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Meriter failed to respond after first reports of abuse in NICU, according to report

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MADISON (WKOW) -- An investigation that began in February following injuries to children in UnityPoint Health-Meriter's neo-natal intensive care unit revealed abuse going back 11 months, according to a federal agency's report obtained today.

The Department of Health and Human Services Centers for Medicare and Medicaid Services notified Meriter on Feb. 23, 2018 that based on a survey by the Wisconsin Department of Health, Division of Quality Assurance, the hospital was not in compliance and risked termination from the Medicare program.

Meriter has since submitted a corrective plan of action that now must be approved in order to prevent termination.

According to the Centers for Medicare and Medicaid Services report, the facility failed to respond to allegations of abuse related to injuries of an unknown origin and protect five of six patients in the NICU going back to April 12, 2017.

Investigators say that on Feb. 2, 2018, a nurse identified bruising on the arm of a patient of an unknown origin according to the report.

The following day, a Saturday, a second patient was discovered with unexplained bruising. At the time, a nurse sent an email to a manager regarding concerns over the bruising of the two patients, and believed the concerns would be addressed the following Monday.

On Feb. 8, a physician recommended additional tests including a skeletal survey and head computed tomography which revealed recent skull fractures
and arm fractures, according to the report.

It was at that point the caregiver was suspended, according to the report.

About a week later, on Feb. 9, a physician recalled a third patient with unexplained bruising in the past. After a review of photographs of the injuries, Madison police were notified. 

A fourth patient was also identified Feb. 9.  Review of that patient's medical record on Feb. 19 revealed that on March 12, 2017, nurses observed bruising on the patients calves, ankles and left foot. Although the bruises were consistent with monitor cord size, no cords were observed in this location. X-rays were then ordered.

As part of the hospital investigation, a fifth patient's parents were notified. The patient had scattered bruising on lower extremities during the hospital stay on Jan. 20, 2018 that staff believed to be related to birth.

The parents informed hospital staff they were uncomfortable with suspected nurse who was the the primary caregiver on the night shift of Jan. 23-24, 2018.

Due to these concerns, a physician consulted a child abuse expert on Feb. 12, 2018 who recommended skeletal survey and CT.

The results revealed multiple fractures including rib and arm fractures.

Madison police announced Feb.9, 2018 the department's special victim's unit had begun its own investigation following a report of several unexplained injuries to babies at Meriter's NICU.

On Feb. 13, upon learning of the incident from the Madison Police Department, the Wisconsin Department of Safety and Professional Services began an inquiry to determine if the subject of the police investigation was a person that held a state license, according to another email.

Also, on Feb. 16, the Office of Caregiver Quality received a report containing an allegation of caregiver misconduct by a credentialed health care provider that also was forwarded to DSPS.

The employee has since been removed from the hospital during the investigation, according to Meriter spokesperson Leah Huibregtse. 

Among the provisions in the corrective plan of action submitted by Meriter, the hospital has initiated safety plan that will remain in place until at least all NICU providers and NICU staff, including volunteers, have received training, and video monitoring is installed and activated.

Also a security officer will be assigned to the NICU front entrance and rounding on the unit 24/7 until at least video monitoring cameras in NICU rooms are installed and activated.

"Our hospital has been and continues working cooperatively with local, state and federal agencies involved in the review of our NICU," Meriter wrote in a statement. "We have successfully worked with the Centers for Medicare and Medicaid Services to address their most immediate concerns, and we continue to work on a longer term corrective action plan for their review."

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