Staff at an HCA hospital, Bayonet Hospital in Florida, say cost cutting and hiring less talented contract workers has created unsafe working conditions and accelerated existing patient safety incidents that pose risks of death.

Unsanitary surgical instruments, inadequate ICU monitoring and an overcrowded emergency department were named as issues by four hospital doctors who spoke to NBC News. Three requested anonymity out of fear that HCA would retaliate.

Anesthesiology errors were also a problem, with one patient even waking up during brain surgery and trying to get off the table while their head rested on sharp support pins.

“Those pins were about two centimeters away from the eye. So, you can imagine that could have been tragic,” said neurosurgeon Dr. George Giannakopoulos, 65, who served as the hospital’s chief of staff for eight years.

Years of complaints
In 2021, surveys by Florida’s Agency for Health Care Administration (AHCA) uncovered several issues at Bayonet Point, including poor nurse-to-patient ratios and failure to enforce an ED policy to keep patients safe. State regulators had voiced concerns at least twice over the past two years, and none of HCA Florida hospitals have a five-star rating on the CMS quality comparison website, with 70% rated below average.

The hospital has an A rating with the Leapfrog Group for patient safety, but the organization says this does not mean it's perfectly safe, just safer than hospitals with a B rating and below.

Giannakopoulos says there were 18 “near misses” among surgery patients in January 2022 alone, with one patient anesthetized on the wrong hip. Additionally, staffers were found to be “answering phones, transferring calls, taking written messages, and being distracted by other tasks” instead of watching ICU monitors, reported NBC News. One patient even died from a ruptured aneurysm. “Nobody had seen the patient from 7 p.m. to 7 a.m.," said Giannakopoulos.

The hospital recently announced it was opening an $85 million tower with 102 additional beds. But doctors said this was an excuse not to repair broken equipment in the existing building, with photos revealing ceiling leaks in a recovery ward, tape holding together oxygen equipment, bloody and backed-up sinks, dangling wires from a hole in the wall, and cockroaches in the operating room.

AHCA told the hospital it risked losing Medicare and Medicaid reimbursements with these deficiencies. A hospital spokeswoman told NBC News that it resolved them and that it was in "good standing" with AHCA and all regulatory and accrediting bodies.

Problems continue
The contract employees were affiliated with HCA’s Physician Services Group, an in-house staffing unit, and were brought on in 2021 after the hospital cut its anesthesiology staff from 15 providers to one. They were less talented and dedicated, said staff, and their arrival was when “terrifying” errors began, said Giannakopoulos.

Following a meeting in December 2021 with a hospital administration official, staff were told that their concerns would be addressed, but little changed, said Giannakopoulos. In fact, he said speaking out led the hospital to reject his reelection as chief of staff for two more years, despite staff supporting the measure.

Dr. Christine Behan, a family medicine physician and contract employee of the hospital, who chairs its board, said Giannakopoulos repeatedly made threats and yelled at and berated staff, doctors and administrators, and that this was the reason for the hospital's decision.

“All those charges were manufactured by the hospital administration to keep me from being chief of staff because I was calling them out on patient care,” said Giannakopoulos.