Famed Baylor St. Luke's surgeon linked to 2015 heart transplant patient deaths

Newly released federal documents obtained by ProPublica and the Houston Chronicle connect famed heart transplant surgeon O.H. "Bud" Frazier, MD, of Houston-based Baylor St. Luke's Medical Center, to a rash of patient deaths at the hospital in 2015.

The documents are part of the two publications' ongoing series investigating Baylor St. Luke's heart transplant program, which lost CMS funding in August after failing to ensure patient safety and routinely exhibiting poor patient outcomes.

Here are six things to know:

1. Under a Freedom of Information Act request, ProPublica and the Houston Chronicle obtained typed notes prepared by a CMS surveyor during the agency's most recent investigation into the hospital's heart transplant program this summer. CMS began investigating the hospital after Baylor St. Luke's suspended its heart transplant program in June following two patient deaths. The notes also detailed the factors behind the deaths of seven patients in 2015 who died within a year of their heart transplant surgeries.

2. The surveyor's notes included an interview with an unidentified surgeon, who the publications determined to be Andrew Civitello, MD, the program's top cardiologist. The notes indicated the rash of patient deaths in 2015 stemmed, at least in part, on "a retiring surgeon" who "wouldn't stop performing transplants," the report states. The publications identified the retiring surgeon as Dr. Frazier. Dr. Civitello told the publications through a hospital spokesperson that he did speak with CMS about staffing changes at the hospital, but said the notes did not accurately reflect his remarks.

3. Additional documents obtained by the publications revealed Dr. Civitello was not the only physician CMS interviewed in December 2017. A second Baylor St. Luke's heart transplant surgeon reportedly explained "one surgeon had bad outcomes" in 2015, and that the deaths, in part, related to how the hospital had been selecting patients eligible for transplants and donors. However, it is unclear which physician with "bad outcomes" the unidentified surgeon was referring to.

4. ProPublica and the Houston Chronicle sent Baylor St. Luke's and its affiliated Dallas-based Baylor College of Medicine a list of questions about their interactions with Dr. Frazier and his outcomes, but the institutions declined the request, citing pending litigation by Dr. Frazier against the publications. Dr. Frazier, who started the heart transplant program in 1982, stopped operating as its lead surgeon sometime in 2015. However, he has remained active in the program, conducting research and sometimes advising surgeons. He also declined the publications' request for comment.

5. Documents obtained by the publications indicate Baylor St. Luke's had poor heart transplant outcomes before the recent deaths. Between 2000 and 2003, when Dr. Frazier still ran the program, only 77 percent of the heart transplant recipients survived at least one year after their surgeries, the report states. Baylor St. Luke's said patient outcomes had improved in 2016 and 2017. However, CMS said in June the hospital had not corrected the previously identified issues, and terminated its Medicare funding in August.

6. Baylor St. Luke's heart transplant program reopened after a brief suspension in June and has continued to treat the 83 patients on its waiting list. However, the program did not perform any heart transplant surgeries in June or July, according to the report.

To access the full report, click here.

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