Bay Area hospitals fined for violations MEDICINE

A hallways at Stanford Hospital in Palo Alto, Calif. A hallways at Stanford Hospital in Palo Alto, Calif. Photo: Michael Macor, The Chronicle Photo: Michael Macor, The Chronicle Image 1 of / 1 Caption Close Bay Area hospitals fined for violations 1 / 1 Back to Gallery

Six Bay Area hospitals were among the 14 California hospitals fined Thursday by the state Department of Public Health for violations serious enough to severely injure or kill patients.

The Bay Area hospitals cited were the Kaiser Permanente hospitals in San Francisco and South San Francisco, St. Francis Memorial Hospital and St. Mary's Medical Center, both in San Francisco, Stanford Hospital in Palo Alto and Menlo Park Surgical Hospital.

State public health officials issued a total of $825,000 in fines to the 14 medical centers. Hospitals, which can appeal the fines, are charged $50,000 for a first violation, $75,000 for a second and $100,000 for a third and subsequent violations.

Kaiser San Francisco was slapped with a $100,000 fine for its third violation, which involved the failure of hospital staff to make sure a patient with an insulin pump was capable of self-administering the medication. The patient suffered from hypoglycemia, which resulted in brain injury and her death.

The hospital immediately revised its procedures after the 2010 incident and developed a detailed policy for self-administered insulin pumps, said Melinda Skeath, Kaiser's director of quality and regulatory services, in a statement.

At Kaiser's South San Francisco medical center, staff left a surgical sponge inside a patient in 2010, requiring the patient to undergo a second surgery to remove damaged tissue from the unhealed wound and a third surgery to remove the sponge.

The hospital made improvements in its procedures to avoid leaving objects inside patients and held a special surgical safety course focused on the issue, Skeath said. This was the hospital's second violation.

A sponge was also left inside a patient following surgery at St. Francis in 2010, requiring a second surgery. At St. Mary's, a patient died after the tubing to her portable heart and lung machine disconnected as she was being placed into an ambulance.

Both hospitals, which are part of the Dignity Health system, were fined $50,000 for their first violations.

"In each separate case, we conducted thorough investigations and are working closely with the medical staff, patient care team and hospital leadership, as well as with (state health officials) to ensure that an incident like this does not happen again," Dignity Health officials said in a statement.

Stanford, in the hospital's first violation, was fined $50,000 for a 2010 incident in which stitches holding a tracheostomy tube in place were removed by a nurse untrained to do the procedure. The tube, which allows patients to breath without using their nose or mouth, dislodged causing loss of oxygen to the brain. The patient later died.

Menlo Park Surgical Hospital, part of Sutter Health's Palo Alto Medical Foundation, was fined $50,000 for using surgical equipment improperly, causing a patient's bladder to rupture.