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Feds to investigate hospital alleged to have kept vegetative patient alive to game transplant survival rates

Hospital Safety Insider, October 10, 2019

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This story was first published on Tuesday, October 9, 2019 in ProPublica

By Caroline Chen

The federal agency that oversees transplant programs said it would investigate Newark Beth Israel Medical Center after ProPublica reported that the hospital was keeping a vegetative patient on life support for the sake of boosting its survival rate.

The U.S. Centers for Medicare and Medicaid Services "takes allegations of abuse and mistreatment seriously," spokeswoman Maria LoPiccolo said in an email on Monday. "CMS is actively monitoring the situation and is in close communication with" New Jersey's Department of Health, she added. The department said Friday that it was reviewing the allegations.

CMS works with state health departments to review transplant programs and determine if they are eligible for Medicare reimbursement.

ProPublica's investigation found that Newark Beth Israel's transplant team was worried about the possibility of being disciplined by CMS after six out of 38 patients who received heart transplants in 2018 died before their one-year anniversary. That translated to an 84.2% survival rate, considerably worse than the 91.5% national probability of surviving a year for heart transplant patients, according to the Scientific Registry of Transplant Recipients, which tracks and analyzes outcomes for the government.

The team appeared to tailor medical decisions for at least four patients because of these concerns. In the case of Darryl Young, a heart transplant recipient, members of the medical staff didn't offer options like hospice care to his family because they wanted to make sure Young lived at least a year after his surgery, according to current and former employees familiar with his care.

In an audio recording obtained by ProPublica, Dr. Mark Zucker, the director of the heart and lung transplant programs, told the team at an April meeting, "I'm not sure that this is ethical, moral or right," but it's "for the global good of the future transplant recipients."In response to the concerns raised by the article, Newark Beth Israel said that it would conduct an "evaluation and review of the program, its processes and its leadership." It later added that it had hired an outside consultant to perform the review.

Dr. Herb Conaway, a New Jersey assemblyman and chair of the Legislature's Health and Senior Services Committee, called for the transplant team's actions to be reviewed. "The implicated doctors must face consequences if the allegations are indeed accurate," he said in a statement on Friday. "Their actions are a stain on the entire medical community, and they must be held accountable for what they have done to both this patient and his family."

The editorial board of The Star-Ledger in Newark, which co-published the ProPublica investigation, urged prompt scrutiny of the hospital. "This is astoundingly unethical, and if true, should prompt firings of those involved and a federal and state review," the board wrote. "The Attorney General's Office should look into it, too, in case there's something criminal here."

ProPublica is an independent, non-profit newsroom that produces investigative journalism in the public interest.

The Attorney General's Office and the New Jersey Board of Medical Examiners would not confirm or deny the existence of investigations, a spokeswoman said.

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