Nephrology News & Issues
NY closes DaVita-affiliated clinic for poor infection control
9/17/2008 10:45:15 AM
By Mark E. Neumann
For the second time in the last six months, DaVita Inc. is facing public scrutiny over the closure of one of its dialysis clinics due to questionable clinical and administrative practices.
In July, the dialysis provider re-opened a clinic in Lufkin, Texas closed for nine weeks after the state cited DaVita for operational deficiencies and a staff nurse was arrested for injecting bleach in two dialysis patients. The patients survived.
Yesterday, DaVita closed its Life Care Dialysis Center in Manhattan after a New York State Department of Health investigation uncovered poor infection control practices and indicated that at least one patient has contracted hepatitis C after receiving dialysis there.
Health Commissioner Richard F. Daines, MD, told the media that the center has surrendered its operating certificate and paid a civil penalty of $300,000 to the state.
Last month, state health officials performed a week-long inspection of the center and documented unacceptable infection control practices, including blood on the treatment chairs and employees failing to wash their hands properly, disinfect equipment, or change gloves between patients.
It was repulsive, said Claudia Hutton, a spokeswoman for the Health Department, in an interview with The New York Times. The treatment chairs that they gave people to relax in had someone elses dried blood on them.
Clinic medical director Dr. Walter Wasser agreed to transfer the clinics 171 patients to alternate dialysis units, but the Department of Health sent letters out on Monday to 657 patients who received treatment at the clinic since January 2004 and who may have been exposed to hepatitis C and other bloodborne pathogens while treated at the center. The letters advised patients to get tested for hepatitis C, hepatitis B and human immunodeficiency virus. Lifecare agreed to pay for the patient testing.
A new statute, signed into law by Governor David A. Paterson on April 23, 2008, raised the possible penalties on health violations from $2,000 per violation up to $10,000 per violation, in some cases.
DOH has established a toll-free information hotline for Lifecare patients at 800.278.2965 that will receive calls 24 hours a day for the foreseeable future.
Problems in Texas
DaVita faced similar problems at its clinic in Lufkin, Texas, which it closed on April 28 after notifying local and state police and the state health department about a recent spike in patient deaths and health complications. The Texas Department of State Health Services conducted a regulatory investigation into the facility along with officials from the Center for Disease Control and Prevention. In a separate investigation, Lufkin Police Department officers charged former DaVita nurse Kimberly Clark Saenz, 34, with injecting two patients with bleach. While both patients survived, a DaVita spokesman has said the company suspects Saenz is linked to a cluster of four patient deaths in early April. Police have not filed any additional charges.
The findings of a state survey conducted in mid-May were released to the media, but most of the information in the 40-page report was blacked out, including a list of deficiencies cited at the facility. Some portions of the corrective action plan from the survey were also blacked out.
The facility was cited with a level three corrective plan of action the highest kind of enforcement the state can apply. DaVita has been operating the clinic since its July 2 re-opening with a physician monitor, two nurse monitors and a technical monitor to oversee staff at the facility.
