TAMPA — Tampa General Hospital has paid a $700,000 award in the medical malpractice case of the late Perry Harvey Jr.
But litigation over the care that the former Tampa City Council member and union boss got at the hospital is not over.
In a new complaint, an attorney for Harvey's estate contends TGH not only allowed Harvey to develop a pressure sore — the medical problem that led to the award — but also missed diagnosing and treating a perforated bowel.
Lawyer Nathaniel Tindall of Tampa contends TGH billed Medicare for treating both the pressure sore and the perforated bowel. When acquired in the hospital, such problems are known as "Never Events," his new complaint says, because Medicare says they should never happen and does not pay for them.
Medicare improperly paid TGH $186,232 as a result of Harvey's "Never Events," according to the complaint, filed last week.
Tampa General says it did nothing wrong in its billing.
"We have reviewed the records in this case and stand firm that we violated no Medicare rules or regulations in the way we coded and billed in this case," TGH said in a statement released Friday.
In October, a state arbitration panel awarded Harvey's widow more than $700,000 in damages as a result of the sore. During the arbitration proceedings, the hospital effectively admitted having at least some liability, but it said Harvey, 81, died from a wide range of serious health problems unrelated to the pressure sore.
Another patient, another sore
Tindall also is suing on behalf of the family of Tiffany Albury, whose stay at TGH overlapped with Harvey's.
Harvey and Albury were both admitted to TGH in March 2012, according to court records. While there, both developed pressure sores on the sacral area, low on their backs.
Both were transferred from TGH to a transitional care hospital on the same day in May 2012. They died a day apart in September 2012.
Tindall outlines his medical negligence claim in a series of court pleadings:
Albury, who was 30 when she died, was admitted to TGH on March 29, 2012, and suffered from diabetes, hypertension and other illnesses.
Nearly two weeks later, Albury was put on a breathing tube and often was sedated during several weeks that followed, according to a review of doctors' and nurses' notes Tindall commissioned.
A month into Albury's hospitalization, a nurse hired by Tindall examined her at TGH's intensive care unit. In a sworn statement, registered nurse Carol Tinsley said Albury had ulcers measuring 2 1/2 by 3 inches near her tailbone and buttocks.
Tinsley also said a primary care nurse she did not name told her Albury was heavy enough that she required a lift team to turn her in bed, but the "intensive care unit was short-staffed and could not turn Ms. Albury on a routine schedule as outlined in Tampa General Hospital's policy and procedure for the prevention of pressure ulcers."
TGH said it couldn't comment because of patient privacy. But in a response filed in court Friday, an attorney for the hospital painted a different picture.
"Ms. Albury's death did not result from her sacral wound," attorney Derek Daniels wrote of the pressure sore. "Ms. Albury's death resulted from her severe kidney disease and diabetes."
Daniels said Albury, who was 5-feet-9 and weighed 350 pounds upon being admitted to TGH, had a complicated medical history. It included long-standing uncontrolled diabetes, peripheral vascular disease, partial amputation of her right foot, end-stage kidney disease, anemia and hypertension. She also had a prior skin breakdown on her lower back at another hospital in 2009, he said.
Albury did not take her insulin or follow a diabetic diet before coming to TGH, Daniels wrote. After being admitted to TGH, he said, she ate what she wanted contrary to medical orders and often refused to let staff turn or reposition her and "did not turn and reposition herself despite encouragement by clinical staff to reduce pressure."
More suits coming?
Last week, Tindall sent notices of claim to TGH on two recent patients who he said were not properly turned in bed, developed pressure sores and did not receive proper treatment.
William A. Powell Jr., 78, of Brooksville was admitted to TGH on May 7, was transferred to Florida Hospital Connerton in Land O'Lakes on June 12 and died Aug. 3.
Denise Fyda, 58, of Tampa was admitted July 31 and transferred on Sept. 13 to Kindred Hospital in South Tampa, where she has been since.
TGH said it had not been served with the notices on those patients and couldn't comment.
A state inspection
While Albury and Harvey were at TGH, a state inspector raised questions about the care given to another patient — one of 12 whose records were sampled.
The patient was admitted in January 2012 with weakness following a fall and underwent cervical spine surgery five days later.
A state inspector reported that "nursing documentation revealed no evidence that hygiene care was provided to the patient" on nine days in March 2012.
"The nursing staff failed to implement appropriate nursing interventions related to meeting (the patient's) hygiene needs," the Florida Agency for Health Care Administration said.
Within a month, TGH provided staff additional education on patient hygiene. It also audited patient charts to make sure they covered, among other things, "skin intervention for compliance with documentation of personal hygiene."
The issue was "one of documentation, not clinical practice," TGH said in a statement. "The nursing staff did provide the appropriate hygiene care, but did not document that aspect of the patient's care. State inspectors scrutinized the entire medical record, and 11 additional medical records selected at random, and did not find any other discrepancies in either clinical documentation or patient care. Our corrective action plan included staff education on the need to document hygiene."