Update as of September 16
Today, regulators from the Centers for Medicare and Medicaid Services (CMS) validated the corrective measures implemented following the recent medication error at Ascension Saint Thomas Midtown, removing the Immediate Jeopardy (IJ) status. This confirmation ensures the hospitals remain active participants in the Medicare program, recognizes the corrective actions previously taken, and establishes an ongoing framework for demonstrating continued improvement in coordination with regulatory agencies.
We have engaged and continue to work with an independent quality consultant to guide and verify the full scope of our corrective actions and process enhancements.
At all times, our hospitals will remain open, operational, eligible for Medicare, and fully committed to serving the Middle Tennessee community.
We are grateful for our ongoing constructive collaboration with regulators, and we will continue to work with both the State of Tennessee regulators and CMS.
Our hearts remain with those impacted by this event, and we are committed to learning from this and upholding the standards of patient safety, quality, and compassionate care.
Update as of September 11
Our hearts remain with the four patients and families impacted by the recent medication error that occurred at Ascension Saint Thomas Midtown. For generations, Ascension Saint Thomas has served Middle Tennessee with compassionate, high-quality care. We are determined to demonstrate that commitment with further transparency and accountability.
We are actively engaged in ongoing, productive collaboration with state and federal regulatory agencies. We are currently refining our corrective action plans in full coordination with these agencies to ensure every requirement is met. In addition, we have proactively engaged an independent expert to review and guide our action plans, enhance our implementation and support our commitment to patient safety and quality initiatives in the hospital.
While we wish we could share more information at this time, it is important that we allow the regulatory process to proceed without speculation or commentary. We appreciate your patience as this process unfolds. Our hospital remains open, fully operational, and eligible for Medicare reimbursement.
We extend our sincere gratitude to our physicians and staff, whose dedication to patient safety remains unwavering. We will emerge from this experience stronger as an organization and we remain resolute in our mission of serving communities with integrity, accountability, and reliability.
Update as of September 9
Recent news coverage regarding Ascension Saint Thomas Midtown and West has generated understandable concern across the communities we serve. Ascension Saint Thomas Hospital Midtown and West are vital to this community and will remain open and operational.
Our heritage in Middle Tennessee spans more than 125 years, and our commitment to serving our community remains firm. We want to share the following facts regarding our operations, our regulatory work and our path forward:
- Our emergency departments, operating rooms, outpatient clinics, transfer centers and procedural areas are open and delivering care. Our patient volume across both campuses reflects the continued trust doctors and patients place in our clinicians and care teams every day.
- We self-reported the medication error that occurred last month and acknowledged our mistakes directly to the impacted patients and their families. We have implemented rigorous clinical safeguards and updated protocols across our pharmacy and surgical services — patient safety remains our highest priority.
- We are actively engaged in ongoing, structured collaboration with state and federal regulatory agencies. Administrative notifications and review cycles are standard components of the oversight process following a significant event. We are refining our corrective action plans in full coordination with these agencies to ensure every requirement is met.
Ascension Saint Thomas provides vital tertiary, medical, surgical, cardiovascular and maternal services that Middle Tennesseans rely on every day. Midtown and West are indispensable hospitals serving our community, and we remain fully dedicated to preserving access to high-quality care across Middle Tennessee.
Update as of August 27
Ascension Saint Thomas has received the survey report from Centers for Medicare and Medicaid Services (CMS) stemming from the recent event in the pharmacy at Ascension Saint Thomas Midtown. We have seen some inaccurate interpretations of this report in the media. For clarification, there were seven patients on the joint replacement surgical schedule on August 14. As we previously shared, four of those patients received the incorrect medication. Our support for those patients and their families remains unwavering.
Providing safe, high-quality, patient-centered care is at the core of our mission, and any gap in meeting that standard receives our immediate, uncompromising attention. Upon identifying the medication error on August 14, hospital leadership self-reported the event to regulators and implemented several changes to our pharmacy processes and safety protocols. We take the survey findings extremely seriously and are continuing to cooperate with state and federal surveyors to ensure a safe environment for our patients. We remain committed to upholding safety standards for every person who trusts us with their care.
Update as of August 21
Our hearts remain entirely with the four patients and families impacted by the recent event at Ascension Saint Thomas Hospital Midtown. On behalf of our leadership and care teams, we extend our deepest apologies for the harm caused. Our clinical teams continue to provide dedicated care to these four individuals, and we are offering our full support and spiritual care resources to their loved ones.
To provide additional information regarding this event, on Friday, August 14, an isolated medication error occurred in our pharmacy impacting four joint replacement patients at our Midtown campus. The patients mistakenly received potassium phosphate, instead of the intended anesthetic medication, mepivacaine. The four patients experienced adverse health reactions and received immediate medical care. A comprehensive review confirmed that no other patients were affected.
Upon identifying the error on August 14, hospital leadership self-reported the event to state regulators. We have since implemented several changes to our pharmacy processes and safety protocols targeted at preventing this error.
Specifically, Midtown has implemented additional physical, technological, and clinical safeguards. The following changes are designed to address medication risks and uphold the standards of safety for our patients and teams:
- Isolated Medication Storage: High-alert medications, including mepivacaine, are stored in separate, distinctly marked locations to eliminate selection errors.
- Mandatory Hard-Stop & Escalation: Implement process to stop and resolve, through independent verification, for any spinal medication scan alert.
- Independent Dual Verification: Spinal medicine workflows now require a second trained pharmacist to perform final visual and physical checks.
Following our self-report, Ascension Saint Thomas continues to collaborate with state and federal officials to ensure a safe environment for our patients. Additionally, we have engaged independent, third-party quality experts to review and validate our mitigation plans.
Providing safe, high-quality, patient-centered care is at the core of our mission. Any gap in meeting that standard receives our immediate, uncompromising attention. We remain steadfastly committed to supporting those affected and upholding safety standards for every person who trusts us with their care.
Frequently Asked Questions
What happened?
On Friday, August 14, an isolated medication error occurred in our pharmacy impacting four joint replacement patients at our Midtown campus. The patients mistakenly received potassium phosphate, instead of the intended anesthetic medication, mepivacaine.
When was this discovered?
The error was identified on Friday, August 14, and immediately self-reported to state regulators.
Did this impact any other patients?
Four joint replacement patients at the Midtown campus were impacted. A comprehensive review confirmed that no other patients were affected.
Did this impact any other service lines?
This was an isolated medication error limited to four joint replacement patients at our Midtown campus.
Was this reported to regulators?
Yes. Upon identifying the error on August 14, hospital leadership self-reported the event to state regulators. Ascension Saint Thomas continues to collaborate with state and federal officials to ensure a safe environment for our patients.
What steps have been taken to prevent this from happening again?
Midtown has implemented additional physical, technological, and clinical safeguards, including:
- Isolated Medication Storage: High-alert medications, including mepivacaine, are stored in separate, distinctly marked locations to eliminate selection errors.
- Mandatory Hard-Stop & Escalation: A process has been implemented to stop and resolve, through independent verification, any spinal medication scan alert.
- Independent Dual Verification: Spinal medicine workflows now require a second trained pharmacist to perform final visual and physical checks.
Additional corrective plans have been submitted for CMS approval.
How are you supporting the impacted patients?
Our teams continue to support these four individuals. We are also offering our support and spiritual care resources to their loved ones.
Are any Ascension Saint Thomas hospitals closing?
No. Our hospitals remain open, fully operational, and eligible for Medicare reimbursement.
I am scheduled to have surgery at Midtown/West, are surgeries continuing to be performed?
Yes, our hospitals remain open and fully operational. We are continuing to schedule surgeries and procedures for all services.
If I have an upcoming elective procedure, can I reschedule or move it to another campus?
Any questions related to upcoming procedures should be addressed directly with your physician who will be able to discuss all available options for you.
What have you been doing to address safety concerns since the incident?
We are actively engaged in ongoing, productive collaboration with state and federal regulatory agencies.
We are currently refining our corrective action plans in full coordination with these agencies to ensure every requirement is met.
In addition, we have proactively engaged an independent expert to review and guide our action plans, enhance our implementation and support our commitment to patient safety and quality initiatives in the hospital.
Are you still delivering babies at Midtown/West?
Yes. Our hospitals remain open and fully operational.
Is the medication used for an epidural in childbirth the same medication that was involved in the medication error?
No.
What is the status of the deadline from CMS regarding potential termination from the Medicare program?
Ascension Saint Thomas and CMS are fully committed and actively working together to ensure the hospital remains in full compliance and in the Medicare program. CMS has given their assurance that Medicare patients need not disrupt their care, as Ascension Saint Thomas will not be terminated from the Medicare Program on September 18, 2026.
If I am a Medicare patient, should I reschedule my appointment?
No. Patients should keep their scheduled appointments and continue seeking care as planned. Ascension Saint Thomas remains open and fully committed to caring for all of our patients, including Medicare beneficiaries. Any specific questions related to upcoming procedures should be addressed directly with your physician.
Will Medicare continue to cover services, procedures, or surgeries scheduled after September 18?
Yes. Ascension Saint Thomas hospitals remain open, fully operational, and eligible for Medicare reimbursement. Based on discussions with CMS, patients receiving care or scheduling procedures after September 18 can expect their Medicare coverage to apply as standard.
Are emergency services, outpatient clinics, or hospital operations affected during this process?
No. All emergency departments, outpatient clinics, surgical, and procedural areas remain open and actively delivering care.
What steps is Ascension Saint Thomas taking to ensure full compliance and patient safety?
Ascension Saint Thomas is collaborating directly with state and federal regulatory agencies to refine corrective action plans. Additionally, an independent expert has been engaged to review action plans, guide implementation, and support ongoing quality and safety initiatives.