End-stage renal disease (ESRD) patients rely on dialysis to survive without
a functioning kidney. When medical errors occur at dialysis facilities,
the results can be deadly. With this in mind, California lawmakers are
considering legislation to improve patient safety at dialysis facilities.
Dialysis-Related Medical Mistakes
More than 500,000 ESRD U.S. patients receive dialysis every year. The majority,
nearly 65 percent, undergo treatment in dedicated centers. In addition
to undergoing hemodialysis, patients often receive multiple medications
at the dialysis center. As a result, medical errors frequently occur.
Some of the most
common dialysis-related medical mistakes include patient misidentification, failure to properly sanitize dialysis
equipment, and medication errors.
Large dialysis facilities often provide dialysis treatment to 30 patients
or more per shift. With three to four shifts per day, the total number
of patients treated can exceed 100 each day. When multiple patients are
completing dialysis treatments at the same time and a new shift of patients
is beginning treatment shortly thereafter, the
risk of medical malpractice increases dramatically.
Proposed California Legislation
Senate Bill Number 349, would impose minimum staffing and minimum transition time requirements
for dialysis facilities. The bill states that “[c]urrent staffing
levels in outpatient dialysis clinics in California are inadequate to
protect patient health and worker safety, and therefore are presently
causing harm to dialysis patients, including unnecessary and avoidable
deaths, hospitalizations, infections, and medication errors.”
Under the bill, at least one nurse must provide direct care for every eight
patients. In addition, at least one technician must provide direct care
for every three patients. A nurse or technician may only count toward
the required ratio during time periods the staff member has no responsibilities
other than direct care. The legislation would also impose a transition
time of at least 45 minutes between patients and mandate that the California
Department of Public Health conduct inspections of chronic dialysis clinics
at least once per year rather than the current schedule of every six years.
Senate Bill Number 349 would also establish a schedule of penalties and
actions to be taken when facilities fail to comply with the minimum staffing
and minimum transition time requirements, including the imposition of
civil fines and the requirement that chronic dialysis clinics submit a
correction action plan. The patient safety legislation would also establish
a private right of action to enforce the minimum staffing and minimum
transition time requirements.
As San Diego medical malpractice lawyers, we are hopeful that this bill
can help improve the safety of California’s 500 licensed outpatient
dialysis clinics. We will continue to track its progress and post updates
as they become available.
If you or someone you love has suffered serious harm due to a dialysis-related
medical error, don’t hesitate to
a San Diego medical malpractice lawyer at the Law Offices of Robert Vaage
for a free consultation.