California public health officials have imposed the first $100,000 fine under a new escalating system of penalties for hospitals that put patients at risk of death or serious injury.
Southwest Healthcare System in Murrieta was assessed the fine after investigators determined that doctors at its Rancho Springs Medical Center performed caesarean sections on three women in October using electrical cauterizing instruments in a delivery room with dangerously low humidity, creating conditions that could have sparked a fire.
Three fines against the hospital, totaling $225,000, were announced Tuesday, bringing Southwest's total to six, the most in the state. Hospital officials have pending appeals in three earlier cases and also plan to appeal the latest three.
Southwest Healthcare was among seven hospitals -- four in Southern California -- fined in the most recent round announced by the California Department of Public Health.
Others sanctioned were:
* California Pacific Medical Center-Pacific Campus Hospital in San Francisco
* Kaiser Foundation Hospital in Fontana
* Scripps Mercy Hospital in San Diego
* St. Bernardine Medical CenterScripps Mercy Hospital in San Diego in San Bernardino
* St. Joseph Hospital* Sutter Davis Hospital in Davis
Southwest officials released a statement Tuesday rejecting the investigators' latest findings, saying the low humidity readings were "in all but one instance . . . taken in the early morning hours well before surgeries took place. By the time those surgeries were performed later in the afternoon, the humidity levels had been raised above the requisite levels."
They also disputed two other fines in which investigators determined that hospital officials had failed to identify three newborns at risk for a dangerous blood enzyme and failed to follow up with the babies’ families.
Hospital officials said the babies were tested for bilirubin, which can cause jaundice, and that follow-up care was left with the attending pediatricians.
"We adamantly dispute and disagree with the findings," Southwest neonatologists Michael Segall and Kathleen Hurwitz wrote in a letter released Tuesday.
". . . All care provided to babies at Southwest was within nationally recognized standards."
The hospital's three previous fines were each for $25,000 and pertained to staffing issues and food safety.
The new fines, imposed under a law passed in 2006, were increased beginning in January 2009 to $50,000 for the first, $75,000 for the second and $100,000 for the third or more at the same hospital.
Since 2007, when the original law went into effect, the state has issued 146 fines totaling about $4.2 million to 97 hospitals and collected nearly $3 million, said Ralph Montano, a spokesman for the Department of Public Health.
After Southwest's six fines, three facilities have four each:
* Olive View-UCLA Medical Center
* John F. Kennedy Memorial Hospital in Indio
Among the fines announced Tuesday were:
* $50,000 against St. Joseph Hospital in Orange for failing to maintain respiratory equipment after a patient who left with an empty oxygen tank had respiratory arrest and died in March 2009.
The patient was being treated for shortness of breath and weakness and had pneumonia in both lungs, regulators found.
It was the hospital's second administrative fine.
Hospital officials said Tuesday that regulators had accepted their plan of correction, which includes standardized guidelines for transporting oxygen-dependent patients, and they remained "committed to providing the highest level of care, safety and support to our patients."
* $75,000 in two fines against Kaiser Foundation Hospital in Fontana, $50,000 for leaving a surgical sponge in a woman last year after a caesarean section, and $25,000 for improperly sterilizing equipment two years ago that gave a patient third-degree burns on his left calf that required skin grafts.
The hospital staff already has taken corrective action in response to the incidents, a spokesman said in a statement Tuesday.
"We regret that these incidents occurred and moved quickly to implement safeguards to prevent similar incidents in the future," the statement said.
* $50,000 against St. Bernardine Medical Center in San Bernardino for failing to remove part of a breathing tube from a patient's throat after gallbladder surgery in March 2009, according to an investigator's report.
The mistake was discovered after the woman was discharged and coughed up the piece of plastic, investigators wrote.
Hospital officials released a statement Tuesday noting that the patient was not seriously harmed and that the hospital has "revised its anesthesia training and procedures to ensure that all caregivers are both familiar with and follow all manufacturers' guidelines."