LOS ANGELES (AP) — Eighteen hospitals in California were fined for state health code violations in which patients died from various mishaps such as an improperly inserted tube and a ventilator that wasn't turned on. Other violations include surgical tools left inside patients after surgery.

The fines made public Monday stem from investigations by the California Department of Public Health that found shoddy care had either killed or endangered the lives of several patients. The hospitals were each fined $25,000 — the latest of dozens of penalties the state has issued in recent years to more than 40 hospitals.

"The number of penalties will decrease and the quality of care will dramatically improve as hospitals take action to improve," said Kathleen Billingsley, director of the health department's Center for Healthcare Quality. "The entire intent of these fines is to improve the overall quality of care in California."