When the news broke that White Rock Medical Center was briefly unable to accept ambulances this spring, it was a clue that all was not as it should be at the East Dallas hospital. Former WRMC employees filing a class-action suit against their employer for not paying their insurance premiums was another clue. D CEO Healthcare began receiving calls and emails from current and former employees describing a lack of payment, financial misdeeds, a lack of electronic medical records, and dangerous patient conditions. The media wasn’t the only entity hearing about conditions at the hospital.
The Department of Health and Human Services visited the hospital this summer and found several deficiencies that echoed what providers described to D CEO Healthcare about hospital conditions this summer. To corroborate the claims made by multiple providers and employees, D CEO Healthcare made a Freedom of Information Act request to the state’s HHS department to learn more about the investigation and visits to the hospital. After weeks of back and forth, the state released some information about the investigation.
According to state documents, HHS visited the hospital on July 16 and found that the hospital didn’t meet the standard of care in several ways. The investigation found that the hospital failed to implement a system to show improvement in identifying and reducing medical errors and measuring, analyzing, and tracking adverse patient events. “The facility failed to ensure the incident reporting system was engaged to document all incidents with evaluation, follow-up, and corrective actions,” the documents say.
The state found that eleven patients did not have incident reports documented despite experiencing a deviation from the intended intervention and care. While the lack of documentation reporting the hospital’s deviation from care was an issue, the departure from the standard of care was also substantial, according to physicians who used to work at the hospital.
HHS found that six of six patients analyzed who needed potassium tests did not receive them in a timely manner. Potassium labs are part of the primary panel of tests and can be used to monitor kidney disease, check for heart problems and high blood pressure, or check for the side effects of cancer treatment or medications. “High potassium levels can be deadly,” one former WRMC physician said. “If any patients needed the labs done and didn’t get them, that’s a huge deal.”
The documents said that WRMC staff reported that only one patient’s labs were not eventually obtained that day. HHS found that a surgeon canceled a scheduled surgery when potassium labs couldn’t be completed promptly. The results for the other patients were eventually completed, but the staff didn’t fill out an incident report for the lack of a timely test result, as is required by the hospital’s policy.
HHS found that other testing failed to be completed in a timely manner. Earlier this year, former WRMC physicians reported a lack of troponin testing at the hospital. At the time, physicians told D CEO that for two weeks in the hospital’s emergency department, all patients who came in with chest pain were asked to sign out of the hospital’s care against medical advice to go to a hospital that was able to treat them properly because the department did not have the supplies to perform a cardiac troponin test. The test helps determine if a patient is currently having or has recently had a heart attack, which is essential for most treatments and medications.
If a woman tests for high levels of troponin, she is at a higher risk of preeclampsia, which is a serious pregnancy disorder that involves high blood pressure and other symptoms that can threaten the health of the mother and baby. Women with high levels of troponin may want to avoid getting pregnant and risking preeclampsia, but the HHS investigation found that five of five patients analyzed did not receive troponin test results promptly.
Additionally, the state looked at health records and interviewed patients and employees and found that WRMC failed to inform all seven of the patients the state interviewed of their rights, including how the patients would be able to report patient complaints, which is required by state law. The documents said WRMC staff created new forms, including the mechanism to report patient complaints, and updated the forms the next day.
The state Attorney General’s office did not turn over any more information about the investigation, who made the complaints, or any follow-up on the issues in the report.
WRMC leadership did not respond to requests to comment about the HHS investigation, but in a conversation earlier this year, CEO Dr. Mirza Baig and general counsel Terry Fokas discussed how Heights Healthcare of Texas purchased the struggling hospital following bankruptcy from Pipeline Health and had made what it described as “key achievements,” including implementing an electronic health record, a strategic realignment of hospital departments, and the completion of surveys by the Texas Health and Human Services Commission, the Center for Medicare and Medicaid Services, and Joint Commission.
