L.A. Hospital Suspends Organ Transplant Program
MELISSA BLOCK, host:
This is ALL THINGS CONSIDERED from NPR News. I'm Melissa Block.
MICHELE NORRIS, host:
And I'm Michele Norris.
One of the largest organ transplant centers in California has suspended its liver program. The hospital discovered that a patient low on the waiting list was bumped ahead to receive an organ intended for someone else. Administrators at St. Vincent Medical Center in Los Angeles say doctors there arranged for a Saudi national to receive an improper transplant, and then staff members falsified records to cover the tracks. Charles Ornstein has been covering this story for the Los Angeles Times. He joins us now.
Charles, this transplant in question took place in September 2003. Could you briefly tell us what happened?
Mr. CHARLES ORNSTEIN (Los Angeles Times): Sure. What happened was that there were two patients at St. Vincent Medical Center, both of them who happened to be Saudi nationals. The first patient was supposed to receive the transplant because he was high up on the waiting list that the government and the regional transplant procurement agencies keep. But he wasn't available. So St. Vincent should have returned the organ, so that it could have gone to the next person on the list, who happened to be at UCLA Medical Center. But instead the hospital kept the organ and gave it to somebody who was 52nd on the list for a transplant. And then afterwards staff members falsified numerous documents to make it seem like the transplant had gone to the more needy patient who actually had not received it.
NORRIS: So since this involved two patients, both Saudi nationals, is it plausible that this might have been a case of mistaken identity?
Mr. ORNSTEIN: It doesn't seem to be so. It seems that, in fact, records at the hospital were kept in the correct name of the patient who actually received the transplant. But when they were sent to UNOS, which is the national organ oversight body, the name was changed, and, in fact, it was digitally altered to insert the name of the patient that should have received the transplant but did not.
NORRIS: And how does money factor into this?
Mr. ORNSTEIN: Well, for foreign nationals, they pay a higher rate than my insurance company or your insurance company or government payors do because they are not entitled to the same discounts that those payors are entitled to. And so in this case, the Royal Embassy of Saudi Arabia paid for the transplants, and they paid $339,000, which was about 25 to 30 percent higher than the market rate would have brought in.
NORRIS: And so the patient that was supposed to receive this liver--what happened to that patient?
Mr. ORNSTEIN: That patient was at another hospital, UCLA Medical Center, and it's not entirely clear at all what happened to that patient.
NORRIS: How did the hospital, St. Vincent's, discover this problem?
Mr. ORNSTEIN: Every few years the national organ network UNOS does regular audits of programs. And it appears that in the course of the audit they asked questions of St. Vincent about certain patients and how they were doing post-transplant. And they asked about the patient who had been high up on the list and how he was doing. And when the administrator began looking through the records--I believe she was new at the hospital--she discovered that that patient hadn't received a transplant, and that began a process of a few days in which these records were determined to have been fabricated. They put the pieces together, and then the hospital informed UNOS, I believe, late last week that it would be suspending its program and that the two doctors who were affiliated with it were no longer affiliated with the program.
NORRIS: Overall how common is a situation like this, where a patient was given questionable priority?
Mr. ORNSTEIN: It's extraordinarily uncommon. From what we've heard, there are very, very few cases, if ever, where this has happened. As you may recall, back in 1995 there were questions raised when baseball Hall of Famer Mickey Mantle received a liver transplant in Dallas.
NORRIS: Oh, yes. Yes.
Mr. ORNSTEIN: And there were questions about whether or not he should have received it given his health status at the time. The national organ network did an investigation and said that was proper. In this case, the hospital did its investigation and itself concluded that what happened was improper. So the conclusion that something actually happened improperly--we're not certain if there's another precedent for it.
NORRIS: Well, now that the liver transplant program at St. Vincent's has been suspended, what happens to the patients that were on the waiting list at St. Vincent's and elsewhere in the city?
Mr. ORNSTEIN: Well, that's a sad story. There are 75 patients who are waiting for livers on the St. Vincent waiting list. And those patients either will remain on that list but not be eligible for an organ because St. Vincent is now not receiving any livers, or they'll have to re-enter the list at another hospital. And at the moment it's not clear where they would enter that list, if they'd have to start from scratch or if they'd maintain their position, but it certainly is a frustrating time for patients and their families.
NORRIS: Charles, thanks so much for talking to us.
Mr. ORNSTEIN: Great to be here.
NORRIS: Charles Ornstein is a reporter for the Los Angeles Times.
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