Understaffing at Carlisle Regional Medical Center did not play a role in the deaths of two emergency department patients in June, the Pennsylvania Department of Health said.
Michael Wolf, the department's acting deputy secretary for quality assurance, said in a letter to Carlisle Regional CEO John Kristel that "the department has carefully examined several patient medical records, documentation, and additional information provided by the Hospital. We now relay that the patient deaths related to staffing as reported in the media appear unfounded and not based on the documentation."
It was not immediately clear what caused the patients' death. However, Kristel made the state's letter public and said in prepared remarks that the findings "substantiate what we have known all along: These patients received prompt and appropriate care by a dedicated team of physicians and healthcare professionals."
The state launched an investigation at Carlisle Regional, which is owned by Naples, FL-based Health Management Associates, Inc., following several complaints, and the deaths of two emergency department patients there.
On June 5, a critical care patient 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.
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."
Carlisle Regional said that a review of medical records found that allegations made by employees who spoke with the state were not accurate, and that the ED patients had, in fact, received prompt and appropriate care before their deaths.
In addition, Carlisle Regional said there was no evidence to suggest that employees who spoke out on hospital issues faced retaliation. The medical center said it encourages employee feedback and has a hotline, operated by a third party, by which employee concerns may be reported anonymously. Only one issue has been reported in this manner this year, Carlisle said in an e-mail to HealthLeaders Media Thursday.
The state also approved Carlisle Regional's correction plan to address deficiencies found in the state's June 22 survey. Wolf said the state has conducted onsite surveys at Carlisle Regional every day, including weekends, since August 19, and has not cited any material deficiencies.
Carlisle, however, in an e-mail to HealthLeaders, called the term "'Plan of Correction' a bit of a misnomer," and described the document as "merely the communication tool used between the hospital and the Department of Health to provide additional information to the State."
Kristel said the state's ruling validates his skepticism of the initial report.
"It has been disappointing to see the reputation of our hospital and its dedicated team of professionals harmed over the past weeks by the inaccuracies contained within the survey, but we are comfortable that our patients know us, and we thank them for their continued confidence," Kristel said.
"We have refrained from commenting publicly until now because we respect the regulatory process. It must be based on fact and evidence, and not on people jumping to conclusions before a proper investigation can be conducted. We have worked closely with the Department of Health and provided all documentation to support our position."
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.