N.J. hospital kept patient on life support for months to boost its survival rates, investigation reveals

Taken from NJ.com

October 3, 2019

By Caroline Chen, ProPublica

This story is co-published with ProPublica. Sign up for their Big Story newsletter to get their latest investigations in your inbox.

On a Thursday morning this past April, 61-year-old Darryl Young was lying unconscious in the eighth-floor intensive care unit of Newark Beth Israel Medical Center. After suffering from congestive heart failure for years, Young, a Navy veteran and former truck driver with three children, had received a heart transplant on Sept. 21, 2018. He didn’t wake up after the operation and had been in a vegetative state since.

Machines whirred in his room, pumping air into his lungs. Nutrients and fluids dripped from a tube into his stomach. Young always had been fastidious, but now his hair and toenails had grown long. A nurse suctioned mucus from his throat several times a day to keep him from choking, according to employees familiar with his care. His medical record would note: “He follows no commands. He looks very encephalopathic” — brain damaged.

That day, in another wing of the hospital, where a group of surgeons, cardiologists, transplant coordinators, nurses and social workers gathered for their weekly meeting in a second-floor conference room, his name came up.

“Anything on Darryl Young?” asked cardiologist Dr. Darko Vucicevic, according to a recording of the meeting obtained by ProPublica.

“Need to keep him alive till June 30 at a minimum,” responded Dr. Mark Zucker, director of the hospital’s heart and lung transplant programs.

Since the transplant, Young had suffered from pneumonia, strokes, seizures and a fungal infection. The Newark transplant team believed he would never wake up or recover function, according to current and former staff members familiar with his case, as well as audio recordings. Yet they did all they could to keep his new heart beating.

The recordings show that the transplant team was fixated on keeping him alive, rather than his quality of life or his family’s wishes, because of worries about the program’s survival rate, the proportion of people undergoing transplants who are still alive a year after their operations, a ProPublica investigation found. Federal regulators rely on this statistic to evaluate — and sometimes penalize — transplant programs, giving hospitals across the country a reputational and financial incentive to game it. Newark Beth Israel’s one-year survival rate for heart transplants had dipped, and if Young were to die too soon, the program’s standing and even its own survival might be in jeopardy.

June 30, Zucker explained at the meeting, was the date of the next report by a federally funded organization that tracks transplant survival rates. “If he’s not dead in this report, even if he’s dead in the next report, it becomes an issue that moves out six more months,” he said in the recording.

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