Becker's Clinical Quality & Infection Control

10 INFECTION CONTROL & PATIENT SAFETY 'I'm not sure that this is ethical, moral or right': Newark Beth Israel kept patient alive to improve transplant program's survival rate By Mackenzie Bean N ewark (N.J.) Beth Israel Medical Center allegedly kept a patient in a vegetative state alive for a year to improve its transplant program's survival rate, according to an investigative report from ProPublica. For the investigation, ProPublica reporters interviewed patients, family members, and eight current and former employees at New- ark Beth Israel. ey also reviewed medical records, emails, text messages and audio recordings of medical staff meetings that were corroborated by several sources. Six takeaways from the report: 1. e report found hospital metrics influ- enced physicians' treatment decisions for at least four transplant patients. At times, physicians failed to consult with patients and families or withheld care options from them. 2. A large portion of the report focuses on the case of 61-year-old Darryl Young, who has been in a vegetative state since undergo- ing a heart transplant at Newark Beth Israel on Sept. 21, 2018. Recordings obtained by ProPublica show the hospital's transplant team was determined to keep Mr. Young alive, despite assuming he would never wake up or regain normal function. "[We] need to keep him alive till June 30 at a minimum," Mark Zucker, MD, director of Newark Beth Israel's heart and lung trans- plant programs, says in one recording of a transplant team meeting. 3. June 30 marked the publication date of a federally funded report on transplant sur- vival rates. While Newark Beth Israel had maintained a high one-year survival rate for heart transplant patients from 2008-17, this rate fell in 2018 for unknown reasons. Six of 38 patients who underwent heart trans- plants at the hospital in 2018 died, which equates to an 84.2 percent survival rate. Mr. Young's death would've dropped this rate to 81.6 percent, which falls below the national average and could've put the transplant program at risk of federal penalties. 4. e recordings show Dr. Zucker instructed hospital staff to avoid giving Mr. Young's family the option to withdraw care and switch to palliative treatments until aer this September, or one year aer his transplant. "I'm not sure that this is ethical, moral or right, [but it's] for the global good of the future transplant recipients," Dr. Zucker said in different recording of an April meeting. 5. Newark Beth Israel told ProPublica it's conducting an internal investigation of the transplant program in response to the report. e hospital declined to comment on Mr. Young's case specifically but told the publication its transplant program "has saved countless lives" and consistently met all regulatory guidelines. "Disclosures of select portions of lengthy and highly complex medical discussions, when taken out of context, may distort the intent of conversations," the hospital said of the recordings. "Our patients are our utmost priority and communication with our patients and their families is paramount in enabling our team to provide the best and most comprehensive care." 6. Mr. Young is still alive and in a vegetative state as of Oct. 3. On Sept. 18 — three days before the one-year anniversary of his trans- plant — clinicians told Mr. Young's family that he was now stable enough to move to a long-term care facility. n Only 52% of US adults plan to get flu vaccine this season, survey finds By Anuja Vaidya A little over half of U.S. adults plan on getting vaccinated this influenza season, according to data released by the National Foundation for Infectious Diseases. The foundation sponsored a survey conducted by National Opinion Research Center at the University of Chicago from Aug. 15-18. The survey included 1,002 complete responses from U.S. adults, ages 18 years and older. Six survey findings: 1. While 60 percent of adults agreed that vaccination is the best preventive measure against the flu, only 52 percent said they plan to get vaccinated this season, and 18 percent said they are not sure. 2. Of those who said they would not get the vaccine, a majority said the reason is they do not think flu vaccines work (51 percent), and many are concerned about side effects from the vaccine (34 percent) or are concerned about getting flu from the vaccine (22 percent.) 3. More than six in 10 indicate that they get information about flu vaccines from healthcare professionals; 55 percent report also getting information from online sources. 4. Seventy percent do not trust social media for information about flu vaccines. 5. Most adults (62 percent) report receiving their last flu vaccine in a health- care setting. 6. Sixty-three percent said that their employers offering flu vaccinations would not make them more likely to get vaccinated. n

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