Planned Parenthood – Indianapolis

• The facility failed to ensure that all contracted services were provided in a safely and effectively. This included 71 services that are provided by contractors.
• There was a report of concern with a medical waste disposal service but no report of corrective action or resolution. The clinic is required to have a quality assessment and improvement program in place for oversight but it is obviously not working
• The facility failed to maintain a list along with the scope and nature of the service provided of all contracted vendors (over 50% were not maintained)
• Medical records were incomplete.
  • “abortion provided under ultrasound – yes/no” was not documented
  • no discharge order in patient’s chart
  • physician did not sign off on the history or abortion sections of the patients charts
  • patients received IV sedation yet the section of the charts – “airway adequate – no/yes” –  left unmarked
  • products of conception tissue exam not completed on patients
  • abortion history section “drug/alcohol use in the last 24 hours” was not documented
  • sedation management not completed “vital signs stable throughout procedure ” and “ready for discharge” left unmarked
  • start and stop time of the procedure not documented
  • Patients did not receive a history and physical before their abortion procedure
• Staff did not have CPR certification
• Vital signs were not recorded in recovery for patients who had received sedation
• A patient’s oxygen saturation dropped to 76% during procedure yet she was not given oxygen. There was no documentation in her medical record of intervention.
• Counseling was not completed per policy on 100% of patients regarding RH negative (Rhogam injection needed) and post procedure hygiene.
• There is no infection control committee or current policy and procedures in place.
• Failed to follow the procedure in place for anesthesia administration
• In 17 of 18 charts reviewed, the physician overdosed the patients on Fentanyl. Maximum does is 1 mcg/kg. All patients were given 100 mcg but weighed under 100 kg.
• There was no documentation of an annual clinic safety inspection
• The clinic administrator did not attend any of the governing body committee meetings for the year 2016
• In reviewing the credentials of one physician, there was no documentation indicating the physician’s competence and judgement
• There is no policy to report medication errors and adverse reactions to the physician responsible for the patient
• Narcotics and other medications were available to unauthorized staff. Drugs were not kept safe and locked.

2018-2019

• The state license was not visibly posted
• Patients’ Medical Records did not contain proper informed consent records
• The clinic management failed to conduct annual evaluation of some employees
• Repeat violation: Staff was not CPR certified
• Quality Control Procedures were not followed to ensure ultrasound equipment was being disinfected properly
•  There were discrepancies on the narcotics log
• An unsecured oxygen tank was stored in the hallway next to a crash cart, creating a potential hazard
• Repeat violation: The Infection Control Committee did not hold quarterly meetings
• The clinic staff did not change disinfection solution after the manufacturer’s recommended time
• The management failed to have a written fire control plan and conduct fire drills