State Health Department Sanctions Choices Women's Med Center
Part of Ongoing Statewide Clinic Surveillance Initiative
Albany, February 3–The State Health Department today ordered Choices Women's Medical Center in Long Island City to immediately cease all operating room procedures until serious violations posing a risk to vulnerable women's health are corrected and corrective action is verified.
"This investigation is part of an ongoing surveillance initiative to ensure New Yorkers receiving health care in all types of clinics are receiving the highest quality care. High quality health care is a right and one I intend to protect for all of our citizens. People using clinics for services ranging from childhood vaccinations to routine medical care need to know that these facilities in their communities are safe and top notch," State Health Commissioner Antonia C. Novello, M.D., M.P.H. said.
In an 11 page Statement of Deficiencies (SOD), the State Health Department detailed numerous violations by Choices Women's Medical Center of Part 750 and other applicable sections of Title 10 of New York's Consolidated Rules and Regulations. A letter accompanying the SOD described the combined deficiencies as representing "serious systemic problems that pose a significant risk to welfare and safety of patients," and "an intolerable situation that cannot continue to exist."
Following are among the deficiencies identified as a result of the State Health Department investigation:
- A review of Operating Room logs revealed that procedures are performed every five minutes. The schedule does not allow adequate time to assess patients prior to surgery, to monitor patients or to clean and prepare the room for the next patient.
- Surgical equipment is not properly maintained; OR tables are old and unable to be positioned adequately. There is only one defibrillator on the premises for use in four operating rooms and a recovery room.
- The clinic has no functioning equipment to monitor patients under general anesthesia for whom endotracheal tubing is required.
- There is no effective infection control program within the facility.
- Nurse staffing is inadequate–during an on–site inspection only one R.N. and two nursing assistants were available to care for 22 post–surgical patients.
- Physician credentialing and Quality Assurance are ineffective. Problems are not being identified nor corrected.
- A physician on the facility's staff has a positive PPD (Tuberculosis screening) test; however there was no appropriate clinical follow up.
- Despite a letter on November 4, 1999 from Dr. Allan Zarkin's psychiatrist notifying Choices that Dr. Zarkin suffers from a brain disorder that could compromise his clinical judgment and performance, no supervisory measures were initiated.
- Dr. Zarkin was allowed to perform laparoscopic surgery at Choices, although he was not credentialed to do so.
Although the facility reported adverse incidents, as is required by law, the incidents either were inadequately described or not described at all.
Some of the violations were cited in the wake of the Department's separate probe of Dr. Zarkin, the former Medical Director for Choices Women's Medical Center. Dr. Zarkin today surrendered his license to practice medicine as a result of disciplinary proceedings by the State Health Department's Office of Professional Medical Conduct. Among other charges, Dr. Zarkin admitted carving his initial's into a patient during a surgical procedure. The incident occurred at Beth Israel Medical Center shortly before Dr. Zarkin was hired by the Choices clinic as its Medical Director.
The Department will pursue fines of $2000 for each of the deficiencies cited, the maximum allowed by law.
Before issuing the order to cease performing operating room procedures, State Health officials contacted all other providers of women's reproductive health services in the region to ensure that they will be able to accept patients who normally would receive reproductive health services at Choices. The Department also is working with women's reproductive health advocates to identify alternative, high quality health care for all patients who need it.
Health officials stress that the situation is not permanent and that Department staff will provide whatever assistance is necessary to Choices Women's Medical Center to ensure a timely resumption of full services once the identified problems are corrected and there is evidence that corrective action will be maintained.