The U.S. Centers for Medicare and Medicaid Services is investigating a New Jersey hospital after an investigative article from ProPublica, an independent, non-profit newsroom that produces investigative journalism in the public interest, published an article on October 9, 2019 in which several of the hospital’s Transplant team discussed keeping a comatose transplant patient alive “because of worries about the transplant program’s survival rate.”
After suffering from congestive heart failure for years, Darryl Young, a Navy veteran and former truck driver with three children, received a heart transplant on Sept. 21, 2018. Since the transplant, Young had suffered from pneumonia, strokes, seizures and a fungal infection. The Newark transplant team believed that he would never wake up or recover function. Yet they wanted to do all they could to keep his new heart beating.
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.
If a program’s survival rate falls too far under its expected rate, which is calculated by a CMS algorithm, the agency could launch an audit. If the audit uncovered serious problems, CMS could pull a program’s Medicare certification, meaning that the federal health care insurer would stop reimbursing for transplants.
In recordings of transplant staff meetings discussing Darryl Young’s prognosis, senior staff are heard discussing the importance of keeping Young alive, even if it meant not informing his family of his deteriorating condition so that decisions to remove him from life support could be made.
Spurred by a ProPublica investigation, CMS will carry out an inquiry.
Chen, C. (2019). Feds to Investigate Hospital Alleged to Have Kept Vegetative Patient Alive to Game Transplant Survival Rates — ProPublica. [online] ProPublica. Available at: https://www.propublica.org/article/feds-to-investigate-hospital-alleged-to-have-kept-vegetative-patient-alive-to-game-transplant-survival-rates [Accessed 5 Nov. 2019].