Banzhoff lawsuit prompts questions about Concord Hospital health outcomes

Monitor staff
Published: 1/22/2017 12:13:00 AM

When it comes to measuring health outcomes, Concord Hospital – like most New Hampshire medical centers – has a mixed record.

Hospitals are routinely ranked and evaluated on a number of factors, like patient outcome, infection rates, timeliness of care and readmissions.

Overall, Concord Hospital falls below the national average for timeliness of care, according to data collected by the Center for Medicare and Medicaid Services. But generally, it’s above the national average for patient experience.

The quality of care offered by Concord Hospital is being questioned in a medical negligence lawsuit filed by the family of Molly Banzhoff, a former Rundlett Middle School seventh grader. The 13-year-old was declared brain dead in May after her family took her to the Concord emergency room with “classic signs of a pediatric brain tumor,” according to the lawsuit filed last week.

She was taken off life support a few days later.

By one measure of timeliness of care, Concord Hospital’s emergency department lags behind both national and state averages. For instance, patients who come to Concord’s emergency room with symptoms of a broken bone have to wait 62 minutes, on average, before they receive pain medication. The national average is 52 minutes, while the state average is 51 minutes, according to data available at Medicare.gov.

By other measures, Concord Hospital does far better. Nationally, 69 percent of emergency department patients with stroke symptoms received brain scan results within 45 minutes of arrival. At the state level, it’s even lower at 64 percent. At Concord Hospital, the number rises well above both at 86 percent.

The suit against Concord Hospital, its affiliates and three of its doctors accuses them of medical negligence because doctors did not order diagnostic brain imaging for months as Molly Banzhoff complained of migraine headaches, vomiting and tongue numbness. The lawsuit says doctors did not order an emergency brain scan until after Molly had stopped breathing and hospital staff had called a Code Blue for cardiac arrest.

“Rather than order diagnostic testing to rule out the most dangerous possible cause of Molly’s symptoms, a brain tumor, the defendants either assumed Molly was faking it or that the most benign possible cause was the source of her symptoms,” the lawsuit states.

Concord Hospital Vice President and Community Affairs Executive Director Pamela Puleo said the hospital does not have specific policies guiding health providers on best practices with imaging or the use of CAT scans.

“The hospital itself doesn’t provide policies or guidance on that,” Puleo said. Instead, hospital officials leave decisions up to the discretion of the individual doctors, she added.

On Monday, Concord Hospital officials said they could not comment on the medical care of a minor or the lawsuit, but still released a statement.

“All of us at Concord Hospital were saddened to learn of the tragic death of Molly Banzhoff,” the statement said. “Although we are unable to comment on pending litigation, our sincere thoughts and prayers are with Molly’s loved ones and friends, who we know miss her dearly.”

Other hospital data collected by the state of New Hampshire looks at specific events at each facility. That record of “adverse events” catalogues each episode resulting in harm to a patient after a mistake by health providers. The annual report counts falls, bedsores, foreign objects accidentally left in patients or surgeries being performed on the wrong person or the wrong body part.

Concord Hospital recorded three adverse events in 2015 – a noticeable drop from eight events in 2014. Over the two year period, Concord Hospital had the third most adverse events among New Hampshire hospitals.

Concord’s adverse events, also known as “never events” because they are never supposed to happen, included an error in the use of a medical device and two patient falls. In 2014, it reported one wrong surgical procedure, one foreign object left from a surgery, two falls and four instances involving patients with bedsores.

The state report does not track incidents involving mainline infections or surgical site infections, and some health officials in the state have criticized its reporting guidelines for having different definitions of what constitutes a serious event than the hospitals do.

Concord Hospital is the fifth-largest in the state when it comes to staffed beds, falling behind Saint Joseph Hospital in Nashua, Catholic Medical Center and Elliot Hospital in Manchester and Dartmouth-Hitchcock Medical Center in Lebanon.

The hospital is also financially stable for its size. Gross patient revenue for Concord Hospital was $1,122,175, according to the American Hospital Directory. That’s the second highest in the state behind Dartmouth-Hitchcock, which reported a $2,181,027 gross patient revenue.

When it came to patient satisfaction, the Medicare survey found Concord Hospital scored fairly high.

Eighty-one percent of patients reported their doctors “always” communicated well, while another 83 percent said nurses “always” communicated well. Eighty-one percent of patients gave the hospital a rating of nine or 10 on a zero to 10 scale.

(Ella Nilsen can be reached at 369-3322, enilsen@cmonitor.com or on Twitter @ella_nilsen.)




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