HCA slammed for unnecessary cath procedures

The largest for-profit hospital chain in the U.S. is under fire for performing thousands of cardiac catheterization procedures that were medically unnecessary, according to an August 6 article in the New York Times.

Cardiologists at HCA, which owns 163 U.S. hospitals, have been unable to justify as many as half of their catheterization procedures going back as far as 2002 and continuing through 2010, according to the article and the results of the company's own internal audit.

The investigation began after a former nurse in one of HCA's Florida hospitals complained to the chain's chief ethics officer that cardiac cath procedures were being performed routinely on patients without a medical need. Less than two months after initiating an investigation, the ethics officer confirmed to a Times reporter that the charges were valid. Meanwhile, the whistleblower nurse, C. T. Tomlinson, told the newspaper that his contract was not renewed after reporting the faulty practices.

No internal documents reviewed by the newspaper calculate how many procedures were wrongly undertaken, and whether patients might have died or been injured as a result. The documents suggest that the problems at HCA were widespread, but whether there was a financial motive for the unnecessary procedures is unclear, the Times wrote of the HCA report.

According to the article, the HCA investigation found the most severe problems at a handful of Florida hospitals, including Cedars Medical Center in Miami, which HCA has sold, the Regional Medical Center Bayonet Point, and Lawnwood Regional Medical Center in Fort Pierce. In some cases, the doctors made misleading statements in medical records to make it appear that the procedures were warranted, according to reports provided to the Times. At Lawnwood, fully half of the 1,200 cardiac catheterization procedures were found to be unnecessary, the article stated.

Responding to the charges, the cardiologists told the Times that the review did not accurately reflect the care they provided to patients, and for its part, HCA said its reviews were "not, by any means, definitive," according to the newspaper.

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