An investigation by the USA Today Network and Kaiser Health News has uncovered evidence that more than 260 patients have died since 2013 after outpatient procedures at surgery centers across the country. Dozens of people – including children as young as two – have died after routine operations, such as colonoscopies and tonsillectomies.
· Surgery centers have dramatically expanded their business by taking on increasingly risky surgeries. The results have been tragic. Investigators found that at least 14 patients have died after having spinal surgeries that were typically reserved for the best hospitals and surgeons.
· The incentives for doctors to steer patients to surgery centers can be significant, with many doctors owning a portion of the surgical center and receiving a fee from their ownership.
· To protect patients, Medicare requires surgery centers to line up a local hospital to take their patients when emergencies arise. This can be a problem in rural areas where centers can be 15 or more miles away from the nearest hospital.
· Even when the hospital is close, surgical centers are not always equipped to handle emergencies and are forced to dial 911 in the face of an emergent situation. Twenty to thirty minutes can pass between a 911 call and arrival at an ER.
· Some surgery centers risk patient lives by cutting corners on training or lifesaving equipment. Others have sent patients home before they were fully recovered from surgery.
· Other surgery centers are treating people with high risk health problems who should only be operated on in a hospital. In fact, at least 25 people with underlying medical conditions left surgery centers and died within minutes or days. These cases include a 49-year-old man awaiting a heart transplant, a woman with out-of-control blood pressure, and several children with sleep apnea. All of these patients died after having quick in-and-out surgical treatment.
· Surgery centers have also been criticized for not having a properly trained staff with the skills required to save a patient from bleeding to death and for not having the necessary tools and equipment needed to deal with an emergency situation such as opening a difficult airway.
Medicare advises surgery centers to transfer patients to hospitals when emergencies arise. However, despite the fact that only a third of surgery centers participate in a voluntary effort to report how often that happens, reports show that at least 7,000 patients were sent to the hospital in 2017 alone.
As of 2018, there are 5,616 Medicare-certified surgical centers in the United States. In 2007, Medicare warned that surgery centers “have neither patient safety standards consistent with those in place for hospitals, nor are they required to have the trained staff and equipment needed to provide the breadth of intensity of care. …” Some procedures are “unsafe” to be handled at surgery centers, the report concluded.