A Fayetteville hospital has been granted a last-minute reprieve by federal regulators, who were set to cut off funding after two patient deaths.
Officials at the Centers for Medicare and Medicaid Services informed administrators at Cape Fear Valley Medical Center on Jan. 3 that federal support would be terminated at midnight Thursday. It came because of violations found after a mentally ill man restrained in the emergency room was strangled and a cancer patient died on his way home after being discharged against his will.
CMS officials in Atlanta accepted documentation Thursday indicating numerous improvements had been made at the hospital after a string of negative reports beginning in October. Cape Fear Valley administrators have also hired an outside consulting firm to help it complete the federal review process in close consultation with federal regulators.
"We welcome this opportunity to work in partnership with CMS," said Michael Nagowski, the chief executive officer of Cape Fear Valley. "We expect this collaboration with CMS will further enhance our operations and quality."
Cape Fear Valley is the sixth largest hospital in North Carolina. It receives $23 million a month in federal insurance reimbursements.
Andre LeMar Walker, 27, who had schizophrenia, was brought into the hospital about 4 p.m. April 17, saying that he heard voices.
Within hours, Walker was dead, strangled as he was restrained by hospital police officers in a psychiatric unit known as the "red zone."
Fayetteville police detectives opened a homicide investigation after the medical examiner sent them his report. Hospital administrators said they had seen no need to report Walker's death to law enforcement.
Security video shows Walker pacing in a corridor. About 7 p.m., records show, a staff psychiatrist interviewed him and prescribed him drugs intended to calm his nerves. Though Walker came to the hospital voluntarily, records show the doctor also initiated legal paperwork to commit him against his will.
Over the next two hours, video footage and medical records show Walker grew more and more anxious. He repeatedly asked for his mother and said he wanted to go home.
Shortly after 9 p.m., two armed hospital police officers entered the darkened room where Walker was waiting and switched on the lights. They were accompanied by two security officers and a nurse.
Walker threw water at the police officers and tried to leave.
The nurse turned her back and walked away as one of the police officers grabbed Walker and wrapped his arm around Walker's neck, according to a medical examiner's report. The four uniformed men then tackled Walker and pinned him to the ground.
After about three minutes Walker stopped moving. The officers lifted his body onto the bed and secured his arms and legs with wide leather straps.
An additional three minutes passed before anyone began measures to save Walker's life, according to his medical records. He was declared dead at 10:11 p.m.
As required when someone dies while in restraints or in the custody of law enforcement officers, Walker's body was sent to the N.C. Office of the Medical Examiner in Chapel Hill. Rogers, the family's lawyer, said he provided the security camera video to the medical examiner.
After reviewing the footage and finding physical evidence that included hemorrhages in the tongue and larynx, the medical examiner ruled Sept. 6 that Walker died of asphyxiation caused by restraint.
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