ST. LOUIS • John Cochran VA Medical Center in St. Louis has again been cited for health and leadership problems after a nurse failed to monitor a patient who died following kidney dialysis.

The nurse did not recognize or report that a man, 58, became unresponsive at some point during a five-hour dialysis treatment in December 2010, according to a report released Monday by the Veterans Affairs Office of Inspector General.

When his condition was discovered by emergency responders, the man was admitted to the intensive care unit and died the next day. An autopsy showed inflammation and bleeding around the heart associated with kidney failure, according to the report.

In the last two years the veterans hospital has also been cited for violating sterilization rules in its dental clinic and operating rooms.

Federal health inspectors visited the hospital in May 2011 after receiving complaints about the dialysis clinic. The allegations involved the patient who died, another patient who may have received inadequate care, favoritism by the nurse manager and improper blood testing procedures.

The investigators concluded that the first patient did not receive adequate care because the man "was well known to the (dialysis) staff and the subject (nurse) presumably should have been able to identify a decline in the patient's mental status."

The investigators did not find evidence of other patients who were treated improperly. They also discounted the allegations of favoritism in the department and improper blood testing.

They did find fault with management, citing "a lack of effective nursing leadership" with "no policy for reporting events to the charge nurse or a physician."

Federal health officials recommended that the hospital clearly define the responsibilities of its nurses and make sure the nurses are competent in those tasks.

The hospital hired additional registered nurses for the unit and has completed the recommendations, according to director RimaAnn Nelson.

It is at least the second time this year the federal agency has reported problems at Cochran. In April, the inspector general's office cited ongoing issues with the hospital's sterilization procedures, two years after problems in the dental clinic were first identified.

In 2010, the hospital notified more than 1,800 veterans that they might have been exposed to HIV, hepatitis or other viruses in the facility's dental clinic after tools were found to be visibly dirty even after going through the sterilization process. Four of the veterans later tested positive for hepatitis, although it was never determined if their exposure occurred at the dental clinic.

More sterilization problems were found in February 2011 when the hospital shut down its operating rooms after rust stains were discovered on surgical equipment.

The operating rooms were cleared to reopen after a month of testing, cleaning and replacing of faulty equipment.

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MINNEAPOLIS, Jun 13, 2012 (BUSINESS WIRE) -- DaVita Clinical Research(R) (DCR(R)), a provider of clinical research services focused on kidney research as well as a multitude of specialty therapeutic populations, presented several posters at the 17th Annual International Society for Pharmacoeconomics and Outcomes Research (ISPOR) International Meeting in Washington, D.C., June 2-6, 2012.

DCR's specialists within the HEOR industry presented seven posters on pertinent topics related to dialysis and health economics. Highlighted examples include:

-- Pseudo-Randomization in Retrospective Analysis Using the Generalized Multinomial Logit for Propensity Score Generation. Poster number PRM44

-- Odds of Missed Hemodialysis Sessions are Increased During Holiday Periods Among In-Center Hemodialysis Patients. Poster number PUK2

-- Erythropoiesis-Stimulating Agent (ESA) Dose Recovery Following Hospitalization of End Stage Renal Disease (ESRD) Patients. Poster number PUK29

-- A Managed Care Cost-Offset Model for Ferric Citrate, an Experimental Phosphate Binder that Can Reduce the Use of Erythropoiesis-Stimulating Agents (ESA) and Intravenous Iron in Hemodialysis Patients with Hyperphosphatemia. Poster number PUK15

"We're pleased to have presented on these important topics at the ISPOR International Meeting," stated DCR Vice President of Clinical Research Mahesh Krishnan. "At DCR, our goal is to continuously contribute to the science, whether it be our budget impact and cost-effectiveness modeling, psychometric development, commercial reimbursement or policy analytics."

Dr. Deborah Lubeck, one of the industry's most respected health economics experts and DCR's new director of health economics, was among the DCR experts attending the ISPOR International Meeting.

An author of more than 160 publications, Dr. Lubeck held previous positions at PAREXEL, ICON, Genentech, Amgen and Stanford University. She was co-principal investigator of a registry at the University of California, San Francisco, with more than 10,000 prostate cancer patients. Dr. Lubeck received her Ph.D. in economics at the University of California, Berkeley.

"We strive to acquire the best talent within the industry," commented Krishnan. "Dr. Lubeck is one of the leading health economics experts of our time, and we're proud to have her leading our HEOR team."

DaVita, DaVita Clinical Research and DCR are trademarks or registered trademarks of DaVita Inc. All other trademarks are the property of their respective owners.

About DaVita Clinical Research (DCR)

DaVita Clinical Research (DCR), a wholly owned subsidiary of DaVita Inc., is committed to advancing the knowledge and practice of kidney care. DCR brings knowledge, skill and expertise to pharmaceutical research, facilitating the success of its clients' clinical trials. DCR's clinical expertise spans the lifecycle of drug development. DCR's biorepository, Early Clinical Research unit (Phase I-IIa) and Clinical Development network of physicians and investigative sites, data research, Health Economics & Outcomes Research, Central Laboratory, Advisory Committee prep, and Medical Communications are focused on providing world-class clinical research in both complex/specialty populations and therapeutic areas, and especially in CKD and ESRD populations. To learn more about DCR, visit www.davitaclinicalresearch.com .

About DaVita

DaVita Inc., a Fortune 500(R) company, is a leading provider of kidney care in the United States, delivering dialysis services to patients with chronic kidney failure and end stage renal disease. DaVita strives to improve patients' quality of life by innovating clinical care, and by offering integrated treatment plans, personalized care teams and convenient health-management services. As of March 31, 2012, DaVita operated or provided administrative services at 1,841 outpatient dialysis centers located in the United States serving approximately 145,000 patients. The company also operated 15 outpatient dialysis centers in three countries outside the United States. DaVita supports numerous programs dedicated to creating positive, sustainable change in communities around the world. The company's leadership development initiatives and social responsibility efforts have been recognized by Fortune, Modern Healthcare, Newsweek and WorldBlu. For more information, please visit www.davita.com .

SOURCE: DaVita

        
        DaVita 
        Vince Hancock, 303-405-2272 
        
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Copyright Business Wire 2012

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