Although we have read many articles this past week of March 5, 2018, we would like to focus on one in particular about how surgery centers can be deadly.

In a recent investigation by Kaiser News and USA Today, surgery centers may be putting profits ahead of patient safety:

Surgery centers “started nearly 50 years ago as low cost alternatives for minor surgeries. They now outnumber hospitals as federal regulators have signed off on an ever widening array of outpatient procedures in an effort to cut federal health care costs. Thousands of times each year, these centers call 911 as patients experience complications ranging from minor to fatal. Yet no one knows how many people die as a result, because no national authority tracks the tragic outcomes. An investigation by Kaiser Health News and the USA TODAY Network has discovered that more than 260 patients have died since 2013 after in and out procedures at surgery centers across the country. Dozens — some as young as 2 — have perished after routine operations, such as colonoscopies and tonsillectomies.”

As Kenneth P. Rothfield, M.D., M.B.A.( Chairman, Department of Anesthesiology, Saint Agnes Hospital (Baltimore, MD), who is on the board of advisors of the Physician-Patient Alliance for Health & Safety, explains, there are differences between hospitals and surgery centers:

“It’s important to realize that surgery centers are not hospitals. They have different resources, different equipment.”

Joan Rivers Died After Undergoing A procedure at a Surgery Center

In discussing Joan Rivers, who died after undergoing a procedure at a surgery center, Dr. Rothfield and his colleagues wrote in their article, “Medical standards of care and the Joan Rivers death”:

“Although hospitals typically seek accreditation from The Joint Commission, ambulatory centers can receive accreditation from a variety of organizations. For example, The American Association for Accreditation of Ambulatory Surgery Facilities (“AAAASF”) accredits ambulatory surgery facilities like the one in which Joan Rivers underwent her medical procedure.”

In their investigation, the Kaiser News/USA Today report notes some of the reasons why surgery centers may be dangerous:

“Surgery centers have steadily expanded their business by taking on increasingly risky surgeries … Some surgery centers are accused of overlooking high-risk health problems and treat patients who experts say should be operated on only in hospitals, if at all. At least 25 people with underlying medical conditions have left surgery centers and died within minutes or days. The cases include an Ohio woman with out of control blood pressure, a 49 year old West Virginia man awaiting a heart transplant and several children with sleep apnea. Some surgery centers risk patient lives by skimping on training or lifesaving equipment. Others have sent patients home before they were fully recovered.” [emphasis added]

Logan’s Death – Sent Home Too Early From a Surgery Center

The last point may seem simple – and yet, if not followed, can lead to tragic results and, in the case of 17-year old son Logan, death.

Logan had successfully undergoing routine surgery to correct his sleep apnea, when he was sent home. His mother, Pamela Parker, writes in “Six Nursing Lessons: Nurse and mother reflects on the untimely death of her teenage son” that he was sent home too early and believes that all patients should be monitored for an extended period in an unstimulated environment prior to discharge – doing so, would likely have meant that Logan might be alive today:

“When we arrived home, he was very weak and sleepy when I helped him out of the car. He appeared to be weaker than when he walked at the surgery center. I helped him to the love seat in the living room and he wanted to watch a movie he had just received as a gift. I started the movie and he never woke up to see it play. He started to look very pale and I told him to take a deep breath.

“Each successive time I woke him up, it was more challenging to awaken him because he was so somnolent. I was afraid to leave him and sat on the floor next to him and watched him closely. Because the popsicle had made his lips purple, I looked at his nail beds, ears and nose. The last time I woke him up, his eyes opened and looking past me, asked quietly, “Where’s mom?” I said, “Logan, I am mom! Take a deep breath.”

“He said “Oh yeah,”  took a couple of deep breaths and fell asleep.

“I called a friend and coworker who lived close to assist me with taking him to the hospital.  

“Logan was clearly not ready for discharge. He was suffering from respiratory compromise and should have been monitored closely at the outpatient surgery center to make sure that he was no longer at risk.”

No healthcare facility should put profits before patient safety – do you agree?

• Patient Safety