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Federal report finds persistent mistakes and poor oversight at UC Irvine Medical Center [Updated]

January 21, 2010 |  1:36 pm

Federal investigators found dozens of problems at UC Irvine Medical Center during a fall inspection that again put the troubled hospital’s Medicare funding at risk, according to a report by the Centers for Medicare and Medicaid Services.

In the 85-page report, regulators said that during their surprise inspection in October, they observed poor oversight and mistakes by UCI doctors, nurses and pharmacists that led to inadequate care that in some cases harmed patients.

It comes a year after regulators, in a 127-page report, documented repeated examples of poor oversight and inadequate systems to protect patients in the hospital and threatened to cut off Medicare funding.

[Updated 4:04 p.m.: A previous version of this post incorrectly reported that regulators faulted the hospital's anesthesiology department.]

Among the new findings:

[Updated at 2:02 p.m.:  An 82-year-old man was mistakenly given a narcotic patch by a medical resident, without approval of doctors or pharmacists, which led to an overdose that required emergency intervention and may have contributed to his death a week later.]

A patient in the neuropsychiatric unit fell twice in three days, despite yelling, “Help me, doctor, help me,” suffered a head injury and had to be taken to intensive care.

In another case, an on-call resident did not respond to repeated pages from nurses in the neurological intensive care unit, where a patient with an irregular heartbeat languished for more than an hour.

Investigators faulted pharmacists for not monitoring and storing drugs correctly, allowing nurses to carry narcotics in their pockets and inject patients without proper oversight.

At one point during the inspection, a federal investigator had to stop a nurse from injecting a brain-injured patient in intensive care with steroids because she had prepared the dose incorrectly, according to the report.

The hospital had to submit a plan of correction by Jan. 18, which has to be approved by federal officials before they return for another surprise inspection, said Jack Cheevers, a spokesman for the Centers for Medicare and Medicaid Service.

The hospital’s October inspection was its second since July, when Medicare officials issued a finding of immediate jeopardy after investigators discovered five UCI patients had received overdoses because nurses using pain medication pumps were not properly trained. UCI officials immediately began training nurses to use the pumps, and the finding was lifted within 24 hours.

UCI spokesman John Murray said hospital officials plan to send a letter to staff today explaining the latest inspection report. Terry Belmont, the hospital’s chief executive, and Dr. Eugene Spiritus, the chief medical officer, are scheduled to discuss the report with The Times this afternoon.

-- Molly Hennessy-Fiske