Infant Heart Surgery Deaths Lead to Suspension of Elective Procedures at Florida Hospital

A Florida hospital faces a federal investigation following an unusual number of infant deaths during or following open heart surgery. 

The U.S. Centers for Medicare and Medicaid Services (CMS) has launched an investigation into St. Mary’s Medical Center in West Palm Beach, Florida, following a CNN investigation into nine infant deaths linked to heart surgeries performed at the hospital since the program was launched at the end of 2011. Amid the concerns, the hospital has suspended the program.

CNN’s probe revealed that from 2011 to 2013, the infant congenital heart surgery mortality rate at St. Mary’s was more than three times the national average, at 12.5%.

However, the hospital disputed those numbers in a recently issued press release, saying the CNN investigation was inaccurate and came up with an incorrect number based on inaccurate volume and classifications. The hospital says its infant heart surgery mortality rate is 5.3%; which is still significantly higher than the national average of 3.4%.

The hospital’s program was reviewed last year by the Florida Department of Health, and the lead investigator of the doctors sent to review the program, Dr. Jeffrey Jacobs, suggested that the hospital cease heart operations on patients younger than six months old.

The hospital continued, however, and last week Davi Ricardo Brandao was just several weeks old when he died following two open heart surgeries at the hospital. The operations, performed in March, were meant to treat truncus arteriosus, a severe heart defect, and in April the hospital reported that he was recovering with a good prognosis.

Jacobs, a professor of cardiac surgery at Johns Hopkins, said that the hospital does not perform enough of the surgeries to become proficient.

The hospital conducted 23 infant heart surgeries in 2013, compared to the majority of U.S. hospitals, which do more than 100 such surgeries annually. Anything less than 100 is considered low volume by the Society for Thoracic Surgeons.

St. Mary’s officials have defended the hospital’s record, saying that its mortality rate is not out-of-step with the rest of the country. However, the hospital says it is now conducting a “comprehensive review” of the program after CNN’s investigative report and will do no more “elective” surgeries until the review is completed.

In most cases, parents whose children died at St. Mary’s appear to not have been warned of the hospital’s high mortality rate for infant heart surgery. That is not uncommon, according to a study reported by the Society of Thoracic Surgeons in April.

According to the findings, only 41.8% of hospitals reported mortality rates following cardiac operations in 2014. And those numbers are twice what they were in 2010.

The study also found that the more likely a hospital was to report its mortality rates, the lower its death rates are likely to be.

Jacobs, who also chairs the Society of Thoracic Surgeons National Database Work Force, has pushed hospitals for more voluntary reporting, saying that parents have a right to know the hospital’s track record.