Hospital Called Health Threat

(Miami, Florida) In a rare move, Florida state regulators have closed Aventura Hospital to all non-emergency patients because it is considered dangerous to the safety, health or well being of patients.

From Miami.com:

[T]he Agency for Healthcare Administration declared the facility presented "an immediate threat to public health and safety" and took the highly unusual move of closing it to all admissions except those entering through the emergency room.

Now get this. Apparently, Aventura Hospital protocol is to admit patients, strap their arms and legs in restraints, dope them unconscious, and then wait for them to die. Okay, I'm exaggerating a bit.

Kidding aside, it appears that at least one death is linked to the use of restraints and the hospital was closed until an investigation of the practice can be completed.

Many of the observations made by a state team, which visited the hospital last week, concerned restraints put on older patients who were simply lying in bed in an "unresponsive" state.

[ ... ]

In one case at Aventura, a physician ordered the use of restraints on a 78-year-old upon admission. The patient was placed in "soft wrist restraints" and taken to intensive care, put on a ventilator and listed as "unresponsive."

The patient remained flat in bed, but the doctor kept ordering restraints.

Now, I'm not a medical expert but I'd surmise that a physician seeing an unresponsive patient while conducting rounds probably wouldn't order restraints. Instead, I'd guess the doctor would probably have the straps removed. With regard to the doctors at Aventura, it appears that my surmising and guessing are wrong.

Complicating the hospital's problems is apparent negligence in accurate and complete record-keeping. In particular, hospital documentation fails to indicate "whether the patient showed behavior justifying the restraints, had been turned to reduce the possibility of bedsores, or had been properly monitored."

Aventura management and the investigators are working to resolve the issues.


[Update 06/02/06]

The state ban on admitting non-emergency patients at Aventura Hospital has been lifted.

From Miami.com:

State officials Thursday lifted a six-day moratorium that had blocked Aventura Hospital from admitting nonemergency patients, but the threat of federal action against the hospital remains.

Brandi L. Brown, deputy chief of staff for the Agency for Health Care Administration sent an e-mail to The Miami Herald announcing the change: "A survey earlier today found the problems leading to the moratorium have been corrected. Federal action is still pending, but the hospital will go back to 'normal' operations."

The hospital's plan for corrective action was accepted by the state but still must be approved by federal regulators. Although Aventura officials expressed confidence that the feds would be satisfied, Sharon Fisher of the Federal Center for Medicare & Medicaid Services stated, "In our eyes, it's not yet resolved." It would be a financial disaster if Aventura lost Medicare payments.