Thread: Amid Scrutiny, Liver Transplants Halted At L.A. Hospital

I guess this is sort of an immigration story since it involves a Saudi national getting an organ transplant he didn't deserve. But the article makes me wonder about the impact illegals may have on the organ transplant programs at the present time and the future in the United States. I do remember reading a few articles where illegals have already been given transplants in the United States. Something else to think about and ponder on regarding illegal immigration.

http://www.10news.com

Amid Scrutiny, Liver Transplants Halted At L.A. Hospital

POSTED: 7:08 am PDT September 27, 2005

LOS ANGELES -- One of California's largest organ transplant centers has suspended its liver program after determining that doctors improperly arranged a liver transplant for a man not among the highest-priority patients, officials said.

Staff at St. Vincent Medical Center then falsified documents to cover up the alleged wrongdoing, hospital President and Chief Executive Gus Valdespino told the Los Angeles Times in Tuesday's editions.

The case involves a Saudi national who was 52nd on a transplant list that covers much of Southern California and is based on who is sickest and who has been waiting longest. St. Vincent officials said the liver should have gone to a higher priority patient.

The transplant was done in 2003 and the Saudi Arabia Embassy paid $339,000 for the operation -- up to 30 percent more than what the hospital would normally receive from insurance companies and government programs, Valdespino said.

The suspension of the liver program at St. Vincent means that lifesaving transplants could be delayed for 75 patients who are on the center's liver waiting list.

Dr. Richard R. Lopez Jr., director of St. Vincent's liver transplant program, and Dr. Hector C. Ramos, the assistant director, are no longer affiliated with the program, hospital officials said. They declined to say whether the men had been fired.

A lawyer for Lopez told the Times that he did not have enough information to comment. An attorney for Ramos, who was paid separately for his services, told the Times her client did nothing wrong. She said the doctor believed the patient was an impoverished Bedouin and didn't know if he would be paid for his work.

The hospital, west of downtown Los Angeles, notified the state Department of Health Services about the case Monday, and agency spokeswoman Lea Brooks said inspectors would immediately investigate.

St. Vincent's directors became aware of the problem this month while answering routine questions from auditors at the United Network for Organ Sharing, the nonprofit group that runs the national transplant system, Valdespino said.

www.latimes.com

Hospital Skipped Its Own Patients
St. Vincent bypassed nine of its own patients to transplant organ into a Saudi national. The state medical board begins a probe of two doctors.
By Charles Ornstein and Rong-Gong Lin II
Times Staff Writers

September 28, 2005

Surgeons at St. Vincent Medical Center bypassed nine of the hospital's own patients on a regional liver transplant waiting list before they inappropriately gave the organ to a Saudi national who ranked 52nd, hospital officials said Tuesday.

But hospital officials said they were at a loss to explain why St. Vincent staff allegedly violated basic rules governing organ transplants in the September 2003 procedure and then falsified documentation to cover up their actions.

"They have not provided us with a motivation," hospital President and Chief Executive Gus Valdespino said at a news conference, referring to the two physicians who ran the liver transplant program. The Los Angeles hospital has terminated the program's relationship with the doctors, he said, and has indefinitely suspended liver transplants.

What is clear is that the Saudi national received a liver that should have gone to a patient at UCLA Medical Center who was much higher on the transplant list. Moreover, the Royal Embassy of Saudi Arabia paid St. Vincent $339,000 for the Saudi patient's transplant and hospital care, plus undisclosed fees to the doctors, according to the hospital. That amount is about 25% to 30% higher than the hospital would have been paid by insurance companies and government programs.

The embassy routinely pays for medical care for Saudi residents in the United States, though fewer nationals have sought care in this country since Sept. 11, 2001, because of the difficulty in obtaining visas, embassy spokesman Nail Al-Jubeir said. He said the embassy would "absolutely not" try to move a patient up the waiting list.

Meanwhile, on Tuesday, the Medical Board of California indicated that it had opened an investigation of Dr. Richard R. Lopez Jr., the St. Vincent program's former director, and Dr. Hector C. Ramos, the former assistant director. Both retain privileges at the hospital, although hospital officials said their status was being reviewed by the medical staff.

An attorney for Ramos said her client had done nothing wrong.

"In Dr. Ramos' mind, he transplanted a patient who was sick and was in the hospital, and as far as he knew, was the only sick person in the hospital who needed a liver transplant," said the attorney, Evelina M. Serafini. "The first time he had heard about the patient's position on the list was when the hospital launched its investigation."

An attorney for Lopez has declined to comment.

The allegations at St. Vincent have renewed calls among some bioethicists and transplant experts for stricter curbs on the number of foreigners allowed to receive transplants in the United States.

With nearly 90,000 patients on U.S. organ transplant waiting lists, "it ought to be Americans first," said Dr. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania. "That's why people donate."

Hospitals should resist the temptation to prioritize foreign nationals who in general pay more for organ transplants because they do not qualify for insurance discounts, Caplan and others said.

"I do think that when we have a shortage, that we are probably obligated to take care of our own citizens and residents first," said Dr. Douglas Hanto, chief of the transplant division at Beth Israel Deaconess Medical Center in Boston.

He added, however, that the United States had an obligation to help foreign countries set up their own transplant centers and to serve visitors who find themselves unexpectedly in need of transplants while in this country.

Others said transplants in the United States are the only hope for some foreign nationals whose countries do not offer those procedures. In addition, foreigners donate organs to U.S. patients in about the same proportion that they receive transplants.

"Part of what makes our country a great one is that we're willing to share our expertise," said Jeffrey Kahn, director of the Center for Bioethics at the University of Minnesota, and vice chairman of ethics for the nation's transplant oversight agency. "Obviously, we can't allow people from outside the country to swamp the system … so there needs to be a balance struck, and that's the trick."

According to national data, St. Vincent has allocated about 8% of its donated livers to foreign nationals since the program was created in 1995, slightly higher than the 5% guideline set by the national organ oversight agency. That group, the United Network for Organ Sharing, spells out no punishments for exceeding its guideline but says that it audits out-of-compliance programs.

Overall, St. Vincent has allocated fewer than 5% of its organs â€â€