Nurses strike against Sutter Health

9-24-11
Mercury News
Replacement nurse involved in 'medical error' leading to patient death at Oakland hospital
By Harry Harris and Matthias Gafni
Oakland Tribune
http://www.mercurynews.com/breaking-news/ci_18972630
A replacement nurse at an Oakland hospital committed a "medical error" while administering a dosage of medication to a cancer patient leading to her death early Saturday morning, police and hospital officials said.
The name of the woman, a 66-year-old Oakland resident who had been a patient at the Summit campus in Oakland since July, was not released.
An autopsy is scheduled for Monday, but the woman's death is believed to have been caused when an Alta Bates Summit Medical Center replacement nurse "administered a nonprescribed
dosage of medication," said Oakland police Sgt. Mike Gantt. Police would not say what type of medication it was and how much was given.
The medication was administered, and a few hours later the patient was found unresponsive during rounds, and she died a half hour later at 1:03 a.m., Gantt said.
The nurse, who came to the hospital from another state to work during the recent one-day nurses strike, was questioned and released by Oakland police. In the interview, the nurse said she made a mistake, but police are still trying to determine whether it was an accident, Gantt said. Her name was not released.
The Alameda County District Attorney's Office was notified and will review the case Monday.
Multiple investigations are under way, and in a statement released Saturday the hospital confirmed the death was caused by a "medical error" but did not elaborate, citing privacy laws. The hospital confirmed it was a replacement nurse.
The hospital said the woman died after "doctors and clinical staff were unable to revive the patient." After the woman's death, the hospital contacted the Alameda County Coroner's Office, which contacted Oakland police.
"This is a tragic event, and our heart goes out to the family of the patient," said Carol Weis, chief nursing executive at the Summit campus.
"We have met and spoken with the family of the patient to express our sorrow and sympathy and let them know our prayers are with them," she said.
The hospital said it is conducting an investigation into the death and is also working with local, state and federal agencies that are also probing the death.
The death "likely was caused by a medical error," said Dr. Steve O'Brien, an Oakland campus medical executive, adding that the hospital activated its patient safety analysis process to review its policies and procedures for opportunities to improve its patient care.
"While medical errors do exist in healthcare we are constantly investing in ways to improve patient care," the medical affairs vice president said in a statement. "This is a most unfortunate event for which we are very sorry."
Nurses throughout Northern and Central California went on strike Thursday, and most non- Kaiser nurses have been locked out for five days. The lockout affects at least eight hospitals run by Sutter Health, including the Oakland hospital.
"We said from the outset that the lockout by Sutter was unnecessary, reckless and unwarranted," said Chuck Idelson, a California Nurses Association spokesman.
"Now we have a very serious concern about the replacement nurses that they have employed during the unwarranted lockout."
The nurses union called the state Public Health Department on Friday, before the incident, Idelson said, to ask for an investigation into demonstrated clinical competence and proper certification of the replacement nurses.
"On Friday, we heard anecdotally about serious concerns about actions by replacement nurses at the two large Alta Bates campuses," Idelson said.
At least one oncology nurse at Summit tried to report for work Friday, but was turned away, he said.
Sutter officials have said they entered into contracts with replacement nurses that require a minimum number of days.
"Once a strike is called, it would be financially irresponsible for hospitals to pay double to compensate both permanent staff and replacement workers," Sutter Health said in a statement earlier in the week.
Nurses, who do not get paid during lockouts, warned Sutter two weeks in advance of the strike, and other companies, like Kaiser, have not locked out their striking nurses, Idelson said.
The Sutter lockout is scheduled to end Tuesday.
Sept. 2011
California Nurses Association
Press Releases
RNs Want Sutter to End Lockout & State to Investigate Safety Violations Following Patient Death
Candlelight Vigil Set Sunday Night at Oakland’s Summit Hospital
http://www.nationalnursesunited.org/press/entry/rns-call-on-sutter-to-end-lockout-ask- state-to-investigate-safety-violation/
The California Nurses Association/National Nurses United today called on Sutter corporation to immediately end the unsafe lockout of its regularly scheduled nurses following media confirmation of a patient death while under the care of a strike replacement RN, as well as reports of other serious problems involving strike replacement RNs.
RNs will hold a memorial candlelight vigil Sunday night and to press Sutter executives to end the lockout. The vigil will be held at 7 p.m. at Sutter’s Alta Bates Summit hospital campus in Oakland at 350 Hawthorne St.
Late Saturday night, the San Francisco Chronicle and Contra Costa Times both reported the death of a female patient which, according to the Chronicle, was due to “what the hospital described as a ‘medical error’ made while she was under the care of a replacement nurse.” The nurse, reported the Contra Costa Times, “came to the hospital from another state” to work during the one day strike which the medical center turned into a 5-day lockout of its nurses.
Sutter RNs held the one-day strike on Thursday to protest demands by Sutter executives for some 200 contract concessions, a number of which would erode the ability of nurses to advocate for safer patient care, especially on the critical issue of safe staffing.
But when RNs sought to return to work Friday morning, they were instead barred from the hospital by hospital officials and armed security guards. Quoting hospital and police officials, the Contra Costa Times stated that the out of state nurse committed the error “while administering a dosage of medication to a cancer patient leading to her death early Saturday morning.” Yet, said CNA, at least one experienced, veteran oncology nurse who tried to report to work Friday was among those turned away at Summit.
"An incident like this is chilling and strikes right to our nurses' concern about their ability to advocate for their patients," CNA/NNU Executive Director RoseAnn DeMoro, told the Chronicle. "It was irresponsible to lock out those nurses."
DeMoro is calling on Sutter’s corporate chief executive officer Pat Fry to “end this disgraceful and dangerous lockout immediately, and to “return to the bargaining table to discuss the issues of patient safety which are at the heart of the nurses’ concerns with Sutter.”
Martha Kuhl, one of the locked out RNs at Children’s, noted that  Kaiser Permanente, where RNs also struck for one day on Thursday did not lock out its regularly scheduled RNs,  “compelling evidence that the punitive lockout by Sutter and Children’s is unwarranted, unnecessary, and unconscionable.”
Just hours before the patient death, CNA Friday had asked the California Department of Public Health to conduct a formal investigation in response to reports that replacement RNs used during the lockout lack the appropriate clinical competencies and certifications that are necessary for safe patient care.
“We are calling on the Department of Public Health to carefully examine conditions in Sutter hospitals that have locked out RNs,” said CNA Legislative Director Bonnie Castillo, RN.
On Friday, a registered nurse at the Alta Bates Summit Medical Center’s Summit hospital in Oakland returned to work after an urgent notification from the hospital to CNA that it needed a nurse it had locked out who has specialized competency and expertise in caring for patients in need of complex procedures such as dialysis and pheresis.
CNA also raised concerns about whether all the replacement RNs are properly certified to ensure they have the appropriate clinical expertise for the areas where they are working.
“Failure to guarantee clinical competencies and not assuring proper certifications violate California law, and put patients at risk,” said Castillo. If found guilty, the Sutter hospitals could face potential fines, depending on the severity of the incidents and the extent of the violations.
“We also call on the California Board of Registered Nursing to scrutinize the clinical competency and certifications of both the strikebreaking nurses and the nurse supervisors at the hospitals to see if they should retain their RN licensure,” Castillo said.
Throughout the region, experienced, long term RNs at Sutter and Children’s hospital arrived for regularly scheduled shifts but were turned away by hospital executives,” said
DeMoro. “This disgraceful and unsafe lockout is the latest indication of Sutter’s disregard for its patients and nurses, which is also seen in its drastic cuts in patient services across the region and the nearly 200 demands Sutter has made for sweeping reductions in nurses and patient care standards.”
The lockout followed a 24-hour strike by 23,000 RNs at Sutter, Children’s and Kaiser hospitals. During the strike, CNA maintained a patient care task force at every hospital consisting of nurses on strike who are available to assist with genuine patient emergencies. CNA also provides the hospitals lengthy advance notice, in this event nearly two weeks, to plan for a strike.
The hospitals cited a pretext for the lockout by claims that they “must” sign long term contracts with strike agencies. That assertion, says Kuhl, is “not credible. Why do they take such a hard line in negotiations with nurses who live and work in their communities and take care of their patients every other day of the year, but spend tens of millions of dollars to give these strike firms whatever they ask for?”
 
Sept. 2011
California Nurses Association

Sutter’s Vaults of Gold
http://www.nationalnursesunited.org/page/-/files/pdf/flyers/sutter-ceo-pay-092011.pdf

Sutter Profits: $3.7 billion since 2005
Sutter’s Assets: $11.6 billion (current)
What Sutter Pays Top Executives*
Pat Fry, CEO $3,992,642
David Drucker, VP, Regional Executive $2,536,081
Robert Reed, VP, CFO $2,248,684
Martin Brotman, West Bay Region $2,068,495
Ed Berdick, East Bay Region $2,067,593
Sarah Krevans, Sacramento Region $2,020,658
Gordon Hunt, VP, Chief Medical Officer $1,966,845
Mike Cohill, VP $1,438,931
Peter Anderson, VP Business Development $1,362,601
Gary Loveridge, VP, General Counsel $1,358,181
David Benn, Central Valley Region $1,304,294
Warren Kirk, CEO East Bay Hospitals $1,267,834
Thomas Gagen, CEO Sacramento Hospital $1,235,145
Jeff Gerard, Peninsula Region $1,212,314
John Burnich, VP, Med Network $1,207,081
Mike Helm, VP Human Resources $1,203,701
Jonathan Manis, VP, CIO $1,194,504
Thomas Blinn, CEO Sacramento, Sierra Region $1,189,402
Morris Flaum, CEO West Bay Med Foundation $1,130,477
Robert Merwin, CEO Mills Peninsula $1,072,023
*Salary as of 2009, Sutter 990 IRS Filings
Does Sutter Really Need to Cut Patient Services—And Demand 200 Cuts from its Registered Nurses?