Florida Republican Gov. Rick Scott’s administration appears to be responsible for jettisoning hospital standards of pediatric heart surgery after Tenet Healthcare – a for-profit hospital chain previously failing to meet state standards – donated $200,000 to Florida Republican interests. The Florida Department of Health stated that the pediatric guidelines, in place for the last 40 years, were eliminated when state legislators repealed cardiac-care standards related to the Children’s Medical Services program, which provides specialized services to children. Pediatric cardiologist Dr. David Nykanen told CNN, “The coincidence is just a little too much. It’s just a little hard to swallow.”
Florida’s Department of Health said that the quality standards had to be rescinded after the Legislature failed to give permission to continue the standards.
“Our number one priority is the health of all Floridians, especially children,” Department of Health spokeswoman Mara Gambineri explained by email to CNN. “We fully support [the] best practices and high standards of care at Florida’s hospitals. As an executive branch agency, the department’s authority is limited to those functions statutorily delegated by the Legislature.”
The state removed the surgery guidelines after Judge John Van Laningham, who said they failed to prove that the department’s move would diminish the quality of care, dismissed a challenge by parents of children suffering from serious heart conditions. Judge Van Laningham added that the notion that doctors and nurses needed the standards to give quality care is “a little insulting to the health care professionals who personally deliver those services.”
The assertions come after Tenet Healthcare, which contributed $100,000 to Scott’s political action committee, and another $100,000 to the state GOP during the same period. Representatives for both Scott’s office and Tenet have denied discussing the elimination of the guidelines.
The guidelines for handling children with heart conditions were eliminated less than three months after a CNN investigation uncovered that Tenet Healthcare’s facility, St. Mary’s Medical Center in West Palm Beach, had a 12.5 % death rate for heart surgeries on children between 2011 and 2013. The Society for Thoracic Surgeons indicates that, by comparison, St. Mary’s death rate was three times greater than the national death rate. In 2014, as part of a state-mandated review, Johns Hopkins surgery professor Jeffrey Jacobs recommended that St. Mary’s discontinue performing heart surgeries on children younger than six months. The hospital, however, continued until August 2015, when it closed its pediatric heart surgery program and hospital CEO Davide Carbone resigned.
“Our opinion was not sought on the standards nor have we expressed a position on the possible repeal of the standards or the role of the Cardiac Technical Advisory Panel,” Tenet spokesperson Shelly Weiss Friedberg said.
Nevertheless, Dr. Nykannen and other pediatric doctors around the state, including members of the Cardiac Technical Advisory Panel, remain incredulous. State officials say the decision came from the surgeon general – a Scott appointee. However, historically important decisions at the Department of Health typically come from the governor’s office. Dr. Ira Gessner, professor emeritus of pediatric cardiology at the University of Florida College of Medicine and an advisory member of the state’s Cardiac Technical Advisory Panel stated Jennifer Tschetter, the Department of Health’s chief of staff, “was always very careful at every meeting to say there’s no political agenda here. But we thought to ourselves, ‘Do you think we’re stupid?'”
By CATHERINE BUCKLER / Contributing Writer