A Dallas hospital where a man was left untreated in an emergency room for 17 hours and later died could face fines after federal health regulators found deficiencies that they believed posed an immediate threat to patients, a newspaper reported Sunday.
Officials at Parkland Memorial Hospital, the largest general hospital in Dallas, were told in a November 2008 letter from the U.S. Centers for Medicare & Medicaid Services that the facility had major deficiencies, including excessive delay in emergency treatment.
The letter, recently obtained by The Dallas Morning News, said "deficiencies are so serious that they constitute an immediate threat to the health and safety of any individual who comes to your hospital with an emergency medical condition."
Federal regulators determined that Parkland violated the nation's emergency-treatment law and should possibly be fined, the letter said.
Parkland officials denied to the newspaper that the Dallas County-owned hospital broke any laws, but neither they nor federal regulators would detail talks over the last year about a possible fine.
The letter was sent following the September 2008 death of Mike Herrera, who went to Parkland's emergency room complaining of severe abdominal pain but wasn't treated for 17 hours. An investigation revealed a nurse didn't document his history of heart disease.
The deficiencies cited in the letter have been corrected, said Dr. Ron Anderson, Parkland president and chief executive. The emergency room wait time has been cut in half -- from 11 hours to just more than 6 hours -- since the incident, hospital officials have said.
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"We're providing a higher standard of care," Anderson told the newspaper. "It's a shame a tragedy had to occur."
Medical records provided to The News showed that Herrera, a 58-year-old Dallas restaurateur, had a history of heart disease and severe hernias, but the medical history taken by a triage nurse failed to reflect his past heart problems. He went to the hospital Sept. 20, 2008, and died the next day.
The U.S. Emergency Medical Treatment and Active Labor Act of 1986 requires hospitals to at least provide "an appropriate medical screening examination" and treatment to stabilize any patient seeking emergency room care.
Herrera's death triggered an investigation by the Joint Commission, an independent hospital accrediting agency. It determined that Parkland did not fulfill almost a dozen health care standards and its patient rights and pain management duties, the newspaper reported.
In response, Parkland told the government agency that it would tighten emergency room patient monitoring and increase staffing. Parkland officials also said they had cut average emergency room waits for treatment from 11 hours in September 2008 to 6 hours and 15 minutes now.
