Patient's fatal overdose sparks investigation at Oakland Medical Center

The California Department of Public Health is investigating Kaiser Permanente's Oakland (Calif.) Medical Center after a patient, Teresa Panepinto, died of a medical overdose in March 2017, according to NBC Bay Area.

Hospital records show Ms. Panepinto received five doses of morphine-based drugs, along with two different sedatives and Ambien, over a 10-hour period. The fifth and final dose of the morphine-based painkiller was administered around 2 a.m. on March 30. Around 7:00 a.m. hospital staff found Ms. Panepinto unresponsive.

Ms. Panepinto was admitted to the hospital for pelvic pain, but also suffered from ongoing pain in her arms and legs. Despite this constant pain, she made an effort to avoid prescription painkillers.

The Alameda County Medical Examiner determined Ms. Panepinto died from a brain injury caused by a lethal mix of drugs. The medical examiner's office found an abdominal mass that likely contributed to Ms. Panepinto's pelvic pain, but did not contribute to her death, according to a coroner's report cited by NBC Bay Area.

NBC Bay Area's investigation found Kaiser did not alert state public health officials about Ms. Panepinto's death, which violates state reporting requirements, prompting the health department's investigation.

Ms. Panepinto's family told NBC Bay Area that their daughter had no monitoringy mechanisms on her in the hospital and no nursing presence in her room, which there would have been if she had been in the ICU,” according to the report.

The family's attorney, Jim Keenley, suggests the medical records portray Ms. Panepinto as angry and hostile during her hospital stay.

"This death was caused by relying on the easiest available solution to deal with a frantic, suffering patient,” Mr. Keenley told NBC Bay Area. "Which is to give them easily administered medication that will calm them down and make them less of a problem on the emergency room floor."

Kaiser Permanente declined NBC Bay Area's request for an interview due to privacy laws, but shared a written statement with the publication.

"We extend our sympathy for the family on the loss of their loved one," wrote Jeff Collins, senior vice president and area manager for Kaiser Permanente East Bay. "As part of our rigorous quality program we follow up and investigate any unusual or unexpected occurrences in the course of care. We comply with all regulatory reporting requirements and evaluate cases using established standards to determine when it is appropriate to file a report."

More articles on clinical leadership and infection control: 

Viewpoint: How state review boards can help curb pregnancy-related deaths
Florida Hospital recognized for risk management, patient safety efforts
Arkansas VA hospital reviews 7K patients for misdiagnosis by impaired physician

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.


IC Database-3

Top 40 Articles from the Past 6 Months