Deaths in LR surgery center featured in report on mixed regulation of centers | Arkansas Blog

Thursday, August 9, 2018

Deaths in LR surgery center featured in report on mixed regulation of centers

Posted By on Thu, Aug 9, 2018 at 2:12 PM

USA Today and Kaiser Health News have combined for an investigation of the patchwork regulation of surgery centers around the country, a story that begins with accounts of deaths in a Little Rock center.

Arkansas is one of 17 states, the article says, with no requirement to report deaths at  surgery centers. So there's no followup when deaths occur to see if they were an anomaly or a cause for alarm, the article notes. This followed anecdotes about two deaths and one emergency case over 15 weeks in 2014 when people stopped breathing after routine colonoscopies at the Kanis Endoscopy Center. The article recounts:

When Faye Watkins, 63, walked into Kanis Endoscopy in Arkansas, she said she was unaware there had been two deaths after care there within the previous three months. She was in the fog of anesthesia when it struck her that something was amiss. She said she heard men say her blood pressure was falling.

“I said (to myself), 'Lord, if it’s time for me to go, take me. But I’m not ready,’ ” Watkins recalled. Her next memory was waking up in a hospital with her chest sore from CPR.

The KHN/USA TODAY examination raises questions about the need for more robust oversight of surgery centers, where public access to important information, such as surgical outcome data, tends to be more limited than what’s available about hospitals. The gap persists even as the nation’s 5,600 surgery centers have surpassed hospitals in number and taken on increasingly complex procedures.
The article indicates the episodes in Arkansas resulted in lawsuits that ultimately were settled and all those involved defended the quality of care.

Medicare spokesman Bob Moos said state recertification inspectors come in every four to seven years and review all cases in the previous year in which a surgery center patient was transferred to a hospital. When the state inspector visited Kanis, “nothing on the hospital transfer log raised a red flag for her to investigate,” the spokesman said.

Officials would not describe what was on the transfer log or which cases were on it or confirm that Smith’s name had been included on it.

A Kanis spokesperson said it would violate patient confidentiality to comment on what the staff showed the inspector. Arkansas Department of Health spokeswoman Meg Mirivel provided no details, saying state law prohibits releasing information about hospital or surgery center investigations.

The state official’s inspection report does not mention any patient transfers. It does say the center was operating outside of industry norms by performing colonoscopies without an additional nurse in the room. The center pledged to health officials that it would add a nurse to the endoscopy suites.

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