On June 2, 2015, the ninth baby died after having heart surgery at a Florida hospital that opened its pediatric open heart surgery program in December 2011. CNN has reported that the death rate for babies after open heart surgery at the Florida hospital between 2011 and 2013 was 12.5%, which is three times higher than the national average for such procedures (the Society of Thoracic Surgeons reports a national average of 3.3%).
The owner of the Florida hospital contests CNN’s calculation of the mortality rate but has not provided its own calculation of the mortality rate for babies undergoing open heart surgery at the hospital. The hospital’s CEO responded to CNN’s report, stating that CNN’s report of raw data regarding the mortality rate “does not give proper context for the complexity and severity of each case, which could potentially lead to providing misleading information to consumers. Our goal is to provide the best possible quality of care to every patient we treat.” Source
Following an April 2014 review of the hospital’s pediatric heart surgery program that involved five independent pediatric heart-surgeon reviewers, it was recommended that the Florida hospital cease such surgeries on babies less than six months of age. The leader of the reviewing team stated, “The number of cardiac surgical procedures performed [at the Florida hospital] seems to be too low for the institution and its staff to acquire and maintain proficiency in these types of challenging procedures.” After receiving the report and recommendations in June 2014, the hospital asserted that its mortality rate was consistent with the national average. Source
Experience Matters: Hospitals That Do More Procedures Report Better Outcomes
Numerous studies have shown that hospitals that perform fewer surgeries typically have higher mortality rates for those procedures, particularly when the surgeries performed are complex.
Most hospitals in the United States that perform pediatric heart surgeries, which are by their nature complex surgeries, perform more than 100 of the cardiac procedures per year. According to the Society of Thoracic Surgeons, 80% of pediatric heart surgery centers in the United States perform more than 100 cases a year, and 40% perform more than 250 cases a year – the Society of Thoracic Surgeons considers less than 100 cases per year to be “low volume.” Source
The Florida hospital where the nine baby deaths occurred following heart surgeries had a much lower volume of the procedures: the hospital performed only 18 pediatric heart procedures in 2014, 23 in 2013, and 27 in 2012. Source
The former head of the pediatric heart surgery program at the Cleveland Clinic stated, “Like anything else, if you use a skill only occasionally, it’s hard to develop. 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. With 27 cases a year, it would be easy to make a total mess with newborn babies.” Source
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