Failure to Report Medication Error Puts Hospital in Medicare’s Crosshairs

hospital administration expert witness

The family of Tennessee resident Chesta Shoemaker has filed a lawsuit against Vanderbilt University Medical Center. Shoemaker was under the care of general surgeon Dr. Gretchen Edwards for a kidney infection when she died of a punctured carotid artery. Blood circulation was cut off to her brain. Shoemaker was removed from life support and died. The lawsuit alleges that the family was never told that Dr. Edwards was a resident, not board-certified, and would not be supervised during the procedure.  Brett Keefer, Shoemaker’s son, is seeking damages between $10M and $30M.

During an unannounced on-site survey of Vanderbilt University Medical Center in November 2018, The Centers for Medicare and Medicaid Services learned a patient died at the hospital in December 2017 due to a medication error. After the wrong medication was administered, the patient went into cardiac arrest and later died. The hospital did not report the incident to the Tennessee Department of Health. The Centers for Medicare and Medicaid Services placed Vanderbilt University Medical Center on “immediate jeopardy” status on November 29, 2018.

Notice is hereby given that effective December 9, 2018, the agreement between Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, Tennessee 37232, and the Secretary of Health and Human Services, as provider of Hospital Services in the Health Insurance for the Aged and Disabled Program (Medicare) is to be terminated. Vanderbilt University Medical Center does not meet the following conditions of participation:

42 CFR 482.13 Patient Rights

42 CFR 482.23 Nursing Services

The Medicare program will not make payment for hospital services to patients who are admitted after December 9, 2018.

When a hospital is barred from Medicare, it can no longer participate in its state Medicaid program. The combined loss can wipe out 75% of hospital revenues. Medicare termination can also jeopardize a hospital’s state license and other payer contracts, damage its reputation, and render the hospital vulnerable as a target for malpractice litigation.

The CMS Regional Office and State Survey Agency inform the provider that the termination process provides an opportunity to make corrections and achieve compliance. On the forty-fifth day following the notice, if the facility has provided credible evidence of compliance, the state agency conducts a revisit to determine whether compliance or acceptable progress has been made.

In litigation against a hospital, the executive leadership team is ultimately responsible for implementing the policies and procedures that keep patients safe. For this reason, the hospital’s governing board, CEO, Chief Medical Officer, and other key hospital administrators may be targeted in complex litigation.  Hospital negligence typically results from one or more of the following situations:

An employee commits a negligent act that was foreseeable or intentional

An employee commits an improper act as a consequence of negligent credentialing

Negligent supervision of hospital employees

Inadequate staffing to address patient census and overcrowding

Failure to comply with state and federal laws, and Joint Commission standards

Improper protocols and oversight in determining observation v. admission status

Charges of hospital negligence may have many serious ramifications.  In the cases against Vanderbilt University Medical Center, lawsuit costs and loss of Medicare income could become financially debilitating as well as damaging to the medical facility’s reputation. Elite Medical Experts review all aspects of healthcare administration litigation. Given the complexity of healthcare administration, an experienced healthcare or hospital administrator from a leading medical center is an invaluable resource. Please contact Elite Medical Experts and speak with a physician or nurse on Elite’s experienced Case Strategy Team today to secure a hand-selected healthcare administration expert witness.

 

 

 

 

 

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