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State threatens Northside Hospital

The facility is ordered to stop dialysis treatments and fix safety problems.

By Lisa Greene, Times Staff Writer
Published February 23, 2008


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ST. PETERSBURG -- State regulators have ordered Northside Hospital to stop giving dialysis treatments and have threatened to suspend hospital operations if safety problems aren't fixed.

In a harsh and sweeping order, the state says that the hospital's board and administration knew about problems with its dialysis unit but did nothing to fix them.

"These failures raise the danger that dialysis patients may suffer grave injury or even death," says the order, issued Thursday by Dr. Andrew Agwunobi, outgoing secretary of the state Agency for Health Care Administration.

"The failure of the hospital's administration" to take any action made it necessary for AHCA to issue the emergency order, Agwunobi said.

In one case cited by Agwunobi, a doctor's order specifically said a patient should not be given heparin, a powerful blood thinner, but the patient was given heparin anyway.

Officials at Northside, a 288-bed hospital owned by HCA, issued a statement Friday evening saying the hospital already has submitted a plan to AHCA to address the problems.

"The hospital is working with the medical staff to ensure that patient care disruptions are minimal," the statement said.

Hospital spokeswoman Gina Stiles said officials couldn't discuss the issue further because of patient privacy concerns.

A doctor on staff at Northside said Friday that he told hospital administrators about several problems, but the hospital responded by docking his privileges to practice.

"They don't want to address the problem," said Dr. Abraham Awwad, a nephrologist. "It's a corporation just like McDonald's or Burger King. ... Doctors need to be involved in the decision-making process."

AHCA's order documented problems with eight patients receiving dialysis treatments at Northside. They failed to get dialysis as scheduled, sometimes more than a day late, or got incorrect medications, the order said. At least one patient had to be transferred elsewhere to get dialysis.

The eight patients AHCA described were treated between August and last week. But AHCA said the hospital knew about problems as early as last July, when the hospital board discussed delays in dialysis and other concerns.

Despite that, little else was done, and in December, the hospital renewed the contract with the company providing its dialysis services, Agwunobi said. That company wasn't named in the order, and its identity could not be confirmed late Friday.

"The Board failed to pursue these concerns, failed to identify and define problems, and failed to fashion solutions," Agwunobi said.

Another doctor on staff at Northside, Dr. Keith Runyan, said he had just heard about the moratorium Friday afternoon. Runyan said he hadn't experienced any serious problems with the dialysis service.

"There have been scheduling issues and things like that," he said. "I haven't had any incidents where the patients' care was compromised."

However, AHCA said its review showed that doctors weren't notified of errors made in prescribing medication or using incorrect dialysis equipment. AHCA lists several times when prescribed medicines weren't given to patients. The order also said the hospital provided no way for doctors to report complaints or errors.

The patients described by AHCA were sick enough to be admitted to the hospital, some with advanced kidney disease. At least one was sick enough to be on a ventilator in intensive care.

The order gave Northside 10 days to submit a plan. AHCA will inspect the hospital and decide when it may provide dialysis again.

Awwad provided a letter from Ward Boston III, the hospital's president and CEO, stating that Awwad's staff privileges would be renewed for only one year because of "past issues with your behavior of which you are aware." Awwad said the only issue hospital officials discussed with him was his complaints about the dialysis service.

Times researcher John Martin contributed to this report. Lisa Greene can be reached at greene@sptimes.com or (813) 226-3322.

[Last modified February 23, 2008, 03:31:59]


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