Lufkin police arrest DaVita nurse on asault charge

The Lufkin Daily News reported on Friday that a former employee of the DaVita Lufkin unit was arrested for injecting two DaVita hemodialysis patients with bleach, confirming the tip from my source. RenalWEB has a news summary of events as they have been reported to date (largely by Jessica Savage Lufkin Daily News reporter).

This is not the end of the story. The incidents that police have identified involving bleach are reported to have resulted in hospitalization but not death. On Wednesday DaVita released a statement saying that they believed four deaths were attributable to the arrested nurse; this means at as minimum six patients are involved. It is unclear what evidence DaVita has indicating murder that the Lufkin police does not have, unless murder or manslaughter charges will be forthcoming.

So many questions need to be answered. Where else did Saenz (the arrested nurse) work? How long had she been working as a dialysis nurse? We need a full accounting of her history. I am concerned by a statement in the Wednesday article:

Dr. David Van Wyck, a nephrologist who is vice president of clinical services for DaVita and working with state officials during the investigation of the Lufkin clinic, said on average two to three patients die a month at dialysis centers.

Does he mean "2 or 3 people die during treatment or immediately after treatment and transport to a hospital" or does he mean 'typically in the US, at a 120 patient unit, several patients die each month", the former would not be usual, the later would be all too true - the overall mortality rate among people on dialysis is stuck stubbornly above 20%. What needs to be made clear is how many deaths had there been among Lufkin patients above the typical general mortality rate of 22 to 24%? What were the number of deaths in comparison to the expected? And were the causes what one would expect? For instance an unexpected number of deaths due to hemolysis or extreme dehydration.   

Comments

[Roberta Mikles RN Health Care Patient Advocate]

Bill, I appreciate your insight. This tragic event should never have happened, and, who is to be held accountable, besides this nurse, if, in fact, this is true? However, let us not lose sight that this facility, according to the surveys, (2007) did, in fact, have problems with adequately trained staff being available to meet patient needs, as well as continuing deficiencies cited for reuse and infection control (2003). Although this is several years ago, we must be reminded that for years we are told that the training and education providers give is sufficient. When there are repeat deficiencies,how can one say there is adequate training? And, if there are not follow up onsite return visits, timely to encourage compliance, how does one even know. I just don't understand how providers can profess nothing is wrong, when, in fact, it is clearly in black and white. Also, providers, have themselves, identified that one of the major sources of medical errors are not following policies and procedures. We just need honest upfront openness and if mistakes are made admit such. To recall, the AMA as well as other organizations, have adopted the thinking of full disclosure with errors. But, again, let's not lose sight of many other needed areas - oversight, which is lacking at CMS' level, therefore, all the more reason for providers to take and have increased responsibility. We must not lose fact that there are patients that have been at the receiving end of a negative outcome that was preventable. It is the thinking that must change to the process of care thinking (Dr. David Nash, Health Care Policy, Jefferson Medical College) versus the usual statements for reasons of negative outcomes e.g. comorbid conditions, happens with dialysis patients, etc.
Roberta Mikles RN Health Care Patient Advocate