Adverse Reactions at Kensington Hospital

By Walter F. Roche Jr.

A full state inspection of a 43-bed Philadelphia hospital turned up multiple adverse drug reactions that the facility failed to report, as required, to a state health agency.
Inspectors from the Pennsylvania Health Department also cited the Kensington Hospital for discontinuing services without notifying the state, sanitation problems,improper food handling and failure to properly assess patients' wounds.
The state surveyors found that the hospital had discontinued outpatient and womens' health services without notifying the state at least 60 days in advance.
The services had been discontinued in September but the state had still not been notified at the time of the Jan. 22 licensure inspection.
In a walk through of the the hospital the inspectors found that there were too many beds in some rooms.
A review of hospital records, the state found, showed a failure to include community representatives to a patient safety committee.
The infection control committee, according to the report, did not include the required members either.
In five of five cases reviewed, the report states, the hospital failed to report to the state Patient Safety Authority that patients had to be transferred to a higher level of care following an adverse event.
Two patients, the report states, experienced adverse drug events which were not reported. In fact one patient had two adverse reactions. In addition the surveyors found there had been 15 "near misses" or medication errors.
Controlled substances and patient records were not properly secured, according to the report.
Concluding that the hospital was "not free from hazards," the surveyors also found the facility was not dust or dirt free.
The hospital filed a plan of correction in which they promised to correct some, but not all of te deficiencies. They did not respond to requests for comment.
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