As a Houston, Texas medical malpractice lawyer, I spend a significant amount of time investigating health care provided by hospitals, doctors, surgeons, anesthesiologists, and nurses.
One of the earliest steps in our investigation of potential defendants in medical negligence lawsuits is to look into a hospital’s past history of compliance or noncompliance with government regulations. One of the sources for quality of care information is the Centers for Medicare and Medicaid Services. This governmental organization sends surveyors to perform site visits at hospitals that are accredited by Medicare and Medicaid.
About Baylor St. Luke’s Medical Center
One of these hospitals in the Harris County, Texas area is Baylor St. Luke’s Medical Center, which is located in the Texas Medical Center, at 6720 Bertner Avenue, Houston, Texas 77030. This hospital was formerly known as St. Luke’s Episcopal Hospital, and was opened in 1954. It has 850 licensed hospital beds, over 1500 registered nurses, almost 2500 additional employees, not counting over 1700 physicians on its medical staff. It is the home of the Texas Heart Institute, as well as eight freestanding emergency centers that offer adult and pediatric care.
Baylor St. Luke’s Medical Center collaborates with Baylor College of Medicine and is also affiliated with The University of Texas Medical School at Houston, The University of Texas Medical Branch (Galveston), Houston Baptist University, and Prairie View A&M University.
Medicare/Medicaid Deficiencies
Since September 2015, Baylor St. Luke’s Medical Center has been cited with two violations by surveyors sent by the Centers for Medicare and Medicaid Services.
In September 2015, the hospital was cited for inadequate registered nurse supervision of nursing care. In particular, the surveyor discovered that a patient had been admitted from the emergency room with a possible diagnosis of tuberculosis. Over eight hours later, the nursing staff had not placed airborne isolation signage and appropriate personal protective equipment and an isolated cart outside the patient’s room. Equally concerning, the patient was not placed in an airborne infection isolation room for nearly 15 hours after she was admitted to the hospital and arrived on the inpatient nursing unit.
The surveyor spoke with three nurses, none of whom was aware that they could initiate isolation precautions without a physician order. As a medical malpractice lawyer, this was surprising to me. The Texas Board of Nursing rules and regulations make it clear that nurses owe a duty to provide competent and safe nursing care to patients.
In many medical negligence lawsuits that I have filed, nursing experts have consistently testified that the standard of care requires that nurses perform various nursing tasks and interventions, even without a physician order. In other words, there are situations where a nurse can begin care that is essential to patient safety and well-being, without waiting for a physician order. On the other hand, some things, like administering medications, require a prescription or order from a doctor.
Even when an order is required, though, the standard of care requires nurses to act as a patient advocate. This means that nurses cannot sit idly by waiting on a physician order, but that they must be proactive in advocating and obtaining the orders necessary to care for their patients.
On May 23, 2017, Baylor St. Luke’s Medical Center was once again cited by a Medicare/Medicaid survey or for a deficiency and registered nurse supervision of nursing care. In this instance, the surveyor found that the nursing staff failed to follow hospital policies and procedures that were in place to protect patients who had a high fall risk.
The surveyor discovered areas of concern in three separate patients. One patient who had undergone a right knee replacement surgery did not have a yellow risk armband on. Another patient had septic arthritis, but did not have yellow non-skid footwear or a yellow risk armband. The third patient had a right heel ulcer, but did not have yellow non-skid footwear or a yellow risk armband on.
Baylor St. Luke’s Medical Center has a policy and procedure in place called “Fall Management-Patient Care,” which is dated September 2014. This document has a section dealing with universal fall precautions, which requires documentation in each patient’s electronic medical record about necessary fall precautions. This documentation is to be reviewed and updated every shift. In addition, the hospital policy and procedure requires patients who have a high risk of a fall, as identified by the healthcare team, must have a yellow fall risk armband placed, in order to identify the patient as high risk. In addition, these high risk patients must be provided with yellow non-skid footwear, which helps to identify the patient as a high risk, but also allows safer walking around.
Patient falls are such a significant problem that the major hospital accreditation organization, The Joint Commission released a new guide to prevent patient falls and falls with injury in hospitals, in October 2016. The Joint Commission estimates that 700,000 to 1 million people fall each year in U.S. hospitals.
When I file a lawsuit against the hospital on behalf of a patient or family, we quickly use the legal process of written discovery to request and obtain copies of relevant hospital policies and procedures. After reviewing those documents, we then request and obtain relevant personnel files of nursing and other staff, to see if the hospital fulfilled its duty to provide training and insure competency of its employees to follow the hospital’s policies and procedures.
We are here to help
The experienced medical malpractice attorneys at Painter Law Firm, in Houston, Texas, are familiar with Baylor St. Luke’s Medical Center and know what to do to investigate care that took place at that facility. If you or someone you care for his been seriously injured, and you think it may be because of medical malpractice, call 281-580-8800, for a free evaluation of your potential case.
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Robert Painter is an attorney at Painter Law Firm PLLC, in Houston, Texas. He represents patients and their families in medical negligence and wrongful death lawsuits against hospitals, pharmacies, doctors, surgeons, and anesthesiologists.
