Hospital Cited in Treatment of Dementia Patient

By Walter F. Roche Jr.

A Bucks County hospital has been cited by the Pennsylvania Health Department for failure to follow proper procedures in the treatment of an elderly patient suffering from dementia and Alzheimer's disease.
In a 24-page report just made public, state surveyors said the patient had been placed in restraints "to prevent inadvertent injury," but the Lower Bucks Hospital in Bristol failed to follow rules limiting the time a patient can be kept in restraints without review and approval from a physician.
The rules also require facility personnel to monitor the patient while restraints are in use but the records did not indicate that procedure was followed. The findings came during a mid-August visit to the hospital.
According to the inspection report the patient was administered doses of Ativan more frequently than prescribed by a staff physician.
"Ativan was administered too soon," the report states.
A hospital spokeswoman said a plan of correction had been submitted to the state and officials were confident it would be approved.
"Our hospital has a remarkable treatment record, and we remain committed to providing the most effective care for the good of all members of our community," Michelle Aliprantis, a hospital spokeswoman, wrote in an email response to questions.
The unidentified patient cited in the report was admitted to the hospital in early June of this year. She was accompanied by a daughter who had power of attorney for her mother. The records indicate the patient became hypotensive during a surgical procedure.
According to the report in addition to Ativan the patient was administered Klonopin and Percocet The justification for the use of those two drugs was not found in the hospital records.
However the patient had been treated with Trazadone by her personal physician. The surveyors faulted the hospital for changing the medication without the consent of the patient or the person holding her power of attorney.
The state surveyors noted that the patient's records contained conflicting information on how a drug was to be administered.
The orders, the report states, should have been clarified.
Finally, the report states, when the hospital transferred the patient to a nursing home on June 12, they failed to provide adequate information from the patient's record.
The hospital was also cited for failing to re-appoint a staff physician along with other staffing deficiencies, including failure to have a full time supervisor of emergency services.
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