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| Florida ASC Slapped With 18-day Shutdown for Letting Male Tech Sexually Abuse Female Patients
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A Fort Lauderdale outpatient surgery center was barred from seeing patients for 18 days last month after state investigators found that the facility failed to stop a male surgical tech from sexually abusing female patients.
Staff and surgeons at the Oakridge Ambulatory Surgery Center witnessed the tech fondling sedated female patients in the recovery room, isolating female patients in the bathroom to help them change their clothes, ogling breasts during plastic surgeries and staring at naked patients from behind during standing preps, according to a report from the Florida Agency for Health Care Administration. The AHCA report alleges that management discouraged and even reprimanded employees for turning in staff who molested patients.
"The leadership of the facility created and fostered an environment where employees were afraid to step forward when they saw the potential sexual abuse of patients," says AHCA Secretary Alan Levine in a statement. "That is unconscionable and will not under any circumstances be tolerated."
The moratorium was ordered May 1 after a weeklong investigation in April at the eight-year-old surgical center, which is housed in a 50,000 square-foot facility that also includes a clinical laboratory, endoscopy suites and diagnostic imaging. The surgical tech was terminated on Aug. 15, 2005, but not before he sexually abused at least four patients dating to before September 2004. The facility didn't investigate three of those incidents, says ACHA — the inappropriate staring at patients, the isolating female patients and assisting them in undressing and the touching of a patient's pubic area in the recovery room.
In its report, AHCA says the surgery center violated Florida statute because it didn't have an operational internal risk management program to investigate and analyze adverse incidents and take appropriate measures to prevent future occurrences and thereby assure the health and safety of patients. "One of the most important components of a risk management function is that staff complaints and concerns are fully investigated and reported. Here staff did not feel their observations of inappropriate behavior were treated seriously and even worse, staff was reprimanded for coming forward with these complaints. This fostered an atmosphere in which observed incidents would not be reported and therefore the protection of the patients was compromised," says AHCA in its report.
The moratorium was lifted May 18 after the facility submitted a corrective action plan to AHCA, says a spokesman for Oakridge. The plan includes a system for patients or staff to report complaints or concerns directly to senior management, bypassing on-site personnel, via a hotline. The administrator who was accused of failing to investigate was suspended, says Oakridge.
"While we understand that ACHA has a job to do and we support their mission, we believe that the moratorium was not necessary as the employee in question had been terminated in August 2005," says an Oakridge spokesman. "We feel our final review of this matter will show we did, indeed, make all required reports and that we had proper and adequate procedures and protocols in place."
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| Hospital, Two Doctors Liable for Failure to Disclose Anesthesiologist's Drug Problem
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If you're hoping to help your facility's problem doc out the door, think twice about writing him a glowing letter of recommendation that conveniently glosses over his darker side: You could be held liable if he gets in trouble at his next job.
In a lawsuit ruling that was the first of its kind, a jury awarded more than $4 million to a Washington hospital and malpractice insurer after finding that a Louisiana hospital and two of its doctors were guilty of fraud and negligent misrepresentation for failing to disclose an anesthesiologist's drug problem in their letters of recommendation.
According to a published report about the suit, anesthesiologist Robert Lee Barry, MD, was hired by Kadlec Medical Center in Richland, Wash., because it didn't know about his past troubles, which included his being asked to leave Lakeview Regional Medical Center and his practice at Lakeview Anesthesia Associates for suspicion of diverting Demerol from patients and for "being impaired on the job." Because Dr. Berry was not fired, this was not recorded by the federal DEA database.
Further, according to another published report, Lakeview Regional Medical Center and Dr. Berry's former colleagues "didn't respond to questions that were asked" about Dr. Berry's history, making it next-to-impossible for his prospective employer to make an informed decision. Kadlec Medical Center only learned about Dr. Berry's problems when he was found responsible for a patient's brain damage in an $8.5 million malpractice settlement.
The precedent set by this case takes some of the burden off facilities as they credential and privilege new physicians, but does not remove it entirely. Many cases have set the bar for credentialing practices, and abnormalities such as state-hopping and unresponsive references may be red flags that "merit further investigation above and beyond regular protocols," say experts.
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| Hospitals Sue California Blue Cross to Stop Endoscopy Payment Policy
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A Blue Cross of California payment policy set to take effect July 1 tells physicians in no uncertain terms where they should perform colonoscopies: out of the hospital. The policy will penalize physicians who perform colonoscopies in hospitals by cutting their payments by 20 percent and incentivize docs who perform them in ASCs or offices by giving them a 5 percent kickback in addition to their regular fees.
The California Hospital Association filed a lawsuit against the insurer last week to stop the policy from taking effect. CHA, which represents more than 400 hospitals in the state, claims the different payment structure will violate state law by inducing doctors to make medical decisions based on financial considerations rather than clinical judgment.
Blue Cross says there's no difference in quality between routine endoscopy in hospitals or surgical centers. But hospital outpatient surgery centers are much more expensive. Colonoscopies cost $2,100 to $6,000 in a hospital setting, but fees in an outpatient surgery center range from $300 to $500.
The lawsuit also alleges Blue Cross is committing fraud by telling its members they have a choice of healthcare providers within the health plan's network, when in fact that choice is severely limited.
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| News and Notes
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A Blue Cross of California payment policy set to take effect July 1 tells physicians in no uncertain terms where they should perform colonoscopies: out of the hospital. The policy will penalize physicians who perform colonoscopies in hospitals by cutting their payments by 20 percent and incentivize docs who perform them in ASCs or offices by giving them a 5 percent kickback in addition to their regular fees.
The California Hospital Association filed a lawsuit against the insurer last week to stop the policy from taking effect. CHA, which represents more than 400 hospitals in the state, claims the different payment structure will violate state law by inducing doctors to make medical decisions based on financial considerations rather than clinical judgment.
Blue Cross says there's no difference in quality between routine endoscopy in hospitals or surgical centers. But hospital outpatient surgery centers are much more expensive. Colonoscopies cost $2,100 to $6,000 in a hospital setting, but fees in an outpatient surgery center range from $300 to $500.
The lawsuit also alleges Blue Cross is committing fraud by telling its members they have a choice of healthcare providers within the health plan's network, when in fact that choice is severely limited.
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