Massachusetts hospital halts heart surgeries due to deaths

  1. High rate cited at Worcester facility

    UMass Memorial Medical Center abruptly stopped doing open heart surgeries this week because an unusually high percentage of cardiac patients have died after bypass operations since 2003.
    Doctors at the hospital in Worcester have known for two years about problems in the heart surgery program, including, at one time, a high infection rate. But they did not alert patients or the public or suspend operations until afterstate public health officials presented them with a detailed analysis last week showing that the hospital's death rate for coronary artery bypasssurgery patients was nearlytwice the average for Massachusetts hospitals.

    The hospital says that from 2003 through this August, 38 patients have died within a month of undergoing the surgery, out of 917 such operations.

    UMass canceled about 10 surgeries scheduled for this week, following a telephone call last Friday during which the hospital and state health officials agreed that the program should be suspended. UMass surgeons will still be able to perform bypass operations on emergency patients who cannot wait.

    Full Story: http://www.boston.com/yourlife/healt...due_to_deaths/
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  2. 10 Comments

  3. by   sirI
    Quote from brian
    High rate cited at Worcester facility


    UMass Memorial Medical Center abruptly stopped doing open heart surgeries this week because an unusually high percentage of cardiac patients have died after bypass operations since 2003.



    Doctors at the hospital in Worcester have known for two years about problems in the heart surgery program, including, at one time, a high infection rate. But they did not alert patients or the public or suspend operations until afterstate public health officials presented them with a detailed analysis last week showing that the hospital's death rate for coronary artery bypasssurgery patients was nearlytwice the average for Massachusetts hospitals.

    The hospital says that from 2003 through this August, 38 patients have died within a month of undergoing the surgery, out of 917 such operations.

    UMass canceled about 10 surgeries scheduled for this week, following a telephone call last Friday during which the hospital and state health officials agreed that the program should be suspended. UMass surgeons will still be able to perform bypass operations on emergency patients who cannot wait.

    Full Story: http://www.boston.com/yourlife/healt...due_to_deaths/
    I, too, would question whether lower socio-economic factors came into play.
  4. by   tvccrn
    It didn't say what the casue was for most of the deaths, but the 6.4% infection rate makes me wonder if it's not an infection control problem as opposed to a socio-economic problem. If the investigation shows that ecomonic statu has a lot to do with it, I would have to question whether the hospital treats patients differently based on that status.

    I know the points of discussion in this would focus on the ability to afford follow-up care and meds, but I think a month post-op is a fairly rapid dowhill slide.
  5. by   BabyRN2Be
    I was thinking along the lines of an infection control problem, too. Maybe their infection control policies need to be examined and revamped if necessary.
  6. by   rmicu
    I hope the economic status did not play a part. This high death rate may be due to combination of infection control and high nurseatient ratios, esp post-op. A very "rich" hospital in my area had a similar problem that was traced to poor post-op care, i.e. too many pts assigned to too few nurses resulting in inadequate monitoring of early s/sx of infection, attendings not responding to pages by residents and nurses on nights. Incidentally, these problems were brought to light when a well-known pt died 1- 2 days after a successful surgery.
  7. by   Marie_LPN, RN
    I'm wondering about the instruments used during the case (especially after hearing about cases of hydraulic fluid getting mixed up with teh cleaning fluid.)
  8. by   URO-RN
    2 or 3 months ago, we had pts post-op either c/o eye irritation and some with scratched corneas. We doc all of this and the md's were informed. What came out of it I don't know, but we have not had a pt.c/o eye problems for awhile.
  9. by   gutym
    Why suppose when only an open mind will find the truth. We have the ability to make numbers fit, but this will only make things worse. Just maybe the criteria at this institution was lowered taking more acute patients that other area hospitals may not take.......some one may be willing to take more risks. Infections should be dealt with in a timely fashion and data would support this...and in order to solve this all must be open. Good Luck, U of Mass Memorial
  10. by   KMSRN
    Quote from brian
    High rate cited at Worcester facility

    UMass Memorial Medical Center abruptly stopped doing open heart surgeries this week because an unusually high percentage of cardiac patients have died after bypass operations since 2003.
    Doctors at the hospital in Worcester have known for two years about problems in the heart surgery program, including, at one time, a high infection rate. But they did not alert patients or the public or suspend operations until afterstate public health officials presented them with a detailed analysis last week showing that the hospital's death rate for coronary artery bypasssurgery patients was nearlytwice the average for Massachusetts hospitals.

    The hospital says that from 2003 through this August, 38 patients have died within a month of undergoing the surgery, out of 917 such operations.

    UMass canceled about 10 surgeries scheduled for this week, following a telephone call last Friday during which the hospital and state health officials agreed that the program should be suspended. UMass surgeons will still be able to perform bypass operations on emergency patients who cannot wait.

    Full Story: http://www.boston.com/yourlife/healt...due_to_deaths/
    Here is a recent occurance in Fredericksburg,VA. In this case the surgeon stopped the program and reported it after 3 suspicious post-surgical infections. They found the problem to be a fluid used during open heart surgery called cardioplegia - from a pharmacy in Maryland. It has gram negative rods. Surgery has resumed at MWH.

    http://fredericksburg.com/News/FLS/2...9142005/129603
    http://fredericksburg.com/News/FLS/2...9232005/131894
  11. by   bluesky
    Quote from siri
    I, too, would question whether lower socio-economic factors came into play.
    Wouldn't all hospitals which serve "lower socioeconomic status" patients suffer from the same statistics, then?
    Last edit by bluesky on Sep 29, '05
  12. by   TechieNurse
    Hi All
    While I don't work at this facility, I am deeply involved in the Mass. State Cardiac Surgery program.

    While I believe it's the Dept. of Public Health's responsibility to alert any hospital when an issue is identified, I'm appalled that only bits of information are being made public and that the DPH is publicly commenting on this situation without all the facts being made clear

    While 38 deaths within 1 month of surgery sounds like a lot, statistically, that's about 4%. For 2002, the rate in Mass. was about 2.19%.
    But this article is citing data from 2003-2005? Has the rate remained the same? What is the confidence interval? Was this hospital truly out of the acceptable range (e.g. an 'outlier') or were they just higher than everyone else?

    What you may not know is that the data is collected and risk adjusted using the Society of Thoracic Surgeons Data Collection Form. This tool is very dependant on manual review/capture/documentation of pre-op conditions to determine the risk for post op complications. It the Data Manager did not do a good job obtaining this information, this could give a higher than expected percentage of deaths.

    This whole thing could be the result of someone, either not documenting preop. conditions well enough, or the Data Manager not capturing/reporting the information acurately.

    I believe that the hospital should have been analyzing their own data over the last 4 years. I believe that the state Dept. of Public Health should have been working with this hospital over the last 3 years to determine if this was a documentation issue or something else.
    This suspension of surgery shouldn't have been a surprise to the hospital. They should have known that there was a problem.
    However, I'm unhappy with the sensationalizm in the press (what else is new?) and the lack of complete information being given to the public.

    As a footnote, I am familiar with this facility. It is a level 3 trauma center and (usually) delivers top notch health care. Their cardiac surgery program, for reasons unknown to me, had a large exodus of cardiac surgeons in 2002 which may have impacted their delivery of care.

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