An intoxicated 12-year-old girl tried to strangle herself with a call-light cord and shoe laces after being left alone last month at a hospital on the Rosebud Sioux reservation. A mentally disturbed 35-year-old man died of cardiac arrest the next day at the same hospital after being restrained by medical staff, who didn’t follow proper procedures.
These incidents, cited in a federal report released Friday, were among the reasons that regulators are threatening to withdraw critical funding from the South Dakota facility, operated by the U.S. Indian Health Service.
The proposed sanctions are the latest blow for the beleaguered agency, which has faced criticism from regulators, members of Congress and tribal leaders over the poor performance of its network of hospitals and clinics, particularly those in a swath of the rural Midwest.
The Wall Street Journal reported last year that conditions at several IHS hospitals, including Rosebud, had worsened, leading to unnecessary patient deaths and repeated federal sanctions.
IHS, which serves about 2.2 million Native Americans, has until Aug. 30 to fix the latest deficiencies at the Rosebud hospital or it will be barred from billing Medicare, the federal health insurance program.
In a statement, the agency said it has made “measurable improvements” and presented a plan to regulators to remedy the problems.
The report said medical staff in both cases it cited failed to follow proper procedures. The 12-year-old girl, who had been asking to see her dead father and was despondent, was left alone for 20 minutes in a closed room before nurses found her with the shoe string and cord around her neck, “with her head through the side rails and legs thrown over the other side rails,” regulators said.
Medical staff failed to follow proper restraint and emergency procedures when dealing with the disturbed man who was high on methamphetamine, regulators said.
One nurse interviewed by regulators said medical staff members never properly alerted other staff that they needed assistance when the man was in distress “because on Saturday not a lot of people are around, who could come and help.”
IHS said it doesn’t comment on specific cases due to medical privacy laws.
Last year, inspectors cited ongoing failures at the Rosebud hospital for at least the third time in a row. And in 2015 and 2016, the agency closed Rosebud’s emergency room for seven months amid the continued problems, citing staffing changes and limited resources.
In addition to its regulatory problems, the IHS has also been without permanent leadership. In February, President Trump’s nominee to lead the agency, Robert Weaver, withdrew from consideration after the Journal published stories in which former colleagues alleged he had in some cases exaggerated his work experience and left a former employer in financial disarray. Mr. Weaver denied the allegations.