St. Joseph Hospital needs to have a written policy on how patients are screened and selected for surgery at the new Heart Institute before the program restarts. And the hospital will be required to have three surgeons (two in addition to the chief cardiac surgeon) in the operating room as required by state law -- at least for a while.
Those are two of the findings of a recently completed state investigation into the open-heart surgery program, according to sources. The program was started in April and closed three months later because of the concern over the number of deaths during the start-up phase.
The report will not be made public until Department of Health Services approves St. Joseph's plan of correction.
"The (state's) report is consistent with what they told us when they were here to review the program," said Willard Foote, acting chief executive officer for the hospital.
In a letter to the community last month, Foote said there had been six deaths out of 40 surgeries during the first three months of the program. (The Journal previously reported four deaths, several of which were high risk patients.)
In addition to an internal review by the hospital and the formal state review, which was the result of a complaint to the state Department of Health, St. Joseph has asked for a review by the Society of Thoracic Surgeons which had not occurred as of press time.
"At the end of this process, we willl make changes as needed and reopen," Foote said in the letter.
Foote told The Journal that the three-surgeon state law is "not necessarily inappropriate" for a start-up heart program, but once programs are up and running that requirement is almost always waived. "In a way the law is archaic," he said.
Foote also confirmed that when the hospital restarts the heart surgery program, it will likely be in conjunction with another cardiac surgical team from out of the county.
Before the Heart Institute opened, North Coast patients requiring open heart surgery were transported to Redding, Santa Rosa or San Francisco for those procedures.
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