Telemetry: Patient Dies after Nurse Turns Off Alarms
February 1, 2014 | Healthcare Risk, Quality, & Safety Guidance
After being fired from his job in a hospital's telemetry unit, a nurse testified during a public unemployment benefits hearing that he turned off the alarms for a hospital patient who later died, saying that the alarms "were always going off, even if the patients weren't in distress." According to a news report of the hearing, a human resources specialist testified that at the time of the incident, the nurse had been on a "last chance agreement" with the facility for unspecified disciplinary issues.
An e-mail from the facility's respiratory therapist was submitted as evidence in the hearing, and it stated that the respiratory therapist and another colleague found the patient "unresponsive, ashen, pale, and cyanotic," so they called a "code blue," which is often used to inform healthcare workers that an adult patient is in cardiac or respiratory arrest. The respiratory therapist also stated that he later reviewed the patient monitors on the unit and noticed that all patient alarms for the unit were turned off for about three hours, during which time the patient's blood oxygen levels dropped slowly from a normal level to a "dangerously low" level for about 45 minutes before he was discovered. An e-mail from another nurse the day after the incident stated that "it was apparent that all...