Hospital fined, live liver transplants banned

Serious safety violations in the live liver transplant program at Mount Sinai Medical Center in New York City warrant an indefinite ban on the procedure and $66,000 in fines, according to Antonia C. Novello, MD, New York state health commissioner. The state’s action prevents the hospital from performing a procedure that has been growing in popularity and which is seen as a giving new hope to patients needing transplants.

The ban and fine were the result of what Novello calls the state’s largest-ever investigation into a health institution. The inquiry found 33 serious violations, mostly in the liver transplant unit, and the commissioner levied fines of $2,000 each, the highest allowed by law. Novello said in a news conference that the findings were disturbing.

"Due to the severity and widespread impact of these violations, I cannot allow Mount Sinai Medical Center to reopen its living donor adult liver transplant program," she said.

The investigation was prompted by the death of a healthy 57-year-old man who was donating part of his liver to his brother. According to the health department, the donor choked on his own blood in a ward filled with 34 postoperative patients under the care of one first-year resident. The health department already has imposed a $48,000 fine after an initial investigation revealed that the death was caused by "woefully inadequate post-surgical care." Further investigation revealed more problems, such as the failure of a surgeon to check on a patient after an operation, and failure to protect patients from falling. Records indicated that in 10 transplant cases, the surgeon named on the consent form was not the surgeon who performed the procedure.

To revive its live transplant program, Mount Sinai must develop a comprehensive plan to address the problems and undergo a thorough inspection by the health department, Novello said. Mount Sinai issued a statement saying that many of the problems already have been addressed and that the hospital is working closely with the health department.