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June 6, 2019

State health officials to investigate UNC Children's Hospital following NYT report

Daily Briefing

    North Carolina health officials on Friday announced they will work with federal regulators to conduct a "thorough investigation" into events occurring between 2016 and 2017 at UNC Children's Hospital, following a New York Times report on the hospital's pediatric heart surgery program.

    The Times' investigation

    Last week, the Times published a report based on recordings of internal discussions among physicians at UNC Children's. In the recordings, which were provided to the Times, doctors expressed concerns with the hospital's pediatric heart surgery program after unexpected complications occurred with lower-risk patients.

    Some on the recordings said they might not feel comfortable allowing their own children to have surgery at the hospital, the Times reported.

    Tim Hoffman, the hospital's chief of pediatric cardiology, in a 2016 meeting said, "It's a nightmare right now. We are in crisis, and everyone is aware of that."

    Doctors at the hospital were unable to identify a cause for the complications. They considered a range of possibilities, including inadequate resources, problems with the hospital's chief pediatric cardiac surgeon, and whether the hospital was admitting patients it couldn't handle, the Times reported.

    In a separate meeting, Kevin Kelly, the head of the children's hospital at the time, told cardiologists who were concerned about referring patients that they should "[d]o what your conscience says" when deciding whether to refer patients. However, Kelly warned that if the hospital started performing fewer surgeries, the cardiologists could lose their jobs.

    "If it reduces the volume of things … we'll just reduce the number of people that we have," he said, according to one of the recordings.

    According to the Times investigation, cardiologists at the hospital were not provided with mortality data related to the hospital's pediatric heart surgery program. They were informed that the program's mortality rate had improved in recent years, but were not given copies or summaries of the statistics and were warned the information is considered confidential by the Society of Thoracic Surgeons.

    State regulators launch 'thorough investigation'

    Mandy Cohen, the secretary of North Carolina's Department of Health and Human Services, announced after the Times report that her office would "conduct a thorough investigation into these events" in collaboration with CMS.

    In a statement, Cohen said, "As a mother and a doctor my heart goes out to any family that loses a child," adding, "Patient safety, particularly for the most vulnerable children, is paramount.”

    UNC's response

    In response to the Times report, UNC Children's said its surgery program is "very strong" and denied that any past problems had affected patient care. The hospital added that there was "a dysfunctional group" in 2016 that sowed mistrust and created "team culture issues," and that the hospital has a different team today.

    Hospital administrators further said they had conducted a "thorough internal investigation" of UNC Children's pediatric heart surgery program in 2016 and determined that "criticism of the program was found to be unsubstantiated."

    Wesley Burks, CEO of UNC Health Care, which runs UNC Children's, said of the Times article, "While this program faced culture challenges in the 2016-2017 time frame, we believe the Times' criticism is overstated and does not consider the quality improvements we've made within this program over many years."

    In an email to staff, Burks said, "As the State's leading public hospital, UNC Medical Center often gets the most complex and serious cases in its pediatric congenital heart program. For many of these very sick children, we are often parents' last hope" (Gabler, New York Times, 5/31; Gabler, New York Times, 5/31 [2]; Bean, Becker's Clinical Leadership & Infection Control, 6/3; Blythe, North Carolina Health News, 6/4).

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