St. Mary’s Medical Center in West Palm Beach, Florida is being evaluated after 9 babies died in the last four years after having heart surgery there. CNN calculated the raw mortality rate from 2011-2013 to be 12.5 percent, which is more than three times the national averages for such surgeries. Doctors affiliated with Children’s Medical Services have recommended the hospital stop operating on infants under six months old.
In 2011, St. Mary’s began its cardiovascular program. In that time the nine deaths, plus one infant who was left with paralyzed legs, has led doctors and state officials to question the viability of the program. The primary complaint from doctors in regard to this issue is that the hospital doesn’t perform enough of these procedures on an annual basis to become proficient. Most programs have more than 100 cases per year, whereas St. Mary’s has much fewer. But the Department of Health does not have the authority to make any changes to the program that could improve the mortality rate.
Earlier in June, the federal Centers for Medicare and Medicaid Services announced it would be investigating the program. Evaluations from the Joint Commission can have a big impact on hospital programs by bringing external scrutiny to them. Dr. Jeffrey Jacobs, a professor of cardiac surgery at Johns Hopkins University performed a peer review of the program last year. As a result, he gave the recommendation that the hospital stop doing heart surgeries on babies younger than six months old, and no complex heart surgeries on any child. The hospital did not heed his recommendation, and two more babies, each only a few weeks old, died after heart surgery at St. Mary’s this year.
St. Mary’s and the state have disputed the findings of CNN, saying the numbers were “wrong,” “exaggerated,” and “completely erroneous.” St. Mary’s said its heart surgery program had a 5.3 percent mortality rate for the four year period ending on June 30, 2014. It has no statistical difference from the national average, but the data for their calculations has not been made public. The hospital has “launched a comprehensive review of the pediatric cardiac surgery program” and does not intend to schedule any further elective surgeries until that review is completed.
Some pediatric cardiologists would like to make St. Mary’s more accountable for its program, advocating a new state law that would require site visits and peer reviews of programs that are serving Florida children. The hospital is currently not bound to make any changes that come from negative reviews.