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PDH: Understaffing a Possible Factor in Deaths at CRMC

John Commins, for HealthLeaders Media, August 10, 2011

Chronic understaffing at Carlisle (PA) Regional Medical Center may have played a role in the deaths of at least two emergency department patients in June, a report from the Pennsylvania Department of Health says.

Executives at Naples, FL-based Health Management Associates Inc., which owns Carlisle Regional, dispute the state's findings.

On June 5, a critical care patient at Carlisle Regional died while undergoing a CT scan. An employee told state investigators that the patient was sent for imaging without a nurse because only four nurses were on duty to service the overflowing emergency department.

The employee, identified as EMP4, told state investigators the "that management was aware of the staffing situation throughout the hospital and ED nurses were told that they must be more creative in their care."

On June 11, a patient in the emergency department complained of chest pains, and light-headedness died at the hospital more than seven hours after a cardiologist recommended that the patient be transferred to Harrisburg Hospital for an aortic valve replacement.

The state report reviewed documents from the hospital and includes interviews with at least 18 unnamed employees who complained about poor and unresponsive management and retaliation against "troublemakers."

A report in the New England Journal of Medicine earlier this year found that inpatient mortality goes up significantly when a hospital has greater patient turnover and when it fails to meet its own nurse staffing targets by at least eight hours.

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