GROSS INCONGRUENCES BETWEEN THE HUNTINGTON MEMORIAL HOSPITAL LAST REPORT ,THE DISCHARGE SUMMARY OF GERONIMO RODRIGUEZ MD. AND THE DEATH CERTIFICATE. BAD FAITH AND LIES...........ALLWAYS LIES
IF YOU PAY ATTENTION AND READ THIS DOCUMENTS YOU´LL FIND THE FOLLOWING:
1. GERONIMO RODRIGUEZ AVOIDED TO DISCHARGE THE TRUE ABOUT THE EXISTENT PRECLAMPSIA,PROGRESSING TO ECLAMPSIA AND HELLP WHICH FINNALLY CONDUCTED VERONICA TO HER DEATH.
WHY???
BECAUSE HE COULDN´T ADMIT THE TRUE HAVING INTO ACCOUNT THAT HE DID NOT PERFORMED ANY KIND OF ACCURATE MANAGEMENT OR TREATMENT TO STOP THE PROOGRESS OF A DISEASE WHICH CLEAR SYMPTOMS HE NEVER RECOGNIZED AT ALL.THAT´S WHY I BLAME HIM AS MAIN RESPONSIBLE OF ABANDONMENT OF VERONICA AND GROSS INCOMPETENCE DUE THEIR TOTAL IGNORANCE ON THE MATTER.HE IS THE MAIN RESPONSIBLE,(AND NURSES INDEED),OF THE DEATH OF MY POOR CHILD.
SO.ALLOW ME TO ASK TO THE INVESTIGATORS OF THE MEDICAL BOARD OF CALIFORNIA: WHERE IS THE "STANDARD OF CARE WITHIN"WHICH ARE YOU TALKING ABOUT???? JUST BLUFF AND CONCEAL OF THE TRUE.NOTHING ELSE THAN THAT.
2.-THE HOSPITAL ATTESTATION CLAIMS AS PRINCIPLE DIAGNOSIS. CORD ENTANGLE NEC-DELIV AND AS A FURTHER POINT:SEVERE PREECLAMPSIA.SO.ALLOW ME TO ASK "MR HOSPITAL",WHER IS THE AFORESAID DIAGNOSIS ON RODRIGUEZ STATEMENT AND MOREOVER,IF CORD ENTANGLE WAS THE PRINCIPLE DIAGNOSIS,SAID "CORD ENTANGLE" IS ONLY GERMANE TO THE HEALTH OF THE BABY,NOT THE MOTHER INDEED. BULLSHIT ! NOTHING ELSE THAN BULLSHIT..MR HUNTINGTON MEMORIAL HI TEC FACILITY !!!! WHERE MIRACLES OCCUR....NEVER THE MIRACLE OF THE TRUE INDEED.......
3.-LAST BUT NOT LEAST,SEE THE DEATH CERTIFICATE SIGNED BY THE IRRESPONSIBLE LIAR DR.GERONIMO RODRIGUEZ....WHEN DID HE KNEW THAT THE HELLP SYNDROME WAS THE CAUSE OF DEATH???? (HE SIGNED ON JULY 8TH,2002) ALMOST A WEEK AFTER THEIR DISCHARGE SUMMARY..........WHO TOLD HIM ABOUT A SYNDROME NEVER TREATED????
COMPARE THIS WITH THE HOSPITAL REPORT
Publicado por Veronica Solange Glaubach en 15:38 0 comentarios Enlaces a esta entrada
CARE DEFICIENCIES: THE CONCLUSIONS OF THE DEPARTMENT OF HEALTH SERVICES.COUNTY OF LOS ANGELES.HEALTH FACILITIES DIVISION.
FINAL REPORT OF THE INVESTIGATION DONE BY THE DHS
SUBJET OF INVESTIGATION: THE HUNTINGTON MEMORIAL HOSPITAL OF PASADENA,CA
THIS IS ONLY ONE OF THE DOCUMENTS ACCESSED BY US.OUR EXPERTS REPORTED GROSS FAILURES AND FURTHER OMISSIONS AND AMMENDEMENTS ON THE MEDICAL RECORDS,SAME MEDICAL RECORDS THAT NOTWITHSTANDING SAID OMISSIONS AND AMMENDMENTS,GAVE TO THE HEALTH FACILITIES DIVISION OF THE DEPT OF PUBLIC HEALTH SERVICES INVESTIGATORS ENOUGH MATERIAL TO ISSUE THE FOLLOWING REPORT
Publicado por Veronica Solange Glaubach en 15:18 0 comentarios Enlaces a esta entrada
miércoles 9 de diciembre de 2009
PREGNANCY PROBLEMS EXTRACTED FROM "WOMAN`S PASSIONS"
PUBLISHED BY:
WOMAN`S PASSIONS
*
Pregnancy problems. Complications
12Nov2009 Filed under: Pregnancy Author: admin
Most common complications during pregnancy: early and late gestosis, threatening interruption of pregnancy, pregnancy with extragenital pathology.
Gestosis
Gestosis of pregnant women include a number of pathological conditions that occur during pregnancy, complicating its course. There are early gestosis, usually occurring in the first trimester of pregnancy, and late gestosis, developing in the second half of pregnancy.
Early gestosis includes: vomiting in pregnancy (mild form), excessive vomiting and ptializm (salivation). Etiological factor of gestosis, according to many authors, is the failure of mechanisms to adapt to emerged pregnancy. Congenital and acquired deficiency of neuroendocrine regulation of adaptive responses (hypoxia, infection, intoxication, malnutrition in the antenatal period, hereditary factors) contribute to gestosis development, as well as presence of extragenital pathology in a woman (on the part of cardiovascular system - hypertension, hypotension, cardiac defects, endocrine disease - diabetes mellitus, hyper-and hypothyroidism, urinary tract disease - pyelonephritis, glomerulonephritis).
Early gestosis (vomiting during pregnancy) include vomiting, which is repeated several times during the day, accompanied by nausea, a decrease in appetite, change in taste and olfactory sensations. In accordance with the severity of the disease they distinguish:
• light form;
• moderate (moderate);
• excessive vomiting (severe).
Mild form corresponds to a phase of functional changes in nervous system (phase neuroses), the form of medium gravity - intoxication phase (phase toxicity), a severe form corresponds to a phase of dystrophy.
Late gestational toxicosis often occurs in the third trimester of pregnancy and is characterized by multiple organ failure. Late gestosis is manifested by three main symptoms - edema, proteinuria, arterial hypertension, at least - more severe symptoms (convulsions, coma, etc.). In modern obstetrics late gestosis is denoted as OPG-gestosis (under the name of three major symptoms). There are many classifications of late gestosis, but in practical obstetrics they distinguish 4 main clinical forms:
• hydrocephalus of pregnant;
• nephropathy (mild, moderate, severe);
• pre-eclampsia;
• eclampsia.
We should also note pre-clinical stage of gestosis - pregestoz. All clinical forms of late gestosis are specific stages of a single pathological process.
Excess weight gain during pregnancy is one of early signs of pregnancy complications called gestosis, an evidence of initially hidden, and then, perhaps, obvious edema.
Hidden edema are detected with regular measurement of body weight (weighing a patient) and definition of diuresis. If weight gain exceeds 300-400 g per week and negative diuresis will be identified, these symptoms indicate underlying edema.
Explicit, visible swelling differ in the degree of distribution:
• I degree - swelling of feet and legs;
• II degree - edema of the lower extremities and the anterior abdominal wall;
• III degree - generalized edema up to anasarca.
Nephropathy of pregnancy is divided into three levels:
• mild (hypertension is not higher than 150/100 mm Hg. Art., swelling of feet not higher than shins, proteinuria less than 1 g / l, the fundus has uneven caliber of retinal vessels);
• moderate (blood pressure not higher than 175/115 mm Hg. Art., swelling extended to the lower extremities and abdominal wall, proteinuria of 1 g / l to 3 g / l, there is swelling of the retina);
• severe degree (blood pressure above 175/115 mm Hg. Art., Anasarca, proteinuria more than 3 g / l, the fundus has hemorrhage, marked degenerative changes).
Pre-eclampsia - a critical, but a reversible condition, which developed against the background of severe gestosis. In addition to the triad of symptoms of gestosis (OPG), a patient has a headache, nasal congestion, visual disturbances. These signs are regarded as cerebral circulation disorder.
Eclampsia - the most severe form of pregnancy problem called gestosis, which is characterized by seizures with loss of consciousness. The duration and number of seizures of eclampsia may be different. During a seizure there develop abnormalities of cerebral blood flow, bleeding in the brain and its membranes. Hemorrhages in internal organs are frequent. Hypoxia and metabolic disease are sharply increasing, there occurs acidosis. Renal function is rapidly deteriorating, oligouriya increases. Internal organs often have degenerative changes. Eclampsia is life-threatening for both mother and fetus.
The threat of termination and miscarriage
The most frequent complication of pregnancy is a threat of interruption and premature birth - one of the main perenataln cause of morbidity and mortality. The main reasons for threat of abortion and miscarriage are:
• infectious diseases of mother;
• complications related to pregnancy;
• traumatic injuries;
• iso serological incompatibility of blood between mother and fetus;
• developmental anomalies of female genitalia;
• neuroendocrine pathology;
• various non-communicable diseases of mother;
• chromosomal abnormalities.
There are genetic reasons for miscarriage. In presence of chromosomal aberrations of an embryo there develops the threat of interruption on early stages of pregnancy. Spontaneous miscarriage in this case can be regarded as a device, worked out in the process of evolution, resulting in the birth of children with deformities is quite rare.
Endocrine causes of miscarriage include hypovaria, hyperandrogenism of different genesis (adrenal, ovarian), thyroid dysfunction. The first place is occupied by mother’s infectious diseases. These are primarily latent infectious diseases such as chronic tonsillitis, urinary organs infections, listeriosis, toxoplasmosis, mycoplasma infection, chronic inflammatory diseases of genital organs and viral infections.
Under certain circumstances, there occurs an immunologic conflict in the mother-placenta-fetus, leading to the risk of abortion and spontaneous abortion.
Among malformations of the uterus as a cause of miscarriages most common are: bicornuate, saddle, unicorns uterus, intrauterine septum, doubling of the uterus, rudimentary uterus.
The reasons contributing to emergence of miscarriages also include genital infantilism, isthmic-cervical insufficiency, uterine myoma and extragenital diseases of mother.
Extragenital pathology
Course of pregnancy is also complicated by presence of mother’s extragenital pathology.
A group of increased risk of miscarriage primarily includes women with cardiovascular system diseases, hypertension, chronic kidney disease, diabetes, anemia.
Premature termination of pregnancy in these women is also contributed by significant changes in the body: hypoxia, metabolic disturbances and complications of pregnancy, which is accompanied by extragenital pathology (toxaemia in the second half of pregnancy, fetoplacental insufficiency).
© 2009 Womanspassions.com. All rights reserved. Web Design by Atmospheric
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Publicado por Veronica Solange Glaubach en 12:00 0 comentarios Enlaces a esta entrada
martes 8 de diciembre de 2009
Malpractice in California:the killing of Veronica: Some pictures of Veronica,Indiana,Jose and Veronica´s works
Malpractice in California:the killing of Veronica: Some pictures of Veronica,Indiana,Jose and Veronica´s works
Publicado por Veronica Solange Glaubach en 10:45 0 comentarios Enlaces a esta entrada
lunes 7 de diciembre de 2009
A CRAZY WAY FOR AN INDUSTRY TO OPERATE by CHARLES ORNSTEIN AND TRACY WEBER
ProPublica : Journalism in the Public Interest
ProPublica
Health & Science
A ‘Crazy’ Way for an Industry to Operate
by Charles Ornstein and Tracy Weber, ProPublica - December 5, 2009 9:06 am EST
When a hospital or temporary agency wants to hire a nurse, there's no easy way to check whether the person has run afoul of regulators elsewhere in the country.
A solution has sat in the hands of federal bureaucrats more than two decades -- but it's off limits to most employers. In 1987, Congress ordered federal health officials to create a database of state disciplinary actions against nurses and other health professionals.
The information was to be added to a database of similar information about doctors, which was opened up to hospitals and other eligible health employers in 1990.
But the move to add the nurses and others got caught in years of technological difficulties, uncertainty over what should be released and questions about who'd foot the bill.
Currently, only federal and state agencies and health plans, such as HMOs, are allowed access to the information about nurses. If hospitals could gain access, "then it would be very hard to hide any action taken against you anywhere in the country," said Katherine Eaves, chief nursing officer for Riverside County Regional Medical Center.
An official at the U.S. Health Resources and Services Administration said the information on nurses and other health professionals should be available next year.
There is one obstacle remaining, however: Under the law, temp agencies would be allowed to search a nurse's background only if they were designated as agents of particular hospitals or other authorized users. Hospitals might not be willing to designate multiple staffing firms as their agents.
"The way our industry works is really crazy," said Mark Stagen, chief executive officer of Emerald Health Services, a temp firm in Marina del Rey. "You've got people with lives in their hands, and there's no effective way to check if they've had serious problems."
See main story: Temp Firms a Magnet for Unfit Nurses [1]
Write to Charles Ornstein at Charles.Ornstein@propublica.org [2].
Want to know more? Follow ProPublica on Facebook [3] and Twitter [4], and get ProPublica headlines delivered by e-mail every day [5].
Tags: California, California Board of Registered Nursing, Nurses, Temp Agencies, Temporary Nurses
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* The Los Angeles Times and ProPublica have conducted a joint investigation into the failed oversight of California's health professionals. In July 2009, we reported that the Board of Registered Nursing took more than three years, on average, to investigate and discipline errant nurses. It failed to act against nurses whose misconduct already had been thoroughly documented and sanctioned by others. And the board gave probation to hundreds of nurses – ordering monitoring and work restrictions – then failed to crack down as many landed in trouble again and again. Read our complete coverage here.
Ask the reporters about the series: Email QandA@propublica.org
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* California Sanctioned Nurse Database - The Los Angeles Times and ProPublica compiled a database of nearly 2,400 California nurses who have been sanctioned since 2002. Search the records of nurses who have faced disciplinary proceedings and the circumstances of allegations against them.
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* Chart: California takes far longer to discipline registered nurses than many other large states, according to a review by the Los Angeles Times and ProPublica. Click graphic to see the full details.
* Interactive Chart: About the Board - The California Board of Registered Nursing oversees the education, licensure, practice standards and discipline of the state's 350,000 nurses.
Profiles
* Spencer Sullivan
* Spencer Sullivan - In the prime of his life, Spencer Sullivan was rendered a quadriplegic. It took the nursing board more than six years later to revoke the license of a nurse involved in his care. Read more | LA Times Audio Slideshow
* Caitlin Greenwell
* Caitlin Greenwell - Caitlin Greenwell's family alleges that she suffers from cerberal palsy because nurses neglected to monitor her during her birth. LA Times Audio Slideshow
* Dr. Iraj Zandi
* Dr. Iraj Zandi – During a surgery, Dr. Iraj Zandi discovered that a nurse had stolen painkiller drugs intended for his patient. He found out later that the nurse had been accused of pilfering drugs from a previous employer. Read more...
* Veronica Glaubach
* Veronica Glaubach – Veronica Glaubach’s nurses missed crucial signs of a life-threatening complication during and after childbirth, her family alleged. She died. The nursing board absolved the nurses. Read more...
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Publicado por Veronica Solange Glaubach en 12:10 1 comentarios Enlaces a esta entrada
Etiquetas: HOW CAN WE BE CONFIDENT WITH SUCH A SYSTEM'?
sábado 5 de diciembre de 2009
WHO KILLED OUR DAUGHTER VERONICA?? DO YOU KNOW MR GOVERNOR ARNOLD??. ANSWER PLEASE !! About the Nursing Board of California-BY CHARLES ORNSTEIN
e-mail sent to my e-mail box by Charles Ornstein. December 5th,2009
I wanted to let you know that the third major installment of our nurses project will run this Sunday in the Los Angeles Times. It is now accessible online at http://www.propublica.org/feature/temporary-nurses-danger-inadequate-oversight-1206 or www.latimes.com/nurses. The package includes several components: a main story, sidebar, interactive graphics, and an update to our extensive online database. Additional stories will run later this month.
I sincerely want to thank you for your help in recent months as we put together this project. We are eager for your comments and feedback.
Top picture:Indiana Agote Glaubach,our granddaughter
Bottom pictures Veronica while she was pregnant few months before being killed by brutish ignorant Doc´s and Nurses at the Huntington Memorial Hospital,Pasadena,a supposed hi-tec facility...?¿?¿?
Temp Firms a Magnet for Unfit Nurses
by Tracy Weber and Charles Ornstein, ProPublica - December 5, 2009 7:52 am EST
A chronic shortage of nurses has created a free-wheeling environment for temp agencies, allowing some to skimp on background checks and hiring standards.
A chronic shortage of nurses has created a free-wheeling environment for temp agencies, allowing some to skimp on background checks and hiring standards.
This story was co-published with the Los Angeles Times [1] on Dec. 6, 2009.
Firms that supply temporary nurses to the nation's hospitals are taking perilous shortcuts in their screening and supervision, sometimes putting seriously ill patients in the hands of incompetent or impaired caregivers.
Emboldened by a chronic nursing shortage and scant regulation, the firms vie for their share of a free-wheeling, $4-billion industry. Some have become havens for nurses who hopscotch from place to place to avoid the consequences of their misconduct. (see related story: A ‘Crazy’ Way for an Industry to Operate [2])
A joint investigation with the Los Angeles Times found dozens of instances in which staffing agencies skimped on background checks or ignored warnings from hospitals about sub-par nurses on their payrolls. Some hired nurses sight unseen, without even conducting an interview.
As a result, fill-in nurses with documented histories of poor care have fallen asleep on the job, failed to perform critical tests or stolen drugs intended to ease patients' pain or anxiety.
"A lot of them are really bad nurses," said Sandra Thompson, a nursing supervisor at Northridge Hospital Medical Center and Sherman Oaks Hospital, both in the San Fernando Valley. "Sometimes I see them here [at Northridge] and think, 'I wonder how long before I see them over' " at Sherman Oaks?
Interactive Graphic: Registered nurse Andrew Fernando Reed was accused of stealing drugs while working for a series of staffing agencies in California and Minnesota. But that didn't stop him from getting new jobs. Click to see interactive graphic.
Interactive Graphic: Registered nurse Andrew Fernando Reed was accused of stealing drugs while working for a series of staffing agencies in California and Minnesota. But that didn't stop him from getting new jobs. Click to see interactive graphic.
[3]Some agencies are diligent about checking nurses' records, said Joey Ridenour, executive director of the Arizona State Board of Nursing.
Others are not. As a result, if wayward nurses want to work, "I think it's easier to hide in the registries," Ridenour said. "Some just sign them up."
Among reporters' findings, based on disciplinary records, personnel files, court documents and interviews:
• Firms hired nurses who had criminal records or left states where their licenses had been restricted or revoked. At least three firms employed a nurse in California [4] whose license had been suspended in Minnesota for stealing drugs at a string of temp jobs. One used him after he'd been convicted of doing the same thing at a Santa Rosa nursing home.
• Temp agencies shuffled errant nurses from one hospital to another, even as complaints mounted. A Culver City agency continued sending one nurse to hospitals [5] despite more than a dozen warnings that she was ignoring her patients and sleeping on the job. Before she was hired, the nurse had been convicted of 12 crimes, including prostitution, carrying a concealed weapon and possessing cocaine.
• Nurses who got in trouble at one agency had no problem landing a job at another. An Oklahoma nurse cycled through [6] at least four Southern California agencies in a year, accused of pilfering drugs while at each. Before her final stop, she was arrested in her home state for calling in prescriptions while posing as a doctor's office employee.
Failings in the temp industry are magnified in states like California, where nurses are in particularly short supply. Almost every facility, from rural medical outposts to prestigious hospitals, must rely on temporary help.
Nearly 6% of registered nurses licensed in California – or about 19,300 people – are temps, based on a 2008 survey commissioned by the state. About half of these nurses live in other states.
Here, oversight of nurses in general has been weak. A Times/ProPublica investigation in July [7] found years-long delays in disciplining nurses accused of serious misconduct. Regulators say they are working to fix the problems. Still, California's registered nursing board is among a minority that does not require hospitals, agencies or anyone else to report even serious lapses by nurses, including temps.
When staff nurses err, hospitals typically retrain or monitor them afterward. Temp nurses often are just exchanged for replacements, never receiving further guidance.
Industry executives and healthcare administrators say the firms are invaluable to hospitals and nursing homes, filling in for nurses who are sick or on strike and helping in swamped emergency rooms.
Nurses find the jobs attractive because they can see the country and control their schedules – all while collecting premium wages, bonuses and sometimes travel and living expenses. Some work locally while others are employed by "travel" firms that send them all over the country. (They must have licenses in states where they work.)
"There are very good people who work registries who do not want to be tied to anything regular," said Katherine Eaves, chief nursing officer at Riverside County Regional Medical Center. "There's another group of people who are working registries because, guess what? They can't work anywhere else."
Many agencies leave it to applicants to reveal previous problems. Using multi-page checklists, they are asked to rate themselves on how well they manage critical care patients, use complex equipment and administer drugs.
Some nurses admit lying on applications or withholding information from their employers.
Raphael Obiora [8] was hired by an agency despite allegations of drug thefts that were fully detailed on the California nursing board's website. Once on staff, he admits, he did not tell the agency when the board placed him on probation.
He said it was up to his agency to verify his credentials.
"I don't have to tell you nothing," he said. "You have to check."
A trail of complaints
In trouble in her home state of North Carolina, nurse Beverley Cathey saw an opportunity out West.
The day after Cathey applied at EZ Staffing in Glendale, she was on the job.
She said on her application in July 2007 that she was qualified to work in critical care units, tending to a hospital's sickest patients.
It didn't take long before hospitals disagreed.
Cathey "sat at the nurse's station most of the time not doing anything," a supervisor at Northridge Hospital Medical Center complained in August 2007, according to EZ Staffing records reviewed by reporters. "Not up to our standards for ER," wrote a nurse from Huntington Memorial Hospital in Pasadena the following week.
The then-57-year-old nurse gave inaccurate patient information to colleagues and failed to perform an electrocardiogram as ordered for a patient with an abnormally fast heart rate, the records show.
In August and September 2007 alone, four hospitals filed six complaints against her, according to the firm's records, including three by Huntington.
The next month EZ Staffing contacted North Carolina's Board of Nursing to check on her license: Cathey, it turned out, was on probation [9]. One condition was that she not work at a staffing agency.
While a temp nurse at a North Carolina hospital, she'd failed to account for drugs she'd signed out, falsified records and provided negligent care, according to the North Carolina board's allegations. These records had been posted on the board's public website since December 2006.
Asked for comment, Cathey said in an e-mail that the accusations against her were "not valid or creditable."
Abraham Abirafeh, who started EZ Staffing in 1991, did not respond to questions about the case and accused a reporter in e-mails of trying to harm EZ's reputation.
In November 2007, the North Carolina board indefinitely suspended Cathey's license [10]. Twenty-one months later, California regulators initiated formal proceedings [11] against her license.
While her case winds its way through the disciplinary process, Cathey remains free to accept temp jobs in California.
Easy profits touted
Dee Patrick, a veteran nurse, built a temp business in the mid-1980s. (Liz O. Baylen / Los Angeles Times)
Dee Patrick, a veteran nurse, built a temp business in the mid-1980s. (Liz O. Baylen / Los Angeles Times)
Dee Patrick recalls sitting in a box at the Kentucky Derby some years ago exchanging pleasantries with a couple next to her. She told them about her Phoenix temp business – how, as a veteran nurse, she'd built it from scratch in the mid-1980s when virtually no one was doing it.
Six months later, Patrick said, she was shocked when the woman called to say, "Hey, we opened up one of those businesses."
"They have no background in nursing," said Patrick. "They don't have to know anything."
Although the healthcare system as a whole is increasingly regulated, the nurse staffing industry remains a Wild West. No one knows how many agencies exist nationwide; estimates range from 3,000 to 6,000.
Dozens of Internet sites tout the easy profits and hawk how-to guides for as low as $69.95.
"Be One among the Millionaires, Start Your Own Nursing Agency," trumpets one site. "You will be up and running in a week," promises another. "You don't have to be a nurse to start your own Nurse Agency," assures a third.
Agencies range from those run on dining room tables to publicly traded companies. They open and close, merge, swap staffs and change locations. Standards for screening vary widely.
Recruiters sometimes poach on one another's rosters. One Los Angeles agency alleged in court papers last year that a rival firm's employee had joined its staff, stolen its list of employees and salaries, and then returned to her old firm.
Many agencies allow applicants to take competency tests online. Testifying in a malpractice lawsuit earlier this year, an official at Fastaff, a large traveling-nurse firm based in Colorado, said applicants have been hired without even a phone interview. References weren't contacted "unless it was out of the ordinary," she said.
Some healthcare institutions say they interview and check the credentials of every temp nurse. Others say they don't, particularly in a crunch. "Clearly we have no time – we have to count on them," said Fred Benson, administrator of Santa Rosa Convalescent Hospital in Northern California.
It hasn't always worked out. He recalled that two temp nurses at his facility took the keys to a drug cabinet.
Mark Stagen, president of the National Assn. of Travel Healthcare Organizations, acknowledges the need for improvement in his industry. (Liz O. Baylen / Los Angeles Times)
Mark Stagen, president of the National Assn. of Travel Healthcare Organizations, acknowledges the need for improvement in his industry. (Liz O. Baylen / Los Angeles Times)
Unlike hospitals and nursing homes, which are inspected regularly, temp firms aren't accountable to anyone but their clients. Mark Stagen, president of the National Assn. of Travel Healthcare Organizations, acknowledged the need for improvement.
Companies' standards can be "loose or nonexistent," allowing poor-performing nurses to easily "game the system," said Stagen, head of a Marina del Rey travel firm.
Reporters asked 12 public entities that run hospitals in California whether they had audited firms that supplied them with nurses. Only five had done so in the last three years.
Last year Los Angeles County health staffers went through the files of 29 agencies seeking to provide nurses to its public hospitals. Most of the firms lacked key documents, including evidence of tuberculosis screenings or proof that nurses had current licenses. One agency had 90 missing or invalid records, another 63.
The lapses were "surprising," said Vivian C. Branchick, director of nursing affairs for the county Department of Health Services. "They know – and they've known it all along" – what the standard is.
All of these firms were allowed to correct their shortcomings and won county business.
In late 2006, the county audited Reliable Health Care Services [12] in Culver City, which had received $8.9 million for temp services during the previous fiscal year.
The audit found that Reliable had "forged" results of tuberculosis skin tests, physical exams and CPR training cards, which "jeopardized the safety of county patients." Reliable also made "false and misleading statements," the audit said, citing a general "lack of trustworthiness and integrity."
After the county terminated the Reliable contract, the firm filed a claim alleging libel [13], breach of contract and fraud. As part of a settlement [14], the county agreed not to formally bar the agency from county work, and Reliable agreed not to seek any for 10 years.
A lawyer for the firm called the county's allegations baseless.
Seal of approval
Some in the industry say staffing firms already have an able watchdog.
Since 2004, the Joint Commission, better known for accrediting hospitals, has been reviewing healthcare staffing firms. The national organization bestows its seal of approval on those that meet standards for screening applicants, following up on complaints and ensuring competency.
This seal is displayed prominently on firms' websites. Some hospitals will use only agencies that have it.
But the program is voluntary and used by a minority of temp agencies – 337 firms – in part because they must pay the commission thousands of dollars to be reviewed. Most of the largest firms are certified.
The commission doesn't release detailed findings on the firms, even to hospitals. It has withdrawn its seal of approval from temporary staffing agencies seven times this year – all but once for nonpayment of fees.
At the same time, firms that display the seal have been cited in audits, nursing board records and court files for bad judgment or behavior.
Joseph Baiden, owner of JFB Staffing, Inc., was arrested on suspicion of fraud. But his firm is still listed with a gold seal of approval on the Joint Commission's website.
Joseph Baiden, owner of JFB Staffing, Inc., was arrested on suspicion of fraud. But his firm is still listed with a gold seal of approval on the Joint Commission's website.
Joseph Baiden, owner of JFB Staffing in Diamond Bar, was arrested in August [15] on charges of defrauding the state workers' compensation fund of $1.4 million by misrepresenting the number of nurses on his payroll.
Some hospitals cut ties with JFB, and authorities froze Baiden's bank accounts and seized his property.
Although Baiden has pleaded not guilty, his attorney Tracy Green said that she is working toward a resolution with the district attorney's office and that Baiden plans to repay whatever he owes.
In the meantime, on the Joint Commission's website, there is a gold seal of approval [16] by the JFB name.
Problems no barrier
Paystaff Pacific not only hired nurse Raphael Obiora in 2007 despite his troubled past, it also kept sending him out when it learned he wasn't a skilled nurse, documents show.
In a little more than a year, seven hospitals rejected Obiora, telling Paystaff he'd made a medication error, failed to follow a doctor's order [17] and been "inappropriate" with a patient's relative.
Hospital managers use such rejection notices, known as "Do Not Sends," to alert agencies to the shortcomings of temp nurses. But the agencies are under no obligation to act on the information.
In April 2008, the Monterey Park firm dispatched Obiora to Garfield Medical Center. There, he failed to adequately monitor [18] the vital signs of two critically ill patients. His conduct was "unsafe," wrote Simon Marcus, the hospital's critical care director, on a form he sent to Paystaff.
Unknown to the hospital, Paystaff had already evaluated Obiora and found his competence to be below average. Shortly before he was sent to Garfield, the firm had determined that he should be fired immediately, according to agency records that became part of a regulatory proceeding.
Only after Marcus raised an alarm did Paystaff fire Obiora.
Hugh Wu, a Paystaff official, said in an e-mail that the company acted responsibly. Other complaints about Obiora were not as serious as Garfield's, he said, and Obiora had hidden state nursing board discipline against his license.
Obiora, an evangelist who preaches at a Celestial Church of Christ in Gardena, ultimately lost his California license.
Marcus said his experience with Obiora "makes you wonder" about temp nurses. "Have they made errors elsewhere? Who is monitoring them?"
Some temp firms indicated that they don't use a nurse again if they feel at all uneasy. "We just don't want to take the risk," said Jim Essey, who runs a New York-based temp agency and is a former chairman of the American Staffing Assn., an industry trade group.
Other agencies say most rejections stem from picayune problems, such as tardiness and personality clashes.
But data provided by public hospitals show this isn't necessarily so.
According to Riverside County Regional Medical Center, for example, more than 60% of the 339 temp nurses rejected since 2003 failed to demonstrate basic nursing skills on the job. Arrowhead Regional Medical Center, San Bernardino County's public hospital, reported that it had rejected 61 temp nurses since 2005 – more than half for performance problems.
Hospitals sometimes lose track of which nurses they have already booted. A nurse can be red-flagged by one unit and later sent to another.
At Lakewood Regional Medical Center in March 2008, temp nurse Kelvin Brown [19] was found in a deep sleep at the nurses' station on a ward of patients hooked up to monitors.
An excerpt from a complaint by the California Board of Registered Nursing against nurse Kelvin Brown, who is accused of falling asleep repeatedly on the job.
An excerpt from a complaint by the California Board of Registered Nursing against nurse Kelvin Brown, who is accused of falling asleep repeatedly on the job.
He was roused but later fell asleep in a patient's room. Awakened again, he dozed off in the break room. Asked to leave the hospital, he made it as far as the intensive care waiting room before slipping into sleep once more. He left after security called police, according to the nursing board's December 2008 accusation against him [20].
A supervisor later discovered that Brown had had problems at the hospital before. He had fallen "heavily asleep on every shift and exhibited behavior – such as talking to and answering himself aloud – that made staff uncomfortable," the accusation said.
In fact, Brown had been placed on the hospital's "Do Not Return" list while working for another agency for such reasons, the document states.
A spokesman for Tenet Healthcare Corp., Lakewood's parent, confirmed that Brown had worked at the hospital before but disputed the state's account that he'd been previously barred from working there.
Brown could not be located for comment.
In another case, St. Jude Medical Center in Fullerton informed MedStaff Healthcare Solutions in March 2007 that it suspected nurse Donald Paradise [21] of stealing drugs and asked that he never return, a hospital spokesman said. Six months later, Paradise was accused of stealing drugs at a sister hospital, where he also had been sent by MedStaff.
Click to see our complete coverage of California's failed oversight of its health professionals.
Click to see our complete coverage of California's failed oversight of its health professionals.
[22]"It's absolutely not acceptable," said Kevin Andrus, a spokesman for St. Joseph Health System, which includes St. Jude.
MedStaff's contract, he said, prohibited it from sending a rejected nurse back to any hospital in the chain, but Andrus conceded that the chain doesn't keep a master list, as some entities do.
A spokesman for MedStaff said that Paradise had passed a drug screening after the St. Jude incident and that the hospital had indicated it was satisfied with that. Andrus says that was not so.
Paradise, who faces a nursing board accusation, could not be reached for comment.
In interviews, several temp nurses who had been in trouble said their employers focused more on keeping slots filled than on who filled them.
That was a lifeline for Obiora.
The agencies "just send and send and send and send," he said.
See related story: A ‘Crazy’ Way for an Industry to Operate [2]
Lisa Schwartz, director of research at ProPublica, and researcher Kitty Bennett contributed to this report.
Write to Charles Ornstein at Charles.Ornstein@propublica.org [23]
Write to Tracy Weber at Tracy.Weber@propublica.org [24].
Want to know more? Follow ProPublica on Facebook [25] and Twitter [26], and get ProPublica headlines delivered by e-mail every day [27].
Tags: California, California Board of Registered Nursing, Health Care, Nurses, Temp Agencies, Temporary Nurses
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This story can be found on the web at the following address:
http://www.propublica.org/feature/temporary-nurses-danger-inadequate-oversight-1206/
Links
* 1. http://www.latimes.com/news/local/la-me-nurses6-2009dec06,0,2880251,full.story
* 2. http://www.propublica.org/feature/a-crazy-way-for-an-industry-to-operate-temp-nurses
* 3. http://www.latimes.com/news/specials/la-me-nurses-6dec62009-f,0,2783623.flash
* 4. http://rn.ca.gov/public/rn609399.pdf
* 5. http://rn.ca.gov/public/rn374283.pdf
* 6. http://rn.ca.gov/public/rn646200.pdf
* 7. http://www.propublica.org/feature/when-caregivers-harm-california-problem-nurses-stay-on-job-710
* 8. http://rn.ca.gov/public/rn509286.pdf
* 9. https://www.ncbon.com/LicenseVerification/Common/Ajax/DocumentViewer.aspx?PTH=http%3A//dmrsys.corp.ncbon.com/DataTier/Documents/Repository/0/0/3/0/0e325297-d147-4c5c-bb4a-861b42c02686.pdf&CB=145
* 10. https://www.ncbon.com/LicenseVerification/Common/Ajax/DocumentViewer.aspx?PTH=http%3A//dmrsys.corp.ncbon.com/DataTier/Documents/Repository/0/0/5/5/194c9671-a7d1-4477-b06a-1289417e215f.pdf&CB=53
* 11. http://rn.ca.gov/public/rn677505.pdf
* 12. http://s3.amazonaws.com/propublica/assets/nurses/reliableaudit.pdf
* 13. http://s3.amazonaws.com/propublica/assets/nurses/reliableclaim.pdf
* 14. http://s3.amazonaws.com/propublica/assets/nurses/reliablesettle.pdf
* 15. http://www.insurance.ca.gov/0400-news/0100-press-releases/0080-2009/release126-09.cfm
* 16. http://www.qualitycheck.org/consumer/searchresults.aspx?nm=jfb+staffing&ddstatelist=&st_nm=-1&st=
* 17. http://s3.amazonaws.com/propublica/assets/nurses/obioradonotsend.pdf
* 18. http://s3.amazonaws.com/propublica/assets/nurses/obioragarfield.pdf
* 19. http://www2.dca.ca.gov/pls/wllpub/WLLQRYNA$LCEV2.QueryView?P_LICENSE_NUMBER=590541&P_LTE_ID=828
* 20. http://rn.ca.gov/public/rn590541.pdf
* 21. http://rn.ca.gov/public/rn697019.pdf
* 22. http://www.propublica.org/series/nurses
* 23. mailto:Charles.Ornstein@propublica.org
* 24. mailto:Tracy.Weber@propublica.org
* 25. http://www.facebook.com/propublica
* 26. http://www.twitter.com/propublica
* 27. http://www.propublica.org/special/propublica-daily-email
Our Complete Coverage
*
* The Los Angeles Times and ProPublica have conducted a joint investigation into the failed oversight of California's health professionals. In July 2009, we reported that the Board of Registered Nursing took more than three years, on average, to investigate and discipline errant nurses. It failed to act against nurses whose misconduct already had been thoroughly documented and sanctioned by others. And the board gave probation to hundreds of nurses – ordering monitoring and work restrictions – then failed to crack down as many landed in trouble again and again. Read our complete coverage here.
Ask the reporters about the series: Email QandA@propublica.org
Database
*
* California Sanctioned Nurse Database - The Los Angeles Times and ProPublica compiled a database of nearly 2,400 California nurses who have been sanctioned since 2002. Search the records of nurses who have faced disciplinary proceedings and the circumstances of allegations against them.
Multimedia
* Vignette
* Interactive Graphic: From 1995 to 2002, at least five employers complained to the California Board of Registered Nursing about Carolyn Fay Thomas. The board did not revoke her license until August 2005. Follow Thomas' case (Los Angeles Times)
* Chart: Complaint to Discipline
* Chart: California takes far longer to discipline registered nurses than many other large states, according to a review by the Los Angeles Times and ProPublica. Click graphic to see the full details.
* Interactive Chart: About the Board - The California Board of Registered Nursing oversees the education, licensure, practice standards and discipline of the state's 350,000 nurses.
Profiles
* Spencer Sullivan
* Spencer Sullivan - In the prime of his life, Spencer Sullivan was rendered a quadriplegic. It took the nursing board more than six years later to revoke the license of a nurse involved in his care. Read more | LA Times Audio Slideshow
* Caitlin Greenwell
* Caitlin Greenwell - Caitlin Greenwell's family alleges that she suffers from cerberal palsy because nurses neglected to monitor her during her birth. LA Times Audio Slideshow
* Dr. Iraj Zandi
* Dr. Iraj Zandi – During a surgery, Dr. Iraj Zandi discovered that a nurse had stolen painkiller drugs intended for his patient. He found out later that the nurse had been accused of pilfering drugs from a previous employer. Read more...
* Veronica Glaubach
* Veronica Glaubach – Veronica Glaubach’s nurses missed crucial signs of a life-threatening complication during and after childbirth, her family alleged. She died. The nursing board absolved the nurses. Read more...
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Publicado por Veronica Solange Glaubach en 16:42 0 comentarios Enlaces a esta entrada
Etiquetas: Indiana Agote Glaubach her daughter and our family we need JUSTICE AND DISCIPLINARIAN ACTION AGAINST NURSES AND DOCS.ARE YOU GOING TO RESPOND OUR CLAIM??, Mr Governor. VERO
TEMP FIRMS A MAGNET FOR UNFIT NURSES. A LOS ANGELES TIMES PROPUBLICA INVESTIGATION BY CHARLES ORNSTEIN AND TRACY WEBER
EMAIL SENT TO ME BY THE PULITZER´S PRIZE WINNER INVESTIGATIVE REPORTER MR CHARLES ORNSTEIN.LOS ANGELES TIMES & PROPUBLICA
Temp Firms a Magnet for Unfit Nurses: A Los Angeles Times-ProPublica investigation
...
Sat, December 5, 2009 12:09:14 PM
From:
Charles Ornstein
...
View Contact
To: Charles Ornstein
I wanted to let you know that the third major installment of our nurses project will run this Sunday in the Los Angeles Times. It is now accessible online at http://www.propublica.org/feature/temporary-nurses-danger-inadequate-oversight-1206 or www.latimes.com/nurses. The package includes several components: a main story, sidebar, interactive graphics, and an update to our extensive online database. Additional stories will run later this month.
I sincerely want to thank you for your help in recent months as we put together this project. We are eager for your comments and feedback.
Charlie Ornstein
---
Charles Ornstein
Senior Reporter, ProPublica
One Exchange Plaza, 55 Broadway, 23rd Floor New York, NY 10006
E-mail: charles.ornstein@propublica.org
Office: (917) 512-0222
Fax: (212) 785-2634
Cell: (818) 679-9363
Publicado por Veronica Solange Glaubach en 16:31 0 comentarios Enlaces a esta entrada
Etiquetas: ANOTHER INVESTIGATIVE GOAL
Sunday, June 11, 2006 at 10:04PM 
Reader Comments (2)
bach. Mr Bell wrote in said letter: "Legal charges (what are called administrative accusations) are filed against doctors in California,only when evidence exists to prove that the doctors engaged in egregious misconduct(typical acts of gross negligence,incompetence or repeated negligent acts)Equally important is the fact that such charges must,by law,be proven by an exceptionally high standard of proof(clear and convincing evidence to a reasonable certainty."
...."Our legislature has delegated to the Medical Board the punishment not of ordinary acts of negligence,but only the most severe forms of misconduct"...."I have spoken with both the assigned investigator (Senior Investigator Allan Irish) and his supervisor (Area supervising Investigator Laura Sweet).We discussed the initial investigation,the conclusions of the medical experts retained by the Board to examine this case,as well as the documents and issues presented in your correspondence".Well,MrBell, allow me to say that I personnaly submitted medical records ,a final and conclusive report from the Public Health Service investigators (more than 10 sheets) and more than six clear,coincident and conclusive reports all blaming Dr Geronimo Rodriguez Md OBGYM from Pasadena,Joseph Li Md OBGYM from Pasadena and nurses of the Huntington Memorial,as direct responsibles of the death of my poor child. Causes ?: Gross Incompetence,Gross Negligence and a transparent,undeniable demonstration of the most absolute Medical Ignorance.Said reports have been given and signed by six renowned and respected experts in USA and in Argentina.There`s no doubt,not a single doubt about this case of malpractice. The medical records,even with evidence of some willful "cosmetical touchs",with false illegible entries,with misleading statements and incongruences (in several reports signed by involved doctors and nurses),with spoil of evidence,doesn`t resist the minnimum analysis.Notwithstanding the serious and complete information I`ve delivered to the Board investigator Mr Irish and to Mr Mc Kim Bell,asking for a clear investigation,he responded that..." It is our conclusion that the steps taken by the staff of the medical board were comprehensive and their initial determination not to prosecute was an appropriate one.Three medical experts (sic)..reviewed this case...(.allow me to say Mr Bell that Mr Irish confessed me that only one expert reviewed the case) Nevertheless I defy you to put white over black and release said three supposed experts reports-if they really exist,to challenge our reports and speciallySir, I defy you to explain us by this same mean or whatever ,OF WHAT KIND OF "PARTICULAR TREATMENTS ADMINISTERED BY DRS LI AND RODRIGUEZ" (mentioned in your self indulgent letter ) are you talking about ?? All our experts are coincident in one point: Nor Rodriguez neither Li recognized any single symptom or any outcome of the mild preclampsia in progress to eclampsia and finnaly HELLP suffered by my poor daughter. ABSOLUTE IGNORANCE !! Dangerous Individuals with license to kill with no punishment !!
When a ICU doctor,called after a Blue Code realized what was going on,it was very late,she was out of any possibility,out of
hope,agonizing,decerebrated. They did not performed any kind of treatement.Just take a look on the final report of Dr Rodriguez
He never mentioned anything pertaining to a diagnosis,no one single word
about preclampsia eclampsia or hellp,and that`s understandable,because mentioning said diagnosis he would be constrained, to explain what kind of management or treatment administered to my child. End of story about the bad faith of Mr Rodriguez If you Mr Bell agree with the co-opted and colluded staff of the Medical Board and its "self indulgent and faked" report done to protect wrongdoers (a real brotherhood of physicians) you have to explain as well of what kind of timely treatment ,management or whatever accurate diagnosis and prescription are you (or the board`s experts) talking about, because no one timely diagnosis,nor a timely management (as a consequence of said lack of diagnosis) emerge or come forth from the medical records. Notwithstanding said evidence, try Mr Bell ! You talk about Single Departure ? Allow me to ask Mr Bell,and..with the due respect of course, do you know if there is any limit to define what the hell (excuse me) is a single departure ? Of course not Mr Bell,because said definition of the Medical Practice Act is nothing else than a corrupted arranged bargain clause impossed to legislators by the medical syndicate with "of course " the blessing of the insurance cartel.You shoul go to 1975 when MICRA was enacted and the Board created and follow satistics and the blurred and uselessness story of this "wellknown" Board. Just in case ...Don`t you know ? Said definiton is nothing else than a big black hole through which the complaints submitted to the board can be expeditiously dismissed,as it mostly happens.Any board`s reviewer report concerning a malpractice case ,even if it involves the death of the patient( as in my daughter`s case ) can be constructed ("drawn" ) in appearance as scientifically correct but using some points "out of context" or even ignoring or avoiding central points .That`s exactly what the board`s staff made in this case and what you Mr Bell endorse indeed.! I wonder myself what would be your position Mr Bell if this case were your daughter`s case ? Would you accept so quick the fake report of the board`s investigator ??? The nature of the human being is so intricate !! You never ever can imagine that a disgrace like this can happen to you....On August, 2006 during my last visit to LA I`ve tried to contact you Mr Bell,asked for an appointment.You denied the possibility (by fax) with a kiddy explanation how was: that the DAG`s office was not prepeared to attend drop in visitors, I`m sure that you are not a bad mannered person,I`m sure you are not such a kind of person who believes that is over the rest of mortals, don`t you ? I went personnaly to your office at Ronald Reagan Building in two opportunities.waiting for hours.with the hope to get directly from you, (you signed the mentioned letter), a clear explanation about from which kind of standardized medical treatement,-not given of course -,those "animals not-doctors" departed to commit just a Single Departure. It is clear Mr Bell that you are and will be unable to give even a single explanation
because the real fact is that no one timely or single accurate treatment has been performed on this case,not even a "by far standard and allways indicated "blood transfussion. Veronica died with "no one platelet" many hours after that horrendous Lab tests were showing ,with "big red lights" a terrible decrease of the quantity of platelets. This is just to give one among a collection of examples about the colossal ignorance showed by said "doctors" . And those are the individuals protected by the "so particular" point of view of the board`s reviewer and with the ok of the DAG,(you Mr Bell), who has the duty of control acccording with the last legislative reports on the board`s investigation (after OCRegister 2002 series Doctors without discipline) and the monitor program (vertical prosecution).In short Mr Bell.on behalf of my grandaughter who lives in LA and on behalf of my poor daughter,I demand Justice,Justice and nothing else than Justice .You as attorney general
YOU have the power to clarify this case.
I`m sure that you know that the malpractice in California is an epidemy due to the irresponsibility of the Board`s authorities co-opted by physicians org.and a poor control over the Board. In the meanwhile,patients are dying and will die on the hands of unskilled professionals.
Roberto Glaubach,architect
robertoglaubach@yahoo.com
Posadas 1265 (1011) Buenos Aires
Argentina