KMAX: News of the West

Two patients die after nurses aren't alerted

LOS ANGELES (AP) Two patients at Martin Luther King Jr./Drew Medical Center died after audio alarms on new machines monitoring their vital signs did not alert nurses that they needed help, and they were discovered too late to be revived.

The first patient, a 33-year-old woman, died June 30, a week after the public hospital installed the monitoring system, the device's manufacturer and Los Angeles County officials said Thursday. A 52-year-old woman died two weeks later, on July 15.

State health officials began investigating the deaths after they were notified by the hospital.

After the second death, Welch Allyn Inc., the manufacturer, found damage to the central monitoring unit that could have caused its speakers to malfunction, company officials said Thursday. The company found that the first patient had been tracked by the wrong monitor, which might have confused nurses.

The damaged unit was replaced, and the system remains in use at the hospital. The nurses were retrained and there have been no reported problems since, Welch Allyn officials said.

Welch Allyn reported the deaths to the FDA, which tracks the performance of medical devices. Still, the company said it was not sure a malfunction contributed to the deaths.

Welch Allyn spokesman Tom McCall said other signals, including visual alerts on monitor screens and bedside audio alarms, were working and should have signaled a problem.

The system tracks the blood pressures, heart rates, oxygen levels and temperatures of 60 patients from a computer at a nurses' station. Visual and audio alarms are supposed to alert nurses when wireless bedside monitors in the patients' rooms detect problems.

John Wallace, a spokesman for the Los Angeles County Department of Health Services, said the agency was also investigating the deaths at the county-run facility.

Wallace said King/Drew was still using the monitors because they were approved by the Food and Drug Administration and ``are actually superior devices to what we had'' before. He said the county asked for the additional training and replacement equipment.

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