Hand-bell system leads to patient death at New Mexico hospital

A system that required patients to use hand bells to call for help led to the death of a patient at Gallup, N.M.-based Rehoboth McKinley Christian Hospital in January, Source New Mexico reported Aug. 30. 

The news outlet reviewed a July CMS inspection report that found the patient died after using a hand bell to call for help rather than a modern call-light system. The hospital switched to the hand-bell system in March 2021. Patients were previously able to call for help by pressing a button on their hospital beds. 

CMS' inspection report said the malfunctions meant "staff could not efficiently call a code" on a patient whose condition rapidly deteriorated, and the hand-bell issue resulted in three "adverse events" in January, Source NM reports. Patients survived after being transferred to the intensive care unit in two instances, and in the third instance, the patient died after family requested staff cease life support. The inspection also found staff did not report the three adverse events to the hospital's quality and risk committee. An employee who listed the events as "no harm" done by a staff member has since been fired, according to the CMS report. 

Source NM said a spokesperson for the hospital had not responded to a request for comment Aug. 30. 

The hospital has faced a number of challenges in recent months. In March, employees held a town hall meeting, reporting that working conditions and staffing issues had worsened since Community Hospital Corp. took over management. In addition, the hospital's labor and delivery unit has been closed since Aug. 3, and it is not clear when it will reopen. Hospital officials attributed the unit closure to a shortage of nurses and physicians. 

Editor's note: Becker's has reached out to Rehoboth McKinley Christian Hospital and will update this report as more information becomes available. 


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