STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, O Y- 170 Y By Y AGENCY FOR HEALTH CARE ip ADMINISTRATION, Ins, $ a Kb, F Petitioner, core S vse 6 gi | % PIs vs. Case No. 2007013458 Les FAWCETT MEMORIAL HOSPITAL, INC., Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW the Petitioner, State of Florida, Agency for Health Care Administration (hereinafter “the Agency”), by and through its undersigned counsel, and files this Administrative Complaint against the Respondent, Fawcett Memorial Hospital (hereinafter “the Respondent”), pursuant to Sections 120.569 and 120.57, Florida Statutes (2007), and alleges as follows: NATURE OF THE ACTION This is an action to impose an administrative fine against a hospital in the amount of TWO THOUSAND DOLLARS ($2,000.00) pursuant to Section 395.1041(5)(a), Florida Statutes (2007). JURISDICTION AND VENUE 1. The Court has jurisdiction over the subject matter pursuant to Sections 120.569 and 120.57, Florida Statutes (2007). 2. The Agency has jurisdiction over the Respondent pursuant to Sections 20.42 and 120.60, Florida Statutes (2007), Chapters 408, Part II, and 395, Part I, Florida Statutes (2007), and Chapter 59A-3, Florida Administrative Code. 3. Venue lies pursuant to Rule 28-106.207, Florida Administrative Code. PARTIES 4. The Agency is the licensing and regulatory authority that oversees hospitals in Florida and enforces the applicable federal and state regulations, statutes and rules governing hospitals pursuant to Chapter 408, Part II, Florida Statutes (2007), Chapter 395, Part I, Florida Statutes (2007), and Chapter 59A-3, Florida Administrative Code. The Agency may deny, revoke, suspend a license, or impose an administrative fine, against a hospital, for the violation of any provision of Chapter 395, Part I, Florida Statutes (2007), or any rule adopted under this part. 5. The Respondent was issued a license by the Agency to operate a 238-bed hospital (License No. 4352) located at 21298 N.W. Olean Boulevard, Port Charlotte, Florida 33952, and was at all times material required to comply with the applicable federal and state regulations, statutes and rules. COUNTI The Respondent Failed To Ensure That Two Patients Had Medical Screening Completed When They Were Present At The Facility’s Emergency Room In Violation Of Section 395.002(9), Florida Statutes (2007) 6. The Agency re-alleges and incorporates by reference paragraphs one (1) through five (5). 7. Pursuant to Florida law, "emergency services and care" means medical screening, examination, and evaluation by a physician, or, to the extent permitted by applicable law, by other appropriate personnel under the supervision of a physician, to determine if an emergency medical condition exists and, if it does, the care, treatment, or surgery by a physician necessary to relieve or eliminate the emergency medical condition, within the service capability of the facility. Section 395.002(9), Florida Statutes (2007). 8. On June 28, 2007 the Agency conducted a Complaint Investigation (CCR# 2007006990) of the Respondent and its facility. 9. Based on staff interview and facility record review, the facility did not ensure two (2) of twenty-two (22) patients had medical screening completed when Patient number twenty- one (21) and Patient number twenty-two (22) were present at the facility's emergency room. 10. An interview with facility staff on June 28, 2007 stated Patient number twenty-one (21) came onto the facility's emergency room parking lot smoking. A staff member saw him and Patient number twenty-one (21) said he had gone to a hospital across the street for emergency treatment but was told to leave if he was going to have a cigarette. He left that hospital and walked across the street to Fawcett Memorial Emergency room parking lot. Staff number one (1) (Fawcett Memorial Hospital Staff) came outside and talked to Patient number twenty-one (21). Staff number one (1) called the other hospital who told him to send Patient number twenty- one (21) back and they will treat him. Staff number one (1) then told Patient number twenty-one (21) to go back to the other hospital. At that time Patient number twenty-one (21) walked back to the other hospital emergency room. A review of the patient records showed there was no record for Patient number twenty-one (21) at Fawcett Memorial Hospital. There was no medical screening completed on Patient number twenty-one (21) when he presented himself in the parking lot of Fawcett Memorial Hospital emergency department. 11. An interview with facility staff on June 28, 2007 stated Patient number twenty-two (22) came to the emergency room parking lot on May 19, 2007. The driver of the car went into the emergency room looking for a wheelchair. Staff number one (1) went outside into the parking lot with the driver and observed the passenger in the car in labor. He told the driver and passenger that he would treat her but the hospital across the street has OB and Fawcett Memorial does not. The driver and passenger decided to go to the other hospital and drove away. A review of the patient records showed there is not a record for Patient number twenty-two (22) at Fawcett Memorial Hospital. There was no medical screening completed on Patient number twenty-two (22) when she was presented in the parking lot of Fawcett Memorial Hospital emergency department. 12. Once Staff number one (1) saw both of these patients he suggested they both go to the hospital’s emergency room across the street. Staff number one (1) did not do any type of examination to ensure they were stable for transfer. A review of the hospital's policy and procedure for stabilization states that Patients being transported or discharged must be stabilized as required. "A". To stabilize means "that the individual is provided such medical treatment as is necessary to assure, within reasonable medical probability, that no medical deterioration of the condition is likely to result from, or occur during, the transfer of the individual from the facility..." '"B". "An individual will be deemed stabilized if the treating physician attending to the individual in the hospital dedicated emergency department has determined within reasonable clinical confidence that the emergency medical condition has resolved." This transfer can occur if it's documented in the patient's file. 13. The policy and procedure to medical screening states, "Any individual who comes to the Fawcett Memorial Hospital emergency department requesting examination or treatment is entitled to and shall be provided an appropriate Medical Screening Examination performed by individuals qualified to perform such examinations to determine whether or not an emergency condition exists." 14. During an interview on June 28, 2007 facility staff stated this Emergency Access violation was reported to her immediately and corrective action took place. Staff number one (1) was given a written report showing this Emergency Access violation and was requested to complete the on-line training. Also on June 7, 2007 and June 24, 2007 staff meetings were conducted to discuss and train staff concerning Emergency Access regulations. 15. | The Agency may deny, revoke, suspend a license, or impose an administrative fine, against a hospital, not to exceed $10,000 per violation for the violation of any provision under Section 395.1041, Florida Statutes (2007), or rules adopted under this Section. Section 395.1041 (5)(a), Florida Statutes (2007). WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, intends to impose an administrative fine against the Respondent in the amount of ONE THOUSAND DOLLARS ($1,000.00). ; COUNT It The Respondent Failed To Ensure That Two Patients Records Reviewed Were Logged In The Emergency Room’s Central Log In Violation Of Rule 59A-3.255(6)(a)-(e), Florida Administrative Code 16. | The Agency re-alleges and incorporates by reference paragraphs one (1) through five (5). 17. Pursuant to Florida law, a control register adequately identifying all persons seeking emergency care be established, and that a medical record be maintained on every patient seeking emergency care that is incorporated into the patient’s permanent medical record. The control register must be continuously maintained and shall include at least the following for every individual seeking care: identification to include patient name, age and sex; date, time and means of arrival; nature of complaint; disposition; and time of departure. Rule 59A- 3.255(6)(a)-(e), Florida Administrative Code. 18. On June 28, 2007 the Agency conducted a Complaint Investigation (CCR# 2007006990) of the Respondent and its facility. 19. Based on staff interview and facility records reviewed, the facility did not log two (2) of twenty-two (22) patients records reviewed in the emergency room central log for Patient number twenty-one (21) and Patient number twenty-two (22). 20. An interview with facility staff on June 28, 2007 stated Patient number twenty- one (21) was observed smoking outside the emergency room in the parking lot on May 19, 2007. Patient number twenty-one (21) told an emergency room staff he was at the hospital across the street emergency room but wanted to go outside and smoke. He stated if a patient went outside to smoke they went Against Medical Advise (AMA). He then walked across the street to Fawcett Memorial emergency room parking lot. The doctor who was working in the emergency room, Staff number one (1), talked to Patient number twenty-one (21) who requested to be treated. Staff number one (1) called the hospital across the street's emergency room doctor who asked that Patient number twenty-one (21) be returned. Staff number one (1) told Patient number twenty-one (21) to return to the hospital across the street. A review of the emergency room Central Log for Fawcett Memorial Hospital showed Patient number twenty-one (21) was ; not put on the Central Log for this visit. 21. On June 28, 2007 during an interview staff stated Patient number twenty-two (22) was brought to the emergency room parking lot. The driver of the car came into the emergency _ room for a wheelchair. Staff number one (1) followed the driver to the parking lot where Patient number twenty-two (22) was sitting in the car in labor. Staff number one (1) told the driver and Patient number twenty-two (22) that he could treat her but the hospital does not have OB and the hospital across the street does. Both the driver and Patient number twenty-two (22) decided to go to the hospital across the street. A review of the emergency room central log for Fawcett Memorial Hospital for May 19, 2007 showed Patient number twenty-two (22) was not put on the Central Log for this visit. 22. A review of the policy and procedure for the Central log in the emergency room showed that each hospital must maintain a central log to track the care provided to each individual who comes either to the dedicated emergency department seeking evaluation or the treatment for a medical condition or presents on hospital property seeking care for an emergency medical condition. 23. An interview with facility staff on June 28, 2007 stated she was told of these situations and immediately took corrective action. In-services were provided in the staff meeting on June 24, 2007. Emergency staff meeting minutes on June 7, 2007 showed Emergency Access violation on May 19, 2007. A report was written to Staff number one (1) to complete the on-line training of Emergency Access. 24. The Agency may deny, revoke, suspend a license, or impose an administrative fine, against a hospital, not to exceed $10,000 per violation for the violation of any provision under Section 395.1041, Florida Statutes (2007), or rules adopted under this Section. Section 395.1041 (5)(a), Florida Statutes (2007). WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, intends to impose an administrative fine against the Respondent in the amount of ONE THOUSAND DOLLARS ($1,000.00). CLAIM FOR RELIEF WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, respectfully requests the Court to grant the following relief: 1. Enter findings of fact and conclusions of law in favor of the Agency as set forth above. 2. Impose an administrative fine in the amount of TWO THOUSAND DOLLARS ($2,000.00) against the Respondent. 3. Order any other relief that the Court deems just and appropriate. Respectfully submitted this yn day of (e20) «__, 2008. Andrea M. Lang, Senior Attorney Florida Bar No. 0364568 Agency for Health Care Administration Office of the General Counsel 2295 Victoria Avenue, Room 346C ’ Fort Myers, Florida 33901 Telephone: (239) 338-3203 NOTICE RESPONDENT IS NOTIFIED THAT IT/HE/SHE HAS A RIGHT TO REQUEST AN ADMINISTRATIVE HEARING PURSUANT TO SECTIONS 120.569 AND 120.57, FLORIDA STATUTES. THE RESPONDENT IS FURTHER NOTIFIED THAT IT/HE/SHE HAS THE RIGHT TO RETAIN AND BE REPRESENTED BY AN ATTORNEY IN THIS MATTER. SPECIFIC OPTIONS FOR ADMINISTRATIVE ACTION ARE SET OUT IN THE ATTACHED ELECTION OF RIGHTS. ALL REQUESTS FOR HEARING SHALL BE MADE AND DELIVERED TO THE ATTENTION OF: THE AGENCY CLERK, AGENCY FOR HEALTH CARE ADMINISTRATION, 2727 MAHAN DRIVE, BLDG #3, MS #3, TALLAHASSEE, FLORIDA 32308; TELEPHONE (850) 922-5873. THE RESPONDENT IS FURTHER NOTIFIED THAT IF A REQUEST FOR HEARING IS NOT RECEIVED BY THE AGENCY FOR HEALTH CARE ADMINISTRATION WITHIN TWENTY-ONE (21) DAYS OF THE RECEIPT OF THIS ADMINISTRATIVE COMPLAINT, A FINAL ORDER WILL BE ENTERED BY THE AGENCY. CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the Administrative Complaint and Election of Rights form has been served to: Thomas J. Rice, Administrator, Fawcett Memorial Hospital, 21298 N. W. Olean Boulevard, Port Charlotte, Florida 33952, by U.S. Certified Mail, Return Receipt No. 7006 2760 0003 1536 6770, on this ehan day of telo , 2008. CY (wv. Andrea M. Lang, Senior Attorney Florida Bar No. 0364568 Agency for Health Care Administration Office of the General Counsel 2295 Victoria Avenue, Room 346C Fort Myers, Florida 33901 Telephone: (239) 338-3203 Copies furnished to: Thomas J. Rice, Administrator Andrea M. Lang, Senior Attorney Fawcett Memorial Hospital Agency for Health Care Administration 21298 N.W. Olean Boulevard Office of the General Counsel Port Charlotte, Florida 33952 2295 Victoria Avenue, Room 346C (U. S. Certified Mail) Fort Myers, Florida 33901 (Interoffice Mail) _ 4 Kriste J. Mennella Field Office Manager Agency for Health Care Administration 2295 Victoria Avenue, Room 340A Fort Myers, Florida 33901 (U.S. Mail)

Docket for Case No: 08-001304