Hospital to revise discharge policy after newborn deaths

[NRSKarenRN, BSN, RN]

Hospital to revise discharge policy

North Collier failed to cite drug effects

By SHARON TURCO, [email protected]

http://www.news-press.com/news/today/010926oxycontin.html

North Collier Hospital has promised to revise its discharge policy regarding high-risk infants after two infants born there were sent home without specific care instructions.

The Agency for Health Care Administration opened an investigation into the hospital in August after a baby born addicted to OxyContin died at home, less than two days after his birth and 10 hours after his release.

The state found hospital officials did not tell James and Laurie Roszelle how to recognize signs their son, James "Jack" Roszelle, was suffering effects from the drug.

The other infant, who suffered trauma at birth, survived. AHCA looked at six high-risk births during its investigation.

In a response to the agency's findings, the hospital disputed the report's claims saying they did instruct the Roszelles on how to care for the son, whom they adopted.

The Roszelles say they are comforted by the hospital's decision to improve discharge procedures, but believe the hospital should take responsibility for Jack's death.

"Jack's gone, nothing can bring him back," Laurie Roszelle said. "And, it's because the hospital made a mistake."

Dr. Shameem Tamton of East Naples Medical Center sent James "Jack" Roszelle III home with his adoptive parents 30 hours after he was born July 31 despite a medical history that showed his birth mother regularly used the prescription painkiller OxyContin.

Baby Jack died 10 hours later, possibly suffering withdrawal from the prescription painkiller, according to a preliminary report from the Collier County Medical Examiner's Office. A final report is not finished.

A toxicology test included in the report showed Jack's blood was positive for Benzodiazepine, a drug used to alleviate anxiety, and opiates.

AHCA found that Tamton did not mention what signs and symptoms the first-time parents should watch for. She said only that Jack may, "just get cranky," according to the report.

Tamton denied the allegation, telling investigators she discussed withdrawal symptoms like tremors and irritability, adding that the Roszelle's were anxious to take Jack home.

She said she did not feel comfortable discharging Jack, but went ahead because the Roszelles appeared mature and receptive to her instructions, the report said.

Tamton had the option of asking the Roszelles to sign paperwork stating they were taking Jack against her wishes, but did not, investigators found.

"It seems the agency has chosen to believe unsubstantiated statements from the adoptive parents, and not given any credibility to the statements made by the pediatrician in her interview," wrote Naples attorney Kevin Crews to AHCA on behalf of the hospital.

Angela Resinger, a hospital spokeswoman, issued a statement Tuesday saying the Roszelles were "given adequate and appropriate instructions.

"North Collier Hospital has always been and will continue to be committed to providing the highest quality of care to all of its patients in the community," she added, refusing to comment further.

Attorney Ellis Rubin, who is representing the Roszelles, said AHCA's conclusions back up what he and the Roszelles already knew.

"The hospital was negligent when they released the baby from the hospital," the prominent Miami attorney said. "They need to take responsibility."

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Copyright 2001, The News-Press.

[purplemania, BSN, RN]

How did the baby get addicted to Oxycontin??? I think the mother ought to be tried for murder.

[dasaSN]

Why do they send newborns with problems home so soon? We need to keep babies in the hospital longer just to keep an eye on them. As we all know insurance companies don't want to pay any more than they have to so the pressure is on the doctors to get them discharged as soon as they can. I don't know if this plays a role but it sure doesn't help the situation. I am just a student but sometimes patients/families are not equipped to deal with some situations even with patient/family education. I just don't think newborns should be discharged so quickly.