Federal government opens investigation into RWJBarnabas, Rutgers' partner
The federal government has opened an investigation into the Newark Beth Israel Medical Center, which is run by RWJBarnabas Health, for allegedly keeping a patient on life support to maintain its survival rate, according to an article on ProPublica.
The Newark hospital's Advanced Heart Transplant and Treatment program, where the incident allegedly occurred, remains fully operational and the team continues to see patients and perform transplants, a company spokesperson said.
Darryl Young, a patient at Newark Beth Israel Medical Center, suffered brain damage after undergoing a heart transplant. Doctors at the hospital supposedly kept him on life support for a year, according to the article.
The family had first been told that Darryl Young’s operation had gone well, said Andrea Young, the patient’s sister. She said she became increasingly concerned as time went on, according to the article.
She said Dr. Margarita Camacho, the surgeon who performed Darryl Young’s transplant, told her that there were no signs that his brain was deprived of oxygen during the surgery. She said it was another cardiologist who told her that his MRI showed brain damage, according to the article.
Audio recordings were obtained showing that the hospital’s transplant team was focused on keeping the patient alive because their one-year survival rate for heart transplants had dropped, according to the article.
There was an audio recording of Dr. Mark Zucker, the director of the Health Advanced Lung Disease and Transplant Program at Newark Beth Israel Medical Center, talking to his team, according to the article.
“I’m not sure that this is ethical, moral or right,” Zucker said. “(But it’s) for the global good of the future transplant recipients.”
They added that Zucker warned the staff against offering Darryl Young’s family the choice of switching from aggressive treatment to palliative care. This would have focused on comfort until September, a year since Darryl Young’s transplant, according to the article.
“Typically, if a patient suffers brain damage in an operation and doesn’t wake up, doctors are supposed to meet with the family to explain the prognosis and options for care,” said Dr. Ali Zarrabi, assistant professor of Medicine in the Division of Hospital Medicine at Emory University School of Medicine.
Taccara Beale, Darryl Young’s daughter, responded to the recordings, according to the article.
“How dare you take it upon yourself to withhold such information from any family?” Beale said, according to the article. “They took a decision away from us.”
Federal regulators use the survival rate statistic to evaluate transplant programs and provide a reputational and financial incentive to these hospital programs, according to the article.
If a program’s rate dropped far below the expected rate, the medical center’s Medicare certification could be revoked and the federal healthcare insurer would no longer reimburse them for transplants. This medical center kept Darryl Young on life support to avoid putting their program in jeopardy, according to the article.
Newark Beth Israel Medical Center responded to ProPublica’s concerns, according to the article.
“(We are) conducting an evaluation and review of the program, its processes and its leadership,” the center stated, according to the article. “(The) disclosures of select portions of lengthy and highly complex medical discussions, when taken out of context, may distort the intent of conversations.”
RWJBarnabas Health is currently in a private-public partnership with Rutgers Biomedical and Health Sciences (RBHS), which supplies the University approximately $1 billion in funding over the next 10 years and access to RWJBarnabas Health's facilities, The Daily Targum reported last month.
The two institutions will remain separate, as the agreement is a partnership, not a merger. Rutgers will manage the academic and research aspects of the partnership in coordination with RWJBarnabas Health, while RWJBarnabas Health will manage the clinical delivery of services in coordination with Rutgers, the Targum reported.
Arthur Caplan, head of the Division of Medical Ethics at NYU School of Medicine, spoke on these recordings and the situation, according to the article.
“The management of this patient is egregiously unethical,” he said. “Prolonging ‘dying’ to preserve a flawed transplant program makes a mockery of transplant medicine and is an assault on both ethics and compassion.”
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