By Barbara Anderson, The Fresno Bee, Calif.
Jun. 21–A day after news of a state report accusing Saint Agnes Medical Center of not protecting patients amid an outbreak of infections, the Fresno hospital suspended open-heart surgeries.
Also Friday, Kaiser Permanente Medical Center officials announced separately that they have stopped sending heart-surgery patients to the troubled hospital, and it was unclear when — or whether — they would resume referrals.
The announcements came as Saint Agnes struggles to respond to criticism about infection outbreaks that began last year and continued through May, when the state shut down its cardiac unit for about a week.
Now the nonprofit hospital will bring in auditors from its corporate parent — Michigan-based Trinity Health — as well as from outside to review the cardiac-surgery program, said Robert Smittcamp, chairman of the Saint Agnes board of trustees.
“We’re extremely concerned with respect to the state’s survey and findings,” he said Friday.
The 54-page state report released this week found that Saint Agnes failed to investigate and track infections in the cardiac-surgery unit and did not ensure that new heart surgeons were monitored.
State officials said this week that the hospital now is subject to unannounced and possibly daily inspections. Saint Agnes has until the end of this month to respond to investigators’ concerns.
The hospital hopes to have a response in the next couple of days, said Dr. Patrick C. Marabella, chief medical officer. But in addition to that, the hospital wants “to prepare a detailed action plan to show we have addressed all the issues, and to sort of re-establish people’s confidence in our program,” he said.
Saint Agnes made the decision to temporarily suspend open-heart surgeries Thursday night, Marabella said. On Friday morning, hospital officials made a telephone call to Trinity, he said.
Kaiser made its decision Friday morning, said Kaiser spokesman Rob Veneski. He declined to say whether the decision was related to Saint Agnes’ suspension of cardiac surgeries.
Most cardiac surgery patients at Saint Agnes are referred by Kaiser, which doesn’t have a heart-surgery program. Kaiser contracts with Saint Agnes for the service. Surgeons from Stanford University Medical Center were brought to Saint Agnes two years ago to perform cardiac surgery on mostly Kaiser patients.
The state’s blistering report was in response to a complaint inspectors received about leg-wound infections in heart surgery patients in May. The state found seven such wounds and shut the cardiac surgery unit from May 23 to 29.
According to Saint Agnes at the time, Kaiser had reported that four of its patients had developed leg infections following surgery. Leg infections are common in open-heart surgery patients. The surgery involves taking a healthy blood vessel from the patient’s leg, arm, chest or abdomen to replace blocked heart arteries.
Kaiser suspended referrals to the cardiac-surgery program during the state investigation of the leg-wound infections. It resumed sending patients there June 3.
Last year, Kaiser stopped referring patients to Saint Agnes in October when the hospital had an outbreak of deep-chest-wound infections among 12 cardiac-surgery patients. The infections may have caused the deaths of two or three patients. Kaiser began referring patients to Saint Agnes again Dec. 17.
During this latest closure, Kaiser patients will be referred elsewhere for open-heart surgery. Toni Flores, Kaiser continuum administrator, wrote in an e-mail message that Kaiser doctors are “consulting with their patients who require cardiac surgery about their different options. Depending on a patient’s individual needs, those options may include having surgery at a Bay Area Kaiser Permanente hospital or another Fresno hospital.”
The suspension at Saint Agnes involves only elective or emergency open-heart surgery. The hospital will stabilize emergency patients and transfer them, if necessary, Marabella said. Saint Agnes continues to be able to treat heart-attack patients, he said.
The reporter can be reached at [email protected] or (559)441-6310.
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