POWAY -- The state has fined Pomerado Hospital $25,000 for a "preventable mistake" that allowed three of the hospital's patients to regain at least partial consciousness while undergoing surgery.

The local hospital is one of 18 on a list of medical facilities hit with fines by the California Department of Public Health. The agency released the list Friday and posted it on the department's Web site Monday.

Department of Public Health spokeswoman Suanne Buggy said Monday that the fines were levied after department investigators confirmed reports of "immediate jeopardy incidents," or those that cause or could cause serious injury or death.

The patients involved in the Pomerado Hospital incidents -- which occurred after the hospital's staff used a faulty anesthesia machine -- did not die. They were not identified.

Buggy said the agency considers any immediate jeopardy incident to be a "very, very serious" matter.

"When that happens, it is incumbent on the facility to fix the problem immediately," she said. "And we work with the hospital to make sure that, whatever it was, was resolved."

Palomar Pomerado Health, a public health care district, owns and operates Pomerado Hospital.

Opal Reinbold, chief quality officer for the district, said hospital officials notified the Department of Public Health after the three patients reported "surgical awareness," including feeling pain, after leaving the hospital's operating room March 31.

The first patient involved did not immediately say anything about the problem, Reinbold said, so the hospital's staff continued to use the anesthesia machine without realizing there was a problem. By the time the second patient regained enough consciousness to report surgical awareness, the third patient's surgery had been completed, she said.

"There was absolutely no indication that this was occurring during the surgery," Reinbold said. "When we knew that we had an issue, we took that anesthesia machine down and we locked it in the administrator's office so there was no chance that anybody could get to it (or) use it."

The hospital replaced all of the machine's parts before it was used again, she said. Pomerado Hospital also provided the three patients and their families with whatever support they asked for, including social workers and psychiatrists, Reinbold said.

"Our major concern, always, when something unusual occurs always is the patient and their family," she said. "It truly is. There's nothing else that I could emphasize more."

The state began fining hospitals for immediate jeopardy incidents after a law authorizing the Department of Public Health to do so took effect Jan. 1, 2007. Buggy said she believed this was the first time Pomerado Hospital faced such a penalty.

Three other San Diego-area hospitals -- Scripps Green Hospital in La Jolla, San Diego-based Promise Hospital (previously known as Villa View Community Hospital) and Sharp Grossmont Hospital in La Mesa -- also are on the latest list of facilities fined for immediate jeopardy incidents.

Visit cdph.ca.gov for information.

Contact staff writer Andrea Moss at (760) 739-6654 or amoss@nctimes.com.