The University of Kansas Medical Center suspended its heart transplant program in early April after patients were left languishing for weeks in the intensive-care unit while available hearts were turned down.
An investigation by the Kansas City Star revealed that from early May 1994 until late March of this year, the hospital in Kansas City, Kan., did no heart transplants. During that time, it still admitted patients for the procedure but turned down every heart offered to it, sometimes for "administrative" reasons. Patients weren't told that hearts were available.
On March 25, a surgeon who hadn't done a transplant in five years and who didn't meet quality guidelines recommended by the United Network for Organ Sharing performed a transplant on a 32-year-old man. The patient died within hours. The hospital "voluntarily inactivated" its cardiac transplant program on April 10 after receiving inquiries from the newspaper.
"There's no question there's been a problem with thoracic surgery here," the surgeon, Hamner Hannah, was quoted as saying in the Star article. "I inherited a mess. My opinion is no patients have been harmed. (The hospital) has done nothing wrong."
Hospital administrators declined to talk to MODERN HEALTHCARE about the transplant program or the Kansas City Star story.
According to the Star, patient Lyle Carver, 46, was admitted to the university hospital's intensive-care unit in August 1994. Four months and $220,000 later, Carver was discharged with no new heart. He was admitted to St. Luke's Hospital of Kansas City, Mo., and got a new heart within weeks. Carver was never told that university medical center doctors had turned down five available hearts because surgeons and nurses were unavailable to do the operation.
Three patients died at the university hospital while awaiting new hearts, although it couldn't be determined whether they would have survived had they gotten transplants.
Two surgeons who ran the program, Jon Moran and Clay Beggerly, complained to administrators for 18 months that there weren't enough qualified surgeons and nurses on staff to carry out heart transplants. Last June they asked the hospital to suspend the program. Administrators ignored their memos, they told the Star.
Moran recalled that on June 6, 1994, the surgical team mobilized to transplant a donor heart for patient Ronald Mulanax. The heart had to be turned down after a nursing supervisor told Beggerly there weren't enough nurses to help with the surgery or post-operative care. Mulanax got a new heart at St. Luke's three weeks later. The hospital agreed to write off his bill of $15,000.
Kim Russel, the university medical center's chief operating officer, was quoted in the Star story as saying the hospital re-examined nurse staffing levels at Moran's request and found them consistent with American Association of Critical Care Nurses standards.
Moran left the medical center in March and is now on staff at Pitt County Memorial Hospital in Greenville, N.C. Beggerly is now on staff at the Iowa Heart Center in Des Moines.
Hannah, the heart surgeon the university hospital hired to continue the transplant program, was formerly director of heart transplants at Menorah Medical Center in Kansas City, Mo. There, he performed six transplants between October 1987 and June 1989. Five patients died, for a survival rate of 16.7%. The expected rate is 78.3%, the Star reported.
Stephen M. Jordan, executive director of the University of Kansas Board of Regents, told MODERN HEALTHCARE that the regents' hospital governance board met with the university chancellor May 10. "The real issue is the issue of medical care," Jordan said. "Our responsibility is to see the hospital is functioning the way it's supposed to."