Bristol Hospital (Conn.) Fined for Unilateral Refusal

Connecticut state regulators have disciplined Bristol Hospital after inspections uncovered violations, including a casesin which a woman died after being taken off a ventilator when her advance request for ventilation was changed without any evidence that she agreed.

The Hartford Courant reports that "in a consent order with the state Department of Public Health signed Tuesday, the hospital agreed to pay a $4,000 fine and make changes in policies and staff training. The hospital did not admit any wrongdoing."

"The woman who suffered a heart attack and congestive heart failure completed an advance directive when she entered the intensive care unit, indicating that she wanted CPR and ventilation, but no tracheotomy.  When the woman's condition deteriorated, a doctor and the woman's health care agent changed her status to "comfort measures only."  Bristol Hospital's policy required informed consent from the patient in such a situation, but regulators found that medical records did not indicate that the woman was consulted, even though she was still alert.  The doctor told regulators that she spoke with the patient's health care agent, but could not recall whether she consulted the patient.  The woman was taken off the ventilator, and she died that night."