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Seriously…Cleveland Clinic?

Sweeping Dirt Under RugHarvard, Yale, Princeton and Stanford – all are very prestigious universities.

Likewise, the Mayo Clinic, Johns Hopkins and Cleveland Clinic – are all are very prestigious medical facilities, right?

Having a stellar reputation takes years (and generations) to build, whether it’s institutions of higher learning, healthcare organizations or law firms, etc. Being ‘prestigious’ comes with many flattering adjectives like: celebrated, trusted, respected, prominent, great, important, imposing, influential, renowned, and exalted.

The Cleveland Clinic has enjoyed this elevated stature for years. But, unfortunately in healthcare, it may be easier (and cheaper) to ‘buy’ an image of quality than it is to consistently perform quality care practices day in and day out – especially when the image is protected by suppressing information from state and federal authorities regarding safety practices.

Believe it or not, Cleveland Clinic was on a “termination track” with Medicare between 2010 and 2013 (19 total months) for more than a dozen inspections that occurred due to patient complaints. Cleveland Clinic was threatened to lose its almost $1 billion annual Medicare reimbursements – quite a hit, even for a multi-billion dollar organization. After repeated Cleveland Clinic violations, the Centers for Medicare and Medicaid Services (CMS) took the unusual step to personally cite CEO Toby Cosgrove and the Cleveland Clinic Governing Board.

In June, Modern Healthcare reported that retired Air Force Col. David Antoon had accused Cleveland Clinic of withholding documents from federal authorities while the Clinic was being investigated for substituting Antoon’s authorized surgeon with a medical resident that resulted in a gross medical mistake. Mr. Antoon suffered serious disabling injuries resulting in the loss of his job as an airline pilot.

According to this article, and based on my correspondence with Mr. Antoon, the Cleveland Clinic hid important documentation from federal inspectors to avoid responsibility (and liability) for their derelict actions. If this can happen at a prestigious institution, you can be confident that it can happen anywhere.

As mentioned in previous blogs, Rosemary Gibson, senior advisor at The Hastings Center, did a splendid job of explaining in her book, “Wall of Silence,” how the ‘medical industrial complex’ in this country is conspicuously silent when it comes to medical mistakes that kill and injure millions of Americans.

U.S News & World Report recently published the ‘Best Hospitals Rankings’ and placed the Cleveland Clinic in the top position for Urology. In contrast, Healthgrades ranked Cleveland Clinic with the lowest possible score for prostatectomy outcomes; CMS data for Hospital Acquired Conditions (HACs) placed Cleveland Clinic in the bottom 7% of all hospitals with a score of 8.7 (scores ranging from 1- 10, with ten being the worst); and the independent Leapfrog Group gave the first ever “D” grade to Cleveland Clinic for patient safety. WDAF-TV (Kansas City, MO) recently reported that hospitals must pay US News to use the “Best Hospitals” logo in advertising. Many rating organizations charge hospitals to market their grades. So what can the public believe: “pay to play” advertising or independent reviews?

The Cleveland Clinic will continue to pay US News to market itself as evidence that they are a ‘prestigious’ medical organization, and yet quietly sweep the CMS action, and other independent negative reviews, under the rug.

Again, my point is simple. If this happens to the prestigious Cleveland Clinic, it can happen anywhere – and it does. Unfortunately, the Cleveland Clinic story is only the tip of the proverbial medical iceberg. The medical industry is unwilling and, quite frankly, unable to reform itself from within. Because of this reluctance, it is now time for the public to apply transparency measures. Our own lives may depend on it.

As the saying goes: “Fool me once, shame on you. Fool me twice, shame on me.” I think this easily applies to all of us who continue to allow the medical establishment to self-regulate with secrecy – resulting in unnecessary harm to unsuspecting patients.

I’d love to hear your thoughts.

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Comments

  1. “Deny and defend,” not “World Class Care,” seems to be the policy of the Cleveland Clinic and the “medical-industrial complex.” 440,000 patients die from medical harm each year in this country–for which the cause is not reported. In the case cited, many patients of one Cleveland Clinic surgeon reported falsified, altered, and unsigned documents while investigating their own devastating negative surgical outcomes. This cluster of harmed patients, not oversight agencies, discovered and reported: “Copy and Paste” picture perfect Op Notes did not reveal severe blood loss, complications, or negative outcomes; progress notes by junior residents and Pa’s were not cosigned; OR logs, audit reports, surgical time-outs were inconsistent; signed informed consent documents (in 28 of 28 medical records surveyed by CMS) were missing; surgeon’s attestations were blank or missing; day of surgery notes with a checklist of review of informed consent with patient were blank, missing, and in two cases signed weeks after the surgery. CMS survey notes cited that this doctor was performing multiple complex major surgeries simultaneously twice per day with the surgeries beginning within minutes of one another–not overlapping. In violation of patient consents, residents were performing these surgeries unsupervised. In two successive years, CMS cited the Cleveland Clinic for lacking credentialing requirements, certification, and privileging for staff and residents in the Urology department. Privileging was not required for use of the da Vinci robot by staff or residents used in the surgery. CMS, nor the Joint Commission, sanctioned the Cleveland Clinic for these serious violations or for the permanent harm to a “staggering number” of .unsuspecting patients. The State of Ohio Medical Board dismissed initial complaints filed by harmed patients. After a cluster of harmed patients filed complaints simultaneously at the suggestion of the American Board of Urology, the Medical Board reopened the case against this doctor on 11 August 2011. The case remains open and this doctor continues to practice at the infamous Cleveland Clinic. Tort reform and other legislation dictating confidentiality of egregious acts by providers pushed by the medical lobby, combined with the inaction of CMS, Joint Commission, ACGME, medical boards, and other “oversight” agencies, allow doctors and hospitals to act with impunity. The only “sunshine” being cast on this national issue comes from patient advocates….and it is growing. Kudos to David Lind for putting “sunshine” on this issue!

  2. My son and his aunt were seriously injured in a kidney transplant done at the Cleveland Clinic,
    The story is much too long to recap here. Our website Kidneytransplantkiller.com and our book “One Foot in the Grave” for sale on Amazon reveals the macabre story of what happened to our family at the Cleveland Clinic. I appreciate your article for finally bringing to light that the Cleveland Clinic only pays for their standing in places like US News and World Report and pays for publicity to con the world into believing they are the best. Their lack of patient safety and infection rates are at an all time high. Their board members consist of a member of the Cleveland Plain Dealer, and prominent people in town. They think they have all their bases covered, but the number of injured patients is becoming even bigger than what they can control with payoffs. More people need to be brave enough to speak up about their so called “world class care”

  3. The book is “Born With One Foot in the Grave”

    • David Lind says:

      Cindy,

      Thank you for sharing your personal experiences at this particular website. Your comments certainly coincide with Rosemary Gibson’s, “Wall of Silence.” I will certainly look for your book, “Born With One Foot in the Grave.”
      My best to you and your family, Cindy.

  4. Brad Banko says:

    You should be careful not to use CMS as a gold-standard yardstick for “world-class care”.
    CMS didn’t build the world’s #1 heart center…

    I would argue that you should be justifying CMS’s role in all of this. Some of the *onerous* regulations that CMS imposes on the healthcare system make it *harder* for health care systems to do a good job.

  5. My girl friend recently passed away on life support while at the Cleveland Clinic.
    What started out as a routine surgical procedure ended up a disaster. My girl friend entered the hospital with some motor deficits where she was unable to stand. The surgery went well and I saw her the next morning in good spirits and showing me that she could again use her legs. I
    left expecting to come back and get her in 3 or 4 days A severe snow storm hit and I was not able to get hold of her .Four days later I decided to call CC. The doctor there said that they had tried to get hold of me but supposedly lost my number. They said she was in serious trouble.
    When I arrived I found her arms 3 times normal size and she was unable to wake up. After 12 hours by just stopping the fluids she began to wake and take ice chips and yogurt orally. Over the next several days she continues to improve. Then The TPN specialists came back in and explained that she was severally malnourished and she would die if we did not start TPN.
    As her POA I told them only If they will reduce the volume and rate of flow of the fluids.
    On entering her room 2 days later I could see that had not been done. I immediately
    told them no more fluids ever. Unfortunately the damage had been done as I tried to continue the
    spoon feeding and ice chips but soon after she began having a seizure. It was on Christmas eve and only 1 doctor was on call for the whole floor. At 12 PM I could no longer give any oral food and asked to see a doctor. They sent a resident in who assured me that I should turn the lights off and the intermittent attacks would dissipate. I watched for another hour and she seemed to improve so I went back to my motel at 4 AM. The next day I went to her room and she had been readmitted to the ICU. From there things spiraled out of control. I am sure because it was on Christmas no one watched her and she had been in an intermittent seizure for much of that night. Now this was a patient that should have extra attention since she had had
    a kidney transplant and only 1 functional kidney and also had short bowel disease with malnutrition. It is my firm believe that over hydration resulted in a cascading group of events that ultimately resulted in her being on life support

    • David Lind says:

      Roger, thank you for your comments. You have my sincere condolences. I certainly hope that new protocols and systems will be ultimately be established in our entire health system, as these stories should never have happened and are egregious. My best to you…

  6. David I forgot several other atrocities my friend endured. Instead of providing physical therapy post operative and assistance to a toilet they apparently sedated her and had installed a rectal flex tube to convey away any fecal material.Then they overhydrated her with IV fluids making it resulting on her going on life support.

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