Though Paradise Valley Hospital in National City closed its maternity ward in 2021, the facility recently received a $75,000 fine from the state for poor obstetric care that led to a baby’s death in 2016.
Why did it take the California Department of Public Health eight years to fine Paradise Valley? Stating that it understands “the gravity of this situation,” the state agency said in a short email Friday that the nearly decadelong delay was “due to operational challenges,” but did not specify the nature of those challenges.
While the short statement indicates that CDPH is “committed to timely resolution to all investigations and has implemented process changes to prevent further delays as experienced in this case,” patient safety experts said such a long gap between lapses in care and the issuance of a fine that is visible to the public deprived patients of important information that could have been used to help decide where they received care.
State investigations often start with a complaint from the public or with a hospital reporting a problem on their own. Investigators visit hospitals and interview those directly and indirectly involved with incidents then write reports and issue fines. The names of patients and caregivers involved are kept private.
According to a document published on the state’s licensure website on June 18, the fine pertains to “deficient practices” employed during the delivery of a baby on March 3, 2016. Delivered at 36 weeks gestation — about two weeks before the typical birth window of 38 to 40 weeks — investigators found that the hospital’s obstetrics team failed to continuously monitor and record labor contractions and the infant’s heart rate during labor and also “failed to provide a physician to oversee and monitor (the patient’s) labor and delivery as required by regulation.”
The result was an infant delivered with its umbilical cord wrapped around its body, according to the state’s assessment.
“These deficient practices delayed treatment interventions which affected the health and wellbeing of the fetus and resulted in the death of the fetus,” the document states.
Though the state received a complaint that same day, and its own documentation indicates that its investigators visited Paradise Valley to interview everyone involved on April 13, 2016, paperwork shows that the inquiry was not completed until July 17, 2023.
In an emailed statement, Paradise Valley said the 2016 incident did not cause it to stop offering labor and delivery services.
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“Our Maternity Services were discontinued in 2021, five years after the events mentioned in the CDPH survey had transpired and had nothing to do with what occurred in 2016,” the statement said. “We closed our Maternity Services department because it was no longer financially feasible for us to maintain it.
“At the time of the department closure, Paradise Valley Hospital had seen a downward trend in births during the previous 10 years and was averaging less than two births per day.”
Recently, Paradise Valley has celebrated a good run on patient safety scorecards from private arbiters such as The Leapfrog Group, a nonprofit quality hospital assessment organization, which has awarded the hospital A safety grades in 2021, 2022, 2023 and the first half of 2024.
The situation concerned Marian Hollingsworth, a San Diego-based patient advocate, because the public lost out on a chance to become informed.
“Women were having babies there, unaware of the death and investigation,” Hollingsworth said in an email.
Indeed, Paradise Valley did subsequently experience another run-in with a labor and delivery-related incident. On Nov. 8, 2021, a local couple sued the hospital, alleging that their baby boy died there on Aug. 30, 2020. Additional details were not available, as the case was settled out of civil court in 2023.
Marianne Johnson, the attorney who represented the family involved in the 2021 incident, said it involved a delayed cesarean section. Though she said she could not provide any additional details, she said her clients would have been interested in learning what they could about the incident in 2016 before deciding to deliver a baby there.
“They made a conscious decision, after doing some research, and chose Paradise Valley Hospital, so I think it would have mattered to them had they known that or been able to find out that the hospital they were considering has been penalized,” Johnson said.
