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Liver Patients Were Left in the Dark

Posted on: Sunday, 13 November 2005, 15:00 CST

By Blythe Bernhard, The Orange County Register, Calif.

Nov. 13--ORANGE--Patients expecting a liver transplant at UCI Medical Center were never informed of problems at the hospital, even after school officials launched an internal review three years ago.

The hospital shut down its liver transplant program Thursday after a separate investigation by the Centers for Medicare & Medicaid Services revealed inadequate staffing, poor survival rates and waiting list mismanagement.

The findings led Medicare to pull the hospital's liver transplant certification, prompting the closure.

Dr. Michael Drake, chancellor at UC Irvine, said Friday that even though the school in recent years tried to fix its problems and become a viable program, "we didn't get to that point."

The center's staffing shortage and related problems were never relayed to patients waiting for livers, said Dr. David Imagawa, chief of the transplant division.

"We would encourage our patients to look at the option of being transplanted" at other centers, Imagawa said.

The problems began long before Medicare forced UCI to close the center.

In 2002, UCI officials brought in two outside doctors to investigate why the number of liver transplants at the center had fallen to eight a year from a high of 24 in 1997. Federal guidelines require centers to perform 12 transplants per year.

But even as the number of liver transplants performed at UCI fell, few liver patients transferred to other programs. As of Friday, none of the 106 liver candidates on UCI's waiting list was registered at other transplant centers in Southern California, according to the Organ Procurement and Transplantation Network.

Now, they have to transfer.

UCI started notifying patients Friday about the closure, and will assign case workers to help patients with the transfer process, Drake said.

The school also plans to assemble a team of physicians and others, from inside and outside the school, to determine what went wrong at the liver transplant center.

The goal, Drake said, is to "learn about the decisions that we made, why we made them."

However, Drake doesn't expect to find problems that might lead to disciplinary action.

"This was a failure to be successful. This is not an episode of wrongdoing," he said.

Drake left open the possibility that UCI might re-open the center, based on the panel's recommendations.

"Part of what we will hear from the review panel is whether or not that seems to be a good idea.

"This service is now not provided in Orange County."

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Copyright (c) 2005, The Orange County Register, Calif.

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Source: The Orange County Register

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