'I'm not sure that this is ethical, moral or right': Newark Beth Israel kept patient alive to improve transplant program's survival rate

Newark (N.J.) Beth Israel Medical Center allegedly kept a patient in a vegetative state alive for a year to improve its transplant program's survival rate, according to an investigative report from ProPublica.

For the investigation, ProPublica reporters interviewed patients, family members, and eight current and former employees at Newark Beth Israel. They also reviewed medical records, emails, text messages and audio recordings of medical staff meetings that were corroborated by several sources.  

Six takeaways from the report:

1. The report found hospital metrics influenced physicians' treatment decisions for at least four transplant patients. At times, physicians failed to consult with patients and families or withheld care options from them.

2. A large portion of the report focuses on the case of 61-year-old Darryl Young, who has been in a vegetative state since undergoing a heart transplant at Newark Beth Israel on Sept. 21, 2018. Recordings obtained by ProPublica show the hospital's transplant team was determined to keep Mr. Young alive, despite assuming he would never wake up or regain normal function.

"[We] need to keep him alive till June 30 at a minimum," Mark Zucker, MD, director of Newark Beth Israel's heart and lung transplant programs, says in one recording of a transplant team meeting.

3. June 30 marked the publication date of a federally funded report on transplant survival rates. While Newark Beth Israel had maintained a high one-year survival rate for heart transplant patients from 2008-17, this rate fell in 2018 for unknown reasons. Six of 38 patients who underwent heart transplants at the hospital died in 2018, which equates to an 84.2 percent survival rate. Mr. Young's death would've dropped this rate to 81.6 percent, which falls below the national average and could've put the transplant program at risk of federal penalties.

4. The recordings show Dr. Zucker instructed hospital staff to avoid giving Mr. Young's family the option to withdraw care and switch to palliative treatments until after this September, or one year after his transplant.

"I'm not sure that this is ethical, moral or right, [but it's] for the global good of the future transplant recipients," Dr. Zucker said in different recording of an April meeting.

5. Newark Beth Israel told ProPublica it's conducting an internal investigation of the transplant program in response to the report. The hospital declined to comment on Mr. Young's case specifically but told the publication its transplant program "has saved countless lives" and consistently met all regulatory guidelines.

"Disclosures of select portions of lengthy and highly complex medical discussions, when taken out of context, may distort the intent of conversations," the hospital said of the recordings. "Our patients are our utmost priority and communication with our patients and their families is paramount in enabling our team to provide the best and most comprehensive care."

6. Mr. Young is still alive and in a vegetative state. On Sept. 18 — three days before the one-year anniversary of his transplant — clinicians told Mr. Young's family that he is now stable enough to move to a long-term care facility.

To view the full report, click here.

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