel at 2125 hours, and began the arrangements to transfer the patient to another hospital with an OB service. MD F documented Patient 12's pain continued and the patient began to deliver the infant at 2200 hours. The infant was delivered stillborn at 2206 hours. MD F documented MD G returned his call during the delivery of the infant.
During an interview with the Medical Director of the ED, MD E, on 7/8/10 at 0900 hours, the MD stated the hospital had a problem with getting it's on call physicians for the ED to return calls.