Surgical Trauma in California

Davis center suspends heart operations, kidney transplants

The University of California Davis Medical Center (U.M.C.) was increasingly cited for excellent patient care and impressive research, particularly in heart disease. But its reputation has now suffered a brutal blow. At the palm-lined campus in Sacramento, all kidney transplants and heart surgery have been suspended because of charges of excessive complications and high mortality rates.

According to a report prepared by U.M.C.'s cardiologists, the facility's four heart surgeons operated on 346 patients over a 22-month span in 1979 and '80.

The results: 17% died and 40% of the 288 survivors had surgical complications. Nationwide, the mortality and morbidity rates for heart surgery are, respectively, about 2% and 8%. The kidney transplant ban results from charges of "gross incompetence and negligence" leveled at Chief Kidney Transplant Surgeon Satya Chatterjee by Dr. William Kirby, a former senior resident in urology at U.M.C., and Nurse Kathleen Whittemore, the hospital's former transplant coordinator.

Chatterjee, 42, now on sabbatical, has practiced for four years at the 405-bed facility. Between 1977 and '79, says Kirby, 24% of Chatterjee's 55 patients rejected kidneys and 36% required additional operations, because of surgical errors. The comparable figures for departmental colleagues, he notes, were no higher than 6% and 18%. In 6 1/2 months in 1980-81, Kirby claims, Chatterjee performed 23 more kidney transplants, and 25% of the patients died. Nationally the mortality rate after one year for kidney recipients is around 10%, and in some centers it is under 5%.

U.M.C. officials are hesitant to comment on just what the heart and kidney statistics may mean. Cautions U.M.C.'s Chief Nephrologist Paul Gulyassy: "Don't assume that every time anybody dies there is negligence." Irate patients and families, however, have slapped U.M.C. with 20 lawsuits seeking more than $500 million in damages.

In addition to raising questions of competence, the controversy has cast doubt on the effectiveness of U.M.C.'s self-policing machinery. Long before last June, when the charges became public,

U.M.C. cardiologists had apparently lost faith in their in-house surgeons and were routinely referring difficult cases to other institutions. Last December, after reviewing the records of heart surgery patients at U.M.C., the cardiologists presented Medical School Dean Hibbard Williams with a report containing the depressing statistics. Williams ordered a review but apparently took no other action. At that point cardiologists became so upset that they began referring almost all patients needing heart surgery to other facilities.

Kirby and Whittemore began complaining to U.M.C. officials about Chatterjee's performance in 1979. Kirby contends that an internal investigation focused on personality conflicts among staff rather than the surgeon's competence. "There is no effective peer review at the medical center," declares Kirby.

Apparently others agree. U.M.C.'s performance is now being investigated by the Joint Commission on Accreditation of Hospitals, California's department of health and the state's board of medical quality assurance.

This file is automatically generated by a robot program, so viewer discretion is required.