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Bayfront avoids loss of funds over death

The hospital could have lost its Medicare funds over violations found after an elderly woman patient died.

By LISA GREENE
Published April 22, 2005

ST. PETERSBURG - After an elderly woman in a wheelchair strangled on a restraint at Bayfront Medical Center last year, state investigators documented several failures by the hospital, including improperly using restraints and not watching video monitors to keep an eye on patients.

Investigators told federal Medicare officials they should move to cut off Bayfront's Medicare funds because of the violations, according to public records released this week.

But state investigators visited Bayfront again March 29 and found the hospital had corrected the problems and was back in compliance. Its Medicare funding is no longer at risk, and Bayfront has made several changes as a result of the death of Edna Buice in November.

"Can you imagine, had they simply had a clerk sitting at the station (watching the monitors)?" said Len Milcowitz, the Buice family's attorney, on Thursday. "For me, the survey points out the multifaceted error-prone (areas) that allowed patients to be" endangered.

But Kanika Tomalin, Bayfront spokeswoman, said the hospital has made changes to be safer.

"Patient safety is a serious concern for every team member at our hospital," she said. "Mrs. Buice's death was a tragically unfortunate incident that deeply saddens the entire Bayfront family."

Buice, 82, was hospitalized at Bayfront last fall after a stroke. Although paralyzed on one side, Buice had been improving and was expecting to return home. But Nov. 7, when she was one of two patients in the rehabilitation unit, Buice was placed in a wheelchair with a padded waist restraint, meant to keep her upright.

Somehow, Buice wound up in an empty hospital room, where she slipped down in the chair and strangled.

When state investigators visited Bayfront in November, they documented two more rehabilitation patients in wheelchairs with waist restraints. But Bayfront contested this finding, saying the patients were in physical therapy, using belts to keep them upright.

Neither patient was using the same type of restraint as Buice, Tomalin said.

The Centers for Medicare and Medicaid, or CMS, contracts with the state Agency for Health Care Administration to survey hospitals after such incidents to see if they comply with federal rules.

Had Bayfront not corrected the problems, CMS could have fined it, stopped allowing Medicare payments, or enacted other penalties.

The investigation, which said Bayfront failed to safeguard patients' rights as required by federal law, also found that:

The restraint used on Buice was not properly documented in her records. There were no doctors' orders authorizing the restraint for several days before her death, and no records that the restraint was discussed with her and her family.

Brochures given to patients upon admission lacked key information. They didn't tell patients they can participate in planning their care, that they have the right to be cared for safely, and that they have the right "to be free from unnecessary restraints."

Video monitors were not continually watched.

The hospital has stopped using the type of restraint that killed Buice, Tomalin said. The hospital also has stricter standards on when any restraints can be used, made video monitoring constant in its brain injury unit, and changed its brochures.

Hospital officials say they also are giving patients more information about belts used during physical therapy.

Buice's estate filed suit last month against Bayfront. Hospital officials have refused to comment on the suit.

[Last modified April 22, 2005, 00:43:11]