Daytona Beach Hospital Facing Recommendation for Medicare and Medicaid Termination After Wrong-Site Surgery

Friday, August 16, 2013
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

It’s usually a nightmare for a physician who performs wrong-site surgery. However, that’s what one surgeon at Halifax Hospital in Daytona Beach, Florida, is accused of doing. The term “wrong-site” refers to the fact that the surgeon has operated on the wrong leg, arm, eye or other organ. According to the Daytona Beach News-Journal, the surgeon allegedly made an initial incision into a patient’s right leg when it was suppose to be made in the left leg on July 3, 2013.

Wrote-site surgery is one of the many medical errors that the health care industry has determined can be easily eliminated. This, in turn, should help reduce health care costs, insurance premiums and patient rehospitalizations.

The alleged wrong-site surgery in this case sparked a review of Halifax’s safety and hygiene procedures by Florida’s Agency for Health Care Administration (AHCA), the licensing authority for all hospitals in the state. The review revealed a number of alleged deficiencies. Now the hospital is facing termination from the Medicare and Medicaid programs, because AHCA has made such a recommendation to the Centers for Medicare and Medicaid Services (CMS).

To read the article from the Daytona Beach News-Journal, click here.


Florida’s AHCA Report Reveals Surgeon Allegedly Called Mistake a Justified Surgery.

According the AHCA report, the patient was admitted to the hospital for vascular disease, which was causing pain in her left leg. The patient gave consent to have surgery on her left leg. However, surgical staff scheduled the procedure for her right leg. During the procedure a nurse anesthetist caught the error after the operation on the patient’s right leg was already underway. The surgeon then proceeded to operate on the patient’s left leg.

After the surgery, the surgeon allegedly told the patient that her other leg needed to be operated on anyway. The surgeon then asked the patient to sign a consent form after the fact, according to AHCA’s report. The surgeon allegedly said the surgery on the patient’s right leg was justified.

The surgeon involved is no longer on staff at Halifax. The operating room team has also been suspended by the hospital, and one of the team members no longer works for the hospital.


State Health Care Agency Called Halifax a “Serious Threat.”


The incident led to the state health care agency (AHCA) conducting an inspection (called a “survey”) of the hospital. State officials conducted interviews with the hospital staff involved, the surgeon and the patient. Officials also observed the hospital’s operating room management and its hygiene procedures.

The survey uncovered a number of problems at the hospital, allegedly including a cleaning person using the same water that was used to mop the floor to clean an operating room table. Officials also found expired medications on drug carts.


Hospital’s Agreement with CMS May be Terminated.


Based on its findings from the inspection, AHCA recommended the hospital’s provider agreements with the CMS be terminated on August 17, 2013. A termination would mean that Halifax Hospital could no longer receive payments for Medicare and Medicaid patients or for any other federally funded programs. According to the Orlando Sentinel, that compromises up to 70 percent (70%) of the hospital’s patients. If one takes into account the Tricare/CHAMPUS patients, military, retired military and VA patients, the percentage might be higher.

A spokeswoman for AHCA said most providers fix their compliance issues before a proposed termination takes effect. If this occurs, Halifax will avoid this devastating consequence.

Click here to read the entire article from the Orlando Sentinel.


Exclusion from Medicare and Medicaid Can Have Devastating Effects.


The Office of the Inspector General (OIG) maintains a list of all currently excluded individuals and entities called the List of Excluded Individuals and Entities (LEIE). The list is meant to provide information to the health care industry, patients and the public regarding those currently excluded from all federal health care programs.

We’ve talked about the significant repercussions exclusion can have on the career and employment of a licensed health professional. The same consequences apply to health care facilities like hospitals and ambulatory surgical centers. Click here to see our previous blog.


Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.


At the Health Law Firm we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other health care provider. We represent facilities, individuals, groups and institutions in contracts, sales, mergers and acquisitions.

The services we provide include reviewing and negotiating contracts, business transactions, professional license defense, representation in investigations, credential defense, representation in peer review and clinical privileges hearings, Medicare and Medicaid audits, commercial litigation, and administrative hearings.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.


Comments?


How common are wrong-site surgeries? What procedures do you follow to ensure a wrong-site surgery never happens? Please leave any thoughtful comments below.


Sources:


Jameson, Marni. “Patient at Halifax Hospital has Surgery on Wrong Leg.” Orlando Sentinel. (August 15, 2013). From: http://www.orlandosentinel.com/health/os-halifax-hospital-wrong-leg-20130815,0,1874175.story

Swisher, Skyler. “Wrong-Site Surgery Prompts Halifax Health Review.” The Daytona Beach News-Journal. (August 6, 2013). From: http://www.news-journalonline.com/article/20130806/news/130809644?tc=ar


About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.


Tag Words: Wrong-site surgery, Halifax Health, surgeon, nurse, operation, patient consent, Florida’s Agency for Health Care Administration, surgical staff, hospital administration, Centers for Medicare and Medicaid Services (CMS), Office of the Inspector General (OIG), Florida Board of Medicine, List of Excluded Individuals and Entities (LEIE), terminate Medicare and Medicaid, Medicare and Medicaid payments, Medicare and Medicaid payments terminated, hospital investigation, operating room management, disciplinary measures, wrong-site surgery discipline, defense attorney, defense lawyer, Florida attorney, Florida Lawyer, The Health Law Firm


"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999. Copyright © 1996-2012 The Health Law Firm. All rights reserved.
8/16/2013

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