Article - May 20, 2008 - Lufkin Daily News

State report: DaVita clinic did not have proper number of trained personnel

By Jessica Savage

DaVita's Lufkin Dialysis Center in 2007 did not have the required number of properly trained personnel present to meet the needs of patients, according to a state health survey conducted nearly a year ago.

An expansion survey conducted by the Texas Department of Health and Human Services on July 18, 2007, indicated the DaVita clinic at 700 S. John Redditt Drive had not adequately staffed its facility and had not given patients the correct prescribed treatments as ordered by a physician. The report was one of several documents released by the state in response to an open records request from The Lufkin Daily News.

A Davita spokesman did not immediately comment on the reports. The spokesman, Michael Chee, has said the company's staffing model has "never deviated from state-mandated staffing requirements."

A recent spike in patient deaths prompted the facility to close its doors April 28. It remained closed Monday pending the outcome of investigations by the Texas Department of State Health Services, Lufkin Police Department and the federal Centers for Disease Control and Prevention.

In the survey conducted in 2007, two clinic employees told a state surveyor they were administering treatments against a physician's order, under the order of a supervisor.

"Both employees said they were instructed to do so by the charge nurse," the report stated.

A charge nurse told the surveyor the facility administrator made the recommendation.

The state surveyor also noted that while she was present, the center ran out of a mix used to treat water before administering dialysis to patients, the report stated. An employee told state health surveyors the only person who knew how to properly mix chemicals to treat water at the facility was also responsible for another facility in Livingston, and was not in Lufkin that day.

The facility administrator was notified of the problem and recommended that patient treatments be altered, the report stated.

"Surveyor informed employee No. 8 around 12:15 p.m. of the concern for patients being placed on the 1K acid instead of the prescribed (amount)," stated the report, which includes patient information withheld by state officials. "The interview with the Charge Nurse revealed that after the surveyors concerns, the facility had some individual jugs of (info withheld) and they began switching patients at about 12:40 p.m. back to the prescribed (amount)."

"A review of the list of patients found 22 (out of 22) patients were being dialyzed with the incorrect dialysate," the report stated.

The surveyor also noted the facility was administering treatment at 32 of its stations — an expansion which had not yet been approved, the report stated.

An exit interview between the state surveyor and a facility administrator stated the staff had been made aware of the problems, the report stated. The report listed a corrective plan of action to be taken, and the plan was accepted by the state Aug. 1, 2007.

State health department spokeswoman Carrie Williams said a surveyor stayed on site July 17 until all corrections were made. The surveyor returned to the facility Aug. 22 and noted that the company's corrective plan had been implemented.

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