What We Can Learn from UNC Children’s Hospital (aka The Place Where Doctors Wouldn’t Send Their Own Children)

The Problem

If a doctor who works at a hospital wouldn’t let her own kids be treated there, that is a real cause for concern. That’s just what happened at North Carolina Children’s Hospital. However, it wasn’t until a recent New York Times investigation into UNC Healthcare, which runs North Carolina Children’s Hospital, that the scope of the problem came to light. Before then, doctors discussed repeatedly in private hospital meetings the high death rate for the hospital’s pediatric surgery patients, but no one warned the public, the vulnerable patients, or their unsuspecting parents.

A lawsuit from the Times uncovered information that UNC Health Care had refused to release. From 2014-1018, the hospital’s mortality rate for pediatric heart surgery was 5.4%. That is bad. The national average is 2.8%. Even worse, the hospital’s risk-adjusted mortality rate was 5.6%. When examining the morality rate for the most complex cases, seven out of 12 patients died (58.3%) with a risk-adjusted mortality rate of 47.4%. The national mortality rate in this category was 14%. So, the UNC statistics aren’t just bad. They’re downright awful.

Once The Times made public this information, the North Carolina secretary of health opened an investigation. (Well, at least that’s good. Better late than never.)

While this particular investigation focused on North Carolina, there are pediatric heart surgery programs all over the country that have had questionable performance statistics. In fact, at least five programs have been suspended or shut down in the last decade, and several others have merged, in an effort to improve results. This information is not easily obtained, which makes it difficult or impossible for parents to make an informed decision for their children.

Misplaced Priorities Leads to Lack of Patient Safety

How did this happen – especially when doctors had made their concerns known (within the hospital) and advocated (again, within the hospital) that the hospital stop handling complex cases, as far back as 2016?

1. Administrators denied there were problems. Instead, they tried to blame the problems on difficult “team dynamics.” Classic.

2. Making statistics public is not required. Only 75% of the 115 hospitals that perform pediatric heart surgery in the US post their information to the Society of Thoracic Surgeons website. Sigh.

3. Hospitals do not keep data (at least when it’s damning). In North Carolina, doctors were concerned about patients who underwent complex surgeries and even lower-risk patients who seemed to have “unexpected complications.” When they tried to get mortality data, the hospital did not have the information they needed. Convenient.

4. Key leaders focused on the hospital’s wellbeing instead of the wellbeing of its patients. When doctors suggested they would begin sending patients elsewhere, the head of the hospital warned them that a reduction in the number of procedures performed at the hospital would hurt revenue, and the lower volume of surgeries would reduce staff. This is the epitome of profits before patient safety. Ka-ching. And retch.

The Solutions – How We Can Help Make Pediatric Heart Surgery Safer

While it is long overdue and took a lawsuit to make changes, the hospital has suspended heart surgeries for the most complex cases, until investigations are completed by state and federal regulators as well as outside experts. State regulators are conducting interviews with former employees to gather more information about their concerns.

In addition, the hospital has plans to create an external advisory board of medical experts and to publicly release mortality data for the program, something it had refused to do before.

Of course, the biggest obstacle the North Carolina hospital faces is restoring the public’s trust in their program. That won’t be easy, but it begins with a commitment to transparency, showing people their results, whether those results are good or bad.

By keeping public pressure on hospitals and doctors, patients and patient safety advocates like the journalists at The Times and the attorneys at The Eisen Law Firm can help increase transparency and improve patient outcomes.

Help is Available

With respect to hospitals in Ohio, the following hospitals have reported data to the Society for Thoracic Surgery public database: Akron Children’s Hospital, Cincinnati Children’s Hospital Medical Center, Cleveland Clinic, Nationwide Hospital, and Rainbow Babies & Children’s Hospital. That database is far from perfect, but it does allow patients to get some information about outcomes at the various facilities. It also can serve as a starting point for a frank discussion between doctor and patient about mortality rates and about the best place for a given heart procedure.

If you or someone you love had an “unexpected outcome” from a pediatric heart surgery, The Eisen Law Firm can help. Call our experienced Cleveland malpractice lawyers to discuss your options for legal recourse and for obtaining the compensation you deserve. We are not afraid to take on even the largest, most-respected hospitals that provide pediatric care. And when we do so, we look for opportunities to convince (or force, if necessary) hospitals to adopt better patient safety protocols, so that every child has a better chance for a successful outcome. To schedule your free consultation, call 216-287-0900 or contact us online today.