Florida Hospital Hid Pediatric Heart Surgery Death Rate

At least eight babies have died since the pediatric open heart surgery program at St. Mary’s Medical Center in West Palm Beach, Florida began in December 2011, and parents want to know why no one warned them that St. Mary’s was relatively inexperienced at such tremendously complicated surgeries.

By the end of 2013, the mortality rate for babies having heart surgery at St. Mary’s was three times the national average, CNN reports. According to documents CNN obtained from the state of Florida, from 2011 to 2013, St. Mary’s Medical Center performed 48 open heart surgeries on children and babies. CNN determined that six infants died, and confirmed their deaths with the parents. From those numbers, CNN calculated that the death rate for open heart surgeries was 12.5 percent, more than three times the national average of 3.3 percent cited by the Society of Thoracic Surgeons.

St. Mary’s said CNN is wrong about the program’s death rate, but refuses to say what it considers the right death rate. In a statement to CNN, David Carbone, the hospital CEO, wrote that providing raw mortality data “does not give proper context for the complexity and severity of each case, which could potentially lead to providing misleading information to consumers.”

Pediatric heart surgeon Michael Black came to St. Mary’s from Stanford’s Lucile Packard Children’s Hospital to head the new program. After Black came to St. Mary’s, the hospital’s website heralded the arrival of “nationally renowned pediatric heart surgeon Dr. Michael Black.” But even after some children had died, parents of sick infants say Dr. Black told them he had never lost a single patient during his time at St. Mary’s

Studies show hospitals with fewer surgeries tend to have higher death rates, especially when the surgeries are complex. While the specific numbers vary according to how they are reported, the numbers at St. Mary’s are very low, CNN reports. St. Mary’s volume of open heart surgery cases went from 27 in 2012 to 23 in 2013 to 18 in 2014, according to documents filed by the hospital with the Florida Agency for Health Care Administration.

Data from the Society of Thoracic Surgeons indicate that 40 percent of pediatric heart surgery centers in the United States perform more than 250 cases a year. Eighty percent of centers do more than 100 cases a year. Anything less than 100 cases a year is considered “low volume” by the society.  “Like anything else, if you use a skill only occasionally, it’s hard to develop,” says Dr. Roger Mee, the former chief of pediatric heart surgery at the Cleveland Clinic. “With something as complex and dangerous as children’s heart surgery, you have to develop a whole team, and it’s hard to develop a team around 27 cases.”

A team of pediatric heart surgery experts visited the St. Mary’s program in April 2014. Dr. Jeffrey Jacobs, chairman of the Cardiac Technical Advisory Panel for Florida’s Children’s Medical Services, who also serves on task forces for the World Health Organization, the American Heart Association, and the Society of Thoracic Surgeons, recommended that St. Mary’s not perform heart surgeries on babies under 6 months of age. For older babies and children, he said the hospital should not perform complex procedures—those that fall into categories four and five on the scale devised by the Society of Thoracic Surgeons, CNN reports.







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