Dried blood, dust and grime found encrusted on 21 out of 25 dialysis stations at the Fresenius Kidney Care East Tucson dialysis clinic.
Improperly disinfected dialysis stations and catheter hubs, which provide access to a patient’s bloodstream, identified repeatedly at DaVita Desert Mountain Dialysis Center in Scottsdale.
Failure to follow a doctor’s treatment orders for two separate patients, leading to the potential for “increased mortality” at Fresenius Kidney Care Central Phoenix.
Since 2019, nearly three-quarters of Arizona’s 130 outpatient dialysis clinics were cited for lapses in protocols designed to keep patients safe, an AZCIR analysis of state inspection data shows. Some facilities are repeat offenders, with recurring infection control and safety violations dating back years.
Such deficiencies are concerning at dialysis clinics because treatment requires a port with direct access to a person’s bloodstream, making patients particularly vulnerable to life-threatening infections as they typically visit a clinic three times a week for four hours at a time.
End-stage renal disease, often the result of chronic kidney disease from diabetes, congenital kidney issues or hypertension, means a person’s kidneys no longer function well enough to filter waste and fluid from blood on their own. For these patients, treatment is a matter of life or death: A kidney transplant or ongoing dialysis treatment is needed for survival.
“Your life changes in a blink of an eye, and I think that can be really traumatic,” former dialysis patient Sachi Kuwahara said of transitioning to the treatment. This stress, she said, makes it hard for patients to proactively approach problems they may see at a clinic.
The Arizona Department of Health Services, the agency responsible for inspecting dialysis clinics, said it has done its part to consistently inspect and issue citations, at times levying fines up to $30,000 for repeat problems. But records obtained by AZCIR show that dialysis companies can negotiate those fines down by an order of magnitude, at times by hundreds of thousands of dollars.
Records also reveal that the size of the fine does not always match the severity of the citation. Fines of between $250 and $1,250 were levied against clinics in seven instances after “actual harm” to patients occurred.