DALLAS (AP) — Texas health officials levied a record $1 million fine against a Dallas County hospital after an investigation into complaints, including an improper surgery follow-up that resulted in a patient's leg being amputated and the death of psychiatric patient who was improperly restrained.
Parkland Health and Hospital System said the fine was part of an agreement with the Texas Department of State Health Services to dismiss any potential litigation or enforcement actions for compliance issues prior to the end of May 2012. The fine is the largest ever issued against a Texas hospital.
"The dollar amount reflects the magnitude and seriousness of the problems that have been discovered inside the hospital over many months," health department spokeswoman Carrie Williams said. "Parkland remains under intense regulatory scrutiny as the hospital works toward doing a better job of keeping patients safe."
The hospital is already operating under a federal agreement with the Centers for Medicare and Medicaid in order to prevent the loss of funding for those programs. The agreement came after an inspection last summer found violations in infection control, emergency care and other areas. The hospital was put on an improvement plan in the fall.
"We're starting to see some of the progress that we've been hoping for," said David Wright, deputy regional administrator for CMS in Dallas.
Debbie Branson, chair of Parkland's board of managers, said in a statement that Parkland has taken responsibility and that the agreement with the state allows the hospital to "focus on completing the changes necessary to secure Parkland's future as one of the most important health care assets in North Texas."
The hospital has hired consultants to help. The federal agreement runs through April 2013.
As part of its agreement with the state, the hospital must provide the state health department with monthly reports on its progress toward getting back into compliance with Medicare and Medicaid conditions of participation. Parkland must also inform the state of any "reportable adverse events" within two business days of becoming aware of the incident.
The agreement said the state conducted numerous on-site surveys and complaint investigations from January 2011 to May 2012, finding deficiencies including failure to keep proper medical records and to enforce its own policies and procedures.
For example, inspectors found failures to adequately staff nurses in certain areas and to ensure that infection control methods were used, such as hand washing, and in reporting infectious diseases to the state health department. They also found inadequate cleaning in operating rooms.
Other incidents included a psychiatry patient who set an article of clothing on fire with a cigarette lighter and a male nurse who unnecessarily assessed the genitalia of a male patient who was admitted for an infected finger.