Palomar expands emergency department

An expected doubling of emergency department demand at Palomar Medical Center Escondido has led to a $4.7 million expansion that will add 14 beds to the facility that serves a wide swath of inland North County.When it opened in August of 2012, the hospital had 52 emergency beds on its ground floor, making it one of the largest operations in the region. But that capacity has not kept pace with the number of patients flooding through Palomar Escondido’s sliding glass doors. According to Palomar Health, the inland health system that also operates Palomar Medical Center Poway, 63,000 emergency patients were seen during the facility’s first full year of operation. That number is expected to reach 112,000 in 2018.Filings with the California Office of Statewide Health Planning and Development indicate that emergency patients on Medi-Cal grew the most from 2012 to 2017, jumping from 26 percent to 38 percent of the hospital’s overall emergency volume.Palomar Escondido also has seen a large increase in the number of patients it treats who have commercial health insurance. In 2012, less than 1 percent of ER patients had commercial insurance compared to more than 3 percent in 2017. That change came as the hospital’s number of “self pay” patients, those who paid for their care out of their own pockets, shrunk from nearly 13 percent of total patients in 2012 to 5.6 percent in 2017. The move from self pay to commercial insurance likely indicates that thousands of people who were previously uninsured purchased coverage from the Covered California health insurance exchange as mandated by the Affordable Care Act which also expanded Medi-Cal coverage to a wider group of Californians.The ER expansion fills a previously-unnocupied 4,500-square foot space near Palomar Escondidio’s emergency waiting room. Palomar held a ribbon cutting ceremony for the space on Monday though it is not expected to begin admitting patients until Apr. 9.About $2 Continue Reading

Sobering center to return to Escondido

A center that will give intoxicated people a place to sleep it off is scheduled to open in Escondido in February, and the program could be a model for others to follow in a county where such services are rare. “The goal here is to model that you can bring all these services together and help people in a holistic, practical way,” Interfaith Community Services CEO Greg Anglea said about the nonprofit’s Recovery and Wellness Center, which began accepting residents last Friday. Eight people so far have moved into the 44-bed center at Interfaith’s headquarters at 550 W. Washington Ave. in Escondido. The new Recovery and Wellness Center will have nurses, counselors, social workers and others to help homeless people in the residential program deal with addiction and mental health. Once Interfaith has a required state license in February, it will add a sobering room at the site, with eight mats where people will stay for three to 10 days, depending on what they substance they are using, Anglea said. “The detox is super critical because there are many treatment programs out there, and they almost all require sobriety upon entry,” he said. “When you can’t get cleaned up, you can’t get into those treatment programs.” Many sobriety programs are costly, and county-run programs are among those that require a period of sobriety before entering. Anglea said he knew of only one other program in the county, the McAllister Institute in East County, that offers a place for people with little money to get sober and enter a program. Interfaith had operated a sobering center as part of a detox and residential program it ran in a city-owned building for 17 years before closing in 2013 after funding was lost and Escondido requested the building back. The sobering program was cut and the detox and residential program was reduced to eight beds in Interfaith’s Hawthorne Veteran Family Resource Center, a medical respite program Continue Reading

Snooping nurse forces Palomar to notify 1,300 patients of records breaches

Palomar Health will notify 1,309 patients that one of its former nurses inappropriately accessed their medical records while they stayed at Palomar Medical Center Escondido during a 15-month period from Feb. 10, 2016, through May 7, 2017. According to a short statement the North County health provider released Friday morning, information accessed in most cases included patients’ first and last names, dates of birth, genders, medical record numbers, diagnoses, treatment locations, medications and allergies. Breaches were more potentially severe for four patients who will be offered free identity-protection services because computer logs show access to parts of Palomar’s electronic medical records system that house social security numbers, health insurance coverage details and financial information. Derryl Acosta, the health system’s spokesman, said the employee voluntarily resigned during an internal investigation. Acosta said that there is no evidence that the former employee did anything with the information that she viewed or that any records were removed from the hospital. An audit of access logs, he said, revealed a pattern of prying for no good medical reason. “The nurse was inappropriately snooping in records, whether they were assigned to that nurse or not. These were records they shouldn’t have been looking at,” Acosta said, adding that, in all cases, affected patients were either assigned to the nurse or to another nurse working in the same unit. The advent of electronic health records, and the need to give bedside professionals such as nurses and doctors broad access so that they can effectively do their jobs, has opened a new privacy minefield in hospitals nationwide, said Matthew Fisher, a health law specialist at Mirrick, O’Connell, DeMallie & Lougee in Worchester, Mass. Health privacy law, Fisher said, is very clear that broad electronic access is not a fishing license. “You can’t just go Continue Reading

UC San Diego Health fined for fatal heart monitor incident

The state health department has fined UC San Diego Health $44,000 for a medical mistake that led to a patient’s death. The penalty involves an incident in September 2015. It was among 10 citations totaling $549,555 handed down to nine hospitals across the state on Dec. 28. The latest fine is the seventh for UC San Diego which, according to a list of all fines provided by the California Department of Public Health, has the third-most penalties since 2007, the year the Legislature created the public reprimands program to hold hospitals more accountable for preventable medical errors. According to a “statement of deficiencies” released by health officials, the latest incident involved an inactive cardiac monitor used to supervise a male patient who had undergone an angioplasty procedure at UC San Diego Medical Center in Hillcrest to open a clogged blood vessel and alleviate chest pain on Sept. 7, 2015. According to the state’s report, the patient, who is not identified by name or age, became disconnected from the bedside electronic device about 5:44 a.m. on Sept. 8. The state’s report says that a technician monitoring the heart signals of many patients on computer screens in another part of the hospital told investigators that he didn’t notice the patient’s heart rate had flatlined because the screen showing this data “was off to the side. I just didn’t scan over that far.” The technician told investigators that he did not hear the alarms that bedside monitors make when they become disconnected, and his remote-monitoring console did not automatically sound an audible alarm. A nurse assigned to the patient, who said he was able to hear the alarm “for only about 10 to 15 feet” in the hallway outside the patient’s room, didn’t enter to check on the patient until 6:35 a.m. He quickly noticed that the man in the bed looked “gray and unresponsive.” In its report, the state says Continue Reading

Flu kills 34 more people, including a 1-year-old, in San Diego

The number of deaths associated with this year’s severe flu season has quadrupled in a week, according to the latest update from the county Health and Human Services Agency.An additional 34 deaths were added to the tally Wednesday, including a one-year-old boy, as influenza raged throughout the region in what experts say is the fiercest battle with the rapidly-mutating virus they’ve experienced since 2009, when a pandemic filled emergency rooms from Oceanside to Chula Vista.That has been the case this year, as well. A feverish mob began arriving at local emergency rooms right around the holidays, creating long waits and forcing some facilities to set up tents in their parking lots to relieve pressure on their emergency waiting rooms — just as they did in 2009 when the H1N1 epidemic hit.Most hospitals reported that they have instituted, or will soon put in place, visitation restrictions barring children and finding other ways to limit the number of people visiting hospitalized patients.“I think we’ve already surpassed what we thought was busy in 2009,” said Michelle Gunnett, director of emergency services at Palomar Medical Center in Escondido, which set up a special flu tent just outside its emergency department entrance over the weekend.Dr. Kristi Koenig, medical director of the county’s emergency medical services system, said her office has been monitoring emergency room traffic on a near real-time basis for weeks and has seen many hospital have to bypass ambulance traffic from areas outside their core territories due to the number of flu patients arriving.“Definitely there is stress on the system,” Koenig said. “The waiting rooms are full, there are long waits to be seen and a high proportion of the patients are testing positive for flu.”A staggering number of flu cases — 3,334 — were reported last week, besting the previous week’s total of 2,338, which was itself the highest Continue Reading

More hikers prompt more rescues on nearby popular trails

Hikers are being warned about how to avoid common mistakes after a Sunday helicopter rescue at Iron Mountain, and an overall increase in the number of rescues at Mount Woodson. On New Year’s Eve, drivers on Highway 67 near Poway Road noticed a large emergency response at the Iron Mountain trail head, including fire engines from Poway and Lakeside, a waiting ambulance and a San Diego Fire Rescue helicopter circling overhead. Fortunately, the female victim suffered only minor injuries to her ankle after a fall and was airlifted off the trail and brought to a waiting ambulance, which transported her to Palomar Medical Center Poway. “It’s not easily accessible,” said Poway Fire Department Battalion Chief Scott Post. “We hike a crew in on foot but there’s a break-off point where you can’t drive any further, so getting to the patient, caring for them and then extracting them out to an ambulance can be cumbersome and that is why the helicopter is used.” It’s a scene first responders are used to in the area, as hikers regularly tackle Iron Mountain and flock to Mount Woodson, prompting rescues of adventure-seekers who get more than they bargained for. Post said most rescues used to be made from Iron Mountain, but now it’s Mount Woodson, a change he attributes to social media and the popularity of Potato Chip Rock. The most common problem, explains Post, is people not bringing enough water as well as underestimating the trail itself, which he describes as, at the very least, “moderate,” especially from the Lake Poway side, which includes switchbacks to the top of Woodson, which can be treacherous. “We go up there for a fair amount of medical-related rescues, where people just get overheated, or start having chest pain or other medical problems,” he said. “Even the healthiest people should probably not be hiking when the temperature is above 90-95 degrees,” warned Post. Continue Reading

One dead, at least five injured, after small plane previously owned by ex-Yankee crashes into car along California highway

One person was killed and at least five injured Saturday when a small plane previously owned by ex-Yankee catcher Matt Nokes crashed into a car on a California freeway. The plane skidded along the roadway for about 150 feet and plowed into a car parked along the shoulder as its driver synced his Bluetooth, according to the San Diego Union-Tribune. The 9:15 a.m. impact killed a woman identified by the Union-Tribune as Antoinette Frances Isbelle, 38, as she sat in the sedan’s backseat 50 miles north of San Diego. Two passengers in the plane, including its pilot, Dennis Hoge, 60, and three people in the vehicle were hospitalized. Jacob Duncan, who was within 50 feet of the collision, told KNSD the plane most likely would have landed safely if the freeway had been clear. "The pilot really, I believe, was trying his best,” he said. Coincidentally, the same experimental kit aircraft lost engine power with Nokes behind the wheel during a 2000 flight. Nokes, who played four seasons with the Yankees, was unable to reach a nearby airport and landed his Lancair IV on the same highway — safely. “I went south, hovered over some cars and waited until they cleared,” the former Major League Baseball player said after the 16-year-old incident. Hoge, the plane’s current owner, did not encounter Nokes’ ideal circumstances during the morning crash. He suffered life-threatening injuries. Three victims were taken to Palomar Medical Center nearby, spokesman John Buchanan said. Two other people were transported to Sharp Memorial. The deceased was a female "in her 20s to 30s" and sitting in the rear right passenger seat of the car, according to KSWB. The passenger of the plane, a 50-year-old woman, has non-life threatening injuries. When firefighters arrived at the scene, it took them nearly 30 minutes to pull the 45-year-old woman, who Continue Reading

High school student dies on birthday after being struck in chest with softball during gym class

A beloved California high school sophomore died on his birthday after being struck in the chest with a softball during gym class. Taylor Dorman, 16, complained of chest pains shortly after he was hit by the ball during a game of "Over the Line" at Ramona High School on Wednesday. He was taken by helicopter to Palomar Medical Center in Escondido, where he was pronounced dead at 4 p.m. Stunned friends and classmates sang happy birthday to the fallen teen at the school on Wednesday night in an emotional tribute. “We had planned our lives together," close friend Chris Hartness told Fox 5 in San Diego. "We were going to play football for another two years and then join the military. Now that’s all gone.” FOX5 San Diego Grieving classmates sang 'Happy Birthday' to the fallen teen. “He was a great young man,” Ramona High School Principal Tony Newman told the Ramona Sentinel. "He was very well-liked by many on campus. This will have an impact on students and staff. We will remember some good memories and keep them alive in our hearts and our thoughts and our conversations.” Newman said he was also concerned about the boy who hit the line drive that struck Dorman in the stomach: "We’ve been in contact with his family. Our hearts are going out to him as well. It was an accident and was not his fault.” Dorman's father died of a heart attack when he was a child, but the cause of the teen's death has not been determined. [email protected] USING MOBILE? CLICK FOR VIDEO FOX5 San Diego Stunned friends console each other. FOX5 San Diego Dorman was well-liked, classmates and the principal said. FOX5 San Diego A friend writes a tribute to Dorman. Join the Conversation: Continue Reading

Passenger in car that crashed into pool dies after days in a coma

A young woman who sat in the passenger seat as a car slammed through a fence and plunged into a pool, died Saturday after several days in a coma. Ashley Garcia’s boyfriend sped around the bend of a street dubbed “roller coaster road” in San Marcos, Calif., and lost control of the car last Monday, according to Fox 5 San Diego. The 2006 Kia Rio flipped over and sank to the bottom of the pool, where Garcia was trapped by her seat belt. Neighbor Jarit Welles was awoken by the crash and immediately dove into the pool to free Garcia. KSWB Garcia was trapped inside the car, tangled in her seatbeat. Welles, 22, performed CPR on Garcia until paramedics arrived and transported her to Palomar Medical Center, California Highway Patrol Officer Jim Bettencourt told Fox 5. Robert Anderson, the driver, was able to get out of the sunken vehicle on his own. Garcia was diagnosed with anoxic brain injury and placed on life support, 10News reports. She was taken off life support when doctors declared her brain dead Saturday. Garcia’s parents, Kara Laxson and Sean Garcia, spoke out Sunday for the first time since the tragic accident. Laxson said that her daughter, who had chosen to be a organ donor, had already helped four people. "It has made it so much easier in the process for us as a family to know that we are able to fulfill her wishes and a piece of her is going to continue to living on and on," Laxson told 10News. Sean Garcia posted a video tribute to his daughter on YouTube Sunday, featuring a montage of photos from Garcia’s childhood. egyptsean/via YouTube Garcia’s parents, Kara Laxson and Sean Garcia, spoke out for the first time since the tragic accident Sunday. “No words can express the emotions that run through your veins when you lose your child,” he wrote in the opening shot. All 13 Chili’s restaurants across San Diego will hold a fundraiser for the cost of Garcia’s Continue Reading

Nearly 2,000 vets may have infected HIV during dental exams at John Cochran Medical Center in MO

Now there really is a good reason to be afraid of the dentist. A Missouri VA hospital may have exposed more than 1,800 veterans to potentially life-threatening diseases like hepatitis and HIV after patients visited the medical center for dental work. Letters were recently mailed from John Cochran VA Medical Center in St. Louis to 1,812 veterans alerting them they may be at risk of contracting hepatitis B, hepatitis C and HIV, according to CNN. The situation resulted from failure to clean dental instruments properly, said Gina Michael, the association chief of staff at the hospital.  The tools were supposed to be sent through a special sterilization machine, but technicians were washing them by hand to avoid damaging them. The hand-washing of instruments started in February 2009 and continued until March of this year. The violation was discovered during a routine inspection by a government medical team. Rep. Russ Carnahan called the blunder “absolutely unacceptable,” and is demanding a formal investigation by the House Veterans Affairs Subcommittee.  “No veteran who has served and risked their life for this great nation should have to worry about their personal safety when receiving much needed health-care services from a Veterans Administration hospital,” Carnahan said. This isn’t the first time patients have been informed that medical tools weren’t being used properly. In June, more than 3,000 patients who underwent colonoscopies were notified by Palomar Hospital in San Diego that they were at risk for infection because medical instruments were being reused. In Missouri, the hospital set up a special clinic and hotline for veterans who think they were exposed. Carnahan said more could have been done to prevent the fiasco. “I can only imagine the horror and anger our veterans must be feeling after receiving this letter,” he said. “They have every right to be angry.” Continue Reading