Over the course of my practice as a Houston, Texas medical malpractice lawyer, I have investigated and filed lawsuits on behalf of clients concerning health care that they received at St. Joseph Medical Center.
About the hospital
St. Joseph Medical Center is located at 1401 St. Joseph Parkway, Houston, TX 77002. This hospital has an interesting history. It opened in 1887, as Houston’s first hospital. In recent years, it was affiliated with the Christus chain of hospitals, but more recently became independently-owned by SJ Medical Center LLC.
The hospital has over 800 board-certified physicians on its medical staff, employs over 1,500 non-physician healthcare providers, and is licensed for 792 beds.
St. Joseph Medical Center provides medical and surgical services, including cardiology, cancer care, behavioral health, intensive care, critical care, a Level III emergency room, neurosurgery, orthopedics, and pediatrics. It also has a full-service women’s hospital, a family birthing center, labor/delivery/recovery suites, and a Level III neonatal intensive care unit. Its specialty services include a certified primary stroke center, an advanced wound care center, behavioral medicine, blood conservation and management, occupational medicine, sports medicine and rehabilitation, and diagnostic imaging.
Healthcare issues at the hospital
Based on my experience as a medical malpractice attorney, Texas hospitals operate with minimal regulatory oversight by the state government. While hospitals, like St. Joseph Medical Center, are accredited by independent organizations, these accrediting bodies focus on broad policies and procedures, rather than on specific patient care.
At the federal level, though, the Centers for Medicare and Medicaid Services regularly dispatches surveyors to visit hospitals and look into patient care issues.
Since May 1, 2013, St. Joseph Medical Center has been cited by Medicare and Medicaid surveyors with an astounding 40 violations.
On May 1, 2013, the surveyor cited the hospital for four violations.
One citation concerned the chief executive officers failure to ensure that necessary environmental maintenance problems on psychiatry units were timely addressed. A second violation dealt with registered nursing supervision of nursing care. The surveyor found that a patient developed an eye injury during his admission, but there was no documentation in the medical records that the nursing staff assessed the injury or referred the patient to a physician for evaluation. The third citation dealt with poor maintenance of the physical facilities of the hospital, including emergency call lights in patient care areas, which could potentially be a patient safety issue. The fourth violation on this date found that the hospital did not enforce its infection control policy, which also could present a danger to patients.
Medicare and Medicaid sent another surveyor to St. Joseph Medical Center on October 23, 2013, resulting in two more violations.
The surveyor cited the hospital for violating patient rights by failing to respond in writing to a patient’s relative who had concerns regarding the patient’s care and services. In a second citation, the surveyor found another instance of inadequate infection control at the hospital. Specifically, the hospital was not following its infection control system to identify beds that were not properly cleaned after patient transfer or discharge. Of course, this posed the potential for the spread of infection to patients.
The next six violations to St. Joseph Medical Center on a Medicare and Medicaid site survey occurred on June 2, 2015. The first violation concerned the governing body, based on the surveyor’s finding that it failed to ensure that patient rights were protected, including a safe environment for patient care and effective nursing assessments and supervision being provided. The second violation also concerned patient rights and safety in the behavioral unit. The facility left physical structures in place that contributed to a patient hanging.
The third violation dealt with other physical structures in patient care areas that posed a danger to patient safety. The fourth violation dealt with other safety issues concerning a patient hanging, and was also critical of the fact that the hospital’s quality assurance improvement process failed to identify the hazards and develop measures to prevent similar events. The final citation on this date dealt with inadequate registered nurse supervision of nursing care, related to the failure to evaluate, supervise, and implement safety precautions for a patient who had expressed urges to commit suicide.
On September 4, 2015, a Medicare and Medicaid surveyor cited St. Joseph Medical Center with an additional eight violations.
The first violation found that the hospital improperly used restraint or seclusion of the patient with anxiety disorder. From my experience as a Houston, Texas medical malpractice lawyer I have learned that there are stringent regulations on how restraints can be used in patient care. The second violation dealt with nursing services, based on a finding that the nursing staff did not supervise non-clinical security officers dealing with patient issues. The third violation dealt with the same issue, from the perspective of inadequate registered nurse supervision of nursing care.
The fourth violation dealt with staffing and delivery of care, finding that the hospital did not ensure that its nursing staff was trained in how to identify and handle psychological changes in patients being cared for in medical/surgical units. From numerous medical malpractice lawsuits that I have handled, I have come to know that psychological changes in patients, including altered mental status, can be an important sign that requires physician notification and assessment. The fifth citation found that the hospital did not have systems in place to protect patients from staff abuse. The surveyor found that the hospital did not have appropriate policies and procedures in place to maintain the safety of confused patients and ensure that they receive appropriate care when exhibiting aggressive behavior toward staff.
The sixth citation dealt with the hospital’s governing body, finding that it failed to ensure protection of patient rights, as well as effective nursing assessment and supervision of patient care. The seventh violation was critical of the hospital’s inadequate systems for handling contracted services, including defining the roles, duties, and responsibilities of contracted security staff. The eighth violation found that the facility had inadequate systems in place to protect patient rights concerning safe and appropriate care.
On October 15, 2015, Medicare and Medicaid sent a surveyor to St. Joseph Medical Center for a return visit, resulting in 14 additional violations on that date. The first violation dealt with infection control, finding that the hospital’s direct-care staff did not remove gloves and wash/sanitize hands after direct contact with contaminated items and patients, and failure to obtain physician orders for insertion of Foley catheters and failure to monitor the appropriateness of continued use of those catheters.
The second citation dealt with the same infection control issues, and was critical of the hospital infection control officer for failing to provide adequate oversight to ensure that the hospital’s policies and procedures were followed. As a Texas medical malpractice lawyer and former hospital administrator, I know that having written policies and procedures are important, but making sure that staff members are trained and supervised to follow them are also key.
The third violation dealt with patient rights in terms of participation in care planning. The surveyor found that hospital staff members presented patients with plans of care, without giving patients an opportunity to participate in their development and implementation. The fourth violation concerned patient rights to care in a safe setting. The surveyor found that the hospital was using a contracted registered nurse to provide services to hemodialysis patients, but did not ensure that this nurse complied with the hospitals policies and procedures.
The fifth citation found that the hospital’s operating room policies were inadequate, in that the hospital failed to develop and implement disinfection procedures for the surgery waiting room, pre-operative area, and operating rooms. The sixth violation dealt with the hospital’s medical record services, finding that medical records were not complete, lacked dating when required, and did not follow hospital policies and procedures. When speaking to many patients and clients over the years, I have repeatedly heard concerns that hospital and physician medical records are plagued with inaccurate or missing information.
The seventh violation dealt with the governing body, finding that it failed to ensure that the hospital’s policies and procedures were enforced, failed to oversee operations of independent contractors, failed to ensure that patient rights were encouraged and supported, and failed to proactively maintain a strong infection control program. The eighth violation concerned contracted services, finding deficiencies in the provision of care by contracted registered nurses to hemodialysis patients.
The ninth violation addressed the hospital’s lax oversight of contracted services staff who provided dialysis treatment to the hospital’s patients, the surveyor found that the hospital did not ensure that the manufacturer recommendations and facility policies were being followed concerning dialysis equipment and supplies. The tenth violation found that the hospital violated patient rights by failing to provide dialysis services in a safe manner. The eleventh and twelfth violation was critical of the hospital’s lack of oversight over contracted registered nurses in the hemodialysis patient care area. The thirteenth deficiency addressed the director of dietary services, for failure to maintain an organized and sanitary kitchen, as well as failing to show evidence of the daily management of dietary services. The fourteenth was critical of the hospital’s use of restraints or seclusion, finding that the hospital staff was not appropriately trained in escort techniques during patient transfers.
The most recent Medicare and Medicaid surveyor visit was on March 21, 2016, resulting in two violations. The first violation found that the hospital failed to provide an appropriate medical screening examination to a patient. The second violation was critical of the hospital for failing to appropriately transfer a patient who had been diagnosed with alcohol withdrawal. The surveyor found that the patient had been discharged home from the emergency room, and was found dead in the hospital lobby restroom three hours later.
We are here to help
If you or someone you care for has been seriously injured as a result of poor health care at St. Joseph Medical Center, call the experienced medical malpractice lawyers at Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case. Our attorneys know how to investigate hospital medical records, as well as past incidents involving poor care, to determine if medical negligence was an issue in a patient’s injury.
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Robert Painter is an attorney at Painter Law Firm PLLC, in Houston, Texas. He focuses his practice on medical malpractice, and investigates and files medical negligence and wrongful death lawsuits on behalf of patients and their families. He is a former hospital administrator.
