Monday, August 15, 2016

Blinded by the Globe

The above-the-fold flash was so bright....

"5 cataract surgeries, 5 people blinded: What went wrong?" by Liz Kowalczyk Globe Staff  August 14, 2016

The patients were lined up in reclining chairs, waiting their turns. When the surgery center’s anesthesiologist reached her, Kathleen White yelped in pain as he injected a numbing agent into her left eye. An assistant whisked her into the operating room for her scheduled cataract surgery.

The surgery lasted no more than 15 minutes — her surgeon had 45 cases on the schedule that day — and seemed to go smoothly. But at a follow-up appointment the next day, a staffer removed the patch over White’s eye and told her to read the letters on a wall chart.

“I can’t,” White recalls telling her. “Everything is black.’’

White, 65, was one of five patients who had surgery at Cataract & Laser Center West in West Springfield on a May morning in 2014, only to discover the next day that the patients could not see out of the eye that had been operated on.

The injuries have shocked and mystified cataract surgeons, who say even one serious injury is rare, and led specialists who examined the patients to conclude that the anesthesiologist on the cases, Dr. Tzay Chiu, possibly pierced their eyeballs or retinas with his needles, according to the surgery center’s investigative reports submitted to the state. Chiu’s attorney, Rebecca Capozzi in Waltham, declined to comment.

The documents reveal confusion about whether Chiu, who had been sent by an agency and was working his first day at the center, was properly screened. He was placed there by an anesthesiologist “broker’’ that had a contract with the center, a common practice.

Unlike many hospitals, the country’s more than 5,400 independent outpatient surgery centers — including about 60 in Massachusetts — often contract with outside companies to provide anesthesiologists, rather than employ them.

Anesthesiologists who are new to a center or substituting for a vacationing or sick colleague must be properly trained and then brought up to speed swiftly, to keep up with the cataract patients who stream through the center at a rapid clip. And if the center and the anesthesiology group are not working together closely, safety checks can fall through the cracks.

Several doctors said it can be hard to find qualified anesthesiologists well-trained to assist with cataract removal, which is the most-often-performed operation in the United States.

The cases also raise a broader issue about the reliance in Massachusetts on using eye blocks for cataract surgery, while physicians nationally tend to use less-invasive numbing drops more often. The patients interviewed by the Globe don’t recall discussing options with the doctors.

An “eye block,’’ involves injecting the numbing agent into the muscles around the eyeball, immobilizing the eye itself.... 

Which pharmaceutical has the contract? 


"Suit claims ex-state official had rules rewritten to help Steward" by Liz Kowalczyk Globe Staff  August 15, 2016

In June 2014, two executives from Steward Health Care System visited John Polanowicz, then the state’s health and human services secretary. They were far from strangers — Polanowicz had previously worked for Steward — and they chatted about golf and children, according to another person at the meeting.

Then Polanowicz handed his visitors a draft of a new policy that would give Steward an avenue to open a heart center, sidestepping a statewide moratorium.

This encounter has become a key element in a lawsuit brought by a Steward competitor against the Massachusetts Department of Public Health. In a recent sworn deposition, a former high-ranking health department employee who attended the meeting said Polanowicz told his guests he wanted to make sure the new policy gets “us what we want.”

The lawsuit contends that Polanowicz directed health officials to essentially rewrite the rules to allow Steward to build the cardiac center without a legitimate public health reason.

In a written statement e-mailed by a Steward spokesman, Polanowicz defended himself, saying the deposition contained “unfounded speculations’’ that are “demonstrably false.’’ The spokesman said hospitals routinely meet with officials and comment on proposed policies.

The deposition from Deborah Allwes, former head of the health agency’s Bureau of Health Care Safety and Quality, provides a glimpse into the behind-the-scenes agendas and disagreements that can shape policy changes.

And it raises questions about whether Polanowicz may have given special attention to a company he had worked for — and eventually would work for again — despite his assurances that he treated Steward the same as any other provider....

Give 'em hell, Globe.


Just made a deal with the union so there will be no strike.

I can't see myself reading this, sorry.