What Role Did Johns Hopkins Have in the Demise of All Children’s?
The shockwave caused by the reports concerning the quality of care at All Children’s Hospital has yet to fully dissipate. Yet it remains clear that the reported failures both inside and outside the hospital contributed to an unprecedented death toll among the patients of the pediatric heart ward. So far, we’ve discussed some of the regulatory failures of the government agencies involved in overseeing the medical profession, but what exactly happened within the hospital that caused the department posted some of the worst statistics of any hospital in the last decade?
According to those who worked within the hospital, there were a number of contributing factors.
Johns Hopkins Brings Sterling Reputation and Structural Chaos
In 2012, All Children’s Hospital reached out to Johns Hopkins in order to upgrade its pediatric surgery program. The hospital already had three doctors on the staff and a solid reputation in the State of Florida. But then-CEO Jonathan Ellen hoped for national and international renown for his hospital. He wanted to put All Children’s on the map, but the hospital personnel is alleged to have gone about it the wrong way.
All Children’s kept two of their chief surgeons, Dr. James Quintessenza and Dr. Jeffrey Jacobs. After losing Dr. Paul Chai, who only performed occasional surgeries at the hospital, the department added Dr. Tom Karl, who had hundreds of publications and had worked in some of Australia’s top heart surgery programs. While Jacobs was primarily known for academic publications, Quintessenza had performed the majority of the surgeries prior to the Johns Hopkins take over getting excellent results along the way. When Karl arrived, the surgeries were split evenly among the three doctors with disastrous results.
Dr. Jacobs became the target of several newspaper articles after the program put up unremarkable and then highly problematic statistics during the 2015 to 2017 stint that saw patient fatalities triple. While Jacobs allegedly shares some of the blame, Johns Hopkins saw fit to replace the entire nursing and support staff of the department at the same time. Meanwhile, as mistakes began piling up, hospital administrators, including CEO Jonathan Ellen, allegedly refused to publish records of fatalities and the State of Florida accused the hospital of failing to report two adverse medical events.
The situation got worse in 2016 when Quintessenza left the department troubled by many of changes that were being made. In 2017, nearly 10% of all the patients that the hospital conducted surgery on died without Quintessenza there.
Karl and Jacobs Struggled to Perform Surgeries
Surgery is a methodical and meticulous craft, and those who are exceptional practitioners aren’t necessarily being published in major journals. Karl and Jacobs had hundreds of publications between them but problems with their surgeries were apparent as early as 2015. Under the oversight of Johns Hopkins’ Dr. Paul Colombani, the department had come from one of the best in Florida to one of the worst in the country. Surgical errors became the new normal.
In one case, Karl had left a surgical needle in a patient’s body. According to reports, other physicians were aware that the needle was left there. In another case, a young woman required three heart surgeries in order to survive a birth defect. The two most difficult were performed by Quintessenza. Only about 20% of those who undergo the surgery that Quintessenza performed survive. But this little girl. She then survived the also risky second surgery, but the third surgery was performed by Jacobs and Karl. Although the third surgery only has about a 2-3% fatality rate, the girl had a stroke. She can no longer move her arms and legs or even keep her head up.
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