Six months of safety inspections at Lankenau Medical Center: August to January
A medication error drew one of the state's most serious warnings, immediate jeopardy.
Lankenau Medical Center received one of the state’s most serious safety warnings after a nurse gave a patient a double dose of a powerful pain medication in August.
The incident, first reported by The Inquirer in October, was one of three visits inspectors made to the Montgomery County hospital for potential safety violations between August and January.
Here’s a look at the publicly available details:
Aug. 23: Inspectors concluded that a nurse had failed to follow hospital protocol for using potentially dangerous drugs when they gave a double dose of an opioid used to treat moderate to severe pain. The patient was found unresponsive, given the overdose-reversing drug naloxone and treated in the ICU. Inspectors issued an immediate jeopardy warning, a sign of life-threatening safety problems, and lifted the sanctions hours later after hospital administers provided a plan to fix the issues inspectors cited. All nurses were retrained on how to administer medications and special policies for controlled substances, such as opioid painkillers. Hospital administrators conducted 30 audits per week for 30 days to ensure nurses were following protocol.
Nov. 9: Inspectors investigated a complaint but found the hospital was in compliance. Complaint details are not made public when inspectors determine it was unfounded.
Dec. 11: Inspectors investigated a complaint but found the hospital was in compliance.
Pennsylvania Department of Health routinely inspects hospitals to ensure the facility is safe for patients and that staff are following all safety protocols. Inspectors may also visit when a hospital staff member or patient files a complaint.
Not all safety violations spark an on-site investigation from inspectors. Hospitals are required to self-report the most serious safety violations and often work directly with the state to address them. Complaint details are not made public when inspectors determine it was unfounded.
The Inquirer tracks publicly available hospital reports related to a complaint, special monitoring, and general safety inspections. The Inquirer does not track inspections for new equipment or occupancy surveys, unless problems are identified.
Inspection reports are publicly available online and are released 40 days after the report is completed.
The Inquirer is publishing roundups of state inspection reports for Pa. hospitals in our coverage area.
