People are dying after procedures in NJ “same day” surgery centers

Source: North Jersey.com

They are called “same-day surgery centers,” leading patients to expect a quick in-and-out for a routine procedure.

But the experience was anything but routine for Rekhaben Shah, 67, who reported to the Oak Tree Surgery Center in Edison for a colonoscopy. During the intestinal exam, her oxygen level plummeted and her pulse dropped. She died two days later.

Nor was it routine for Pedro Maldonado, 59, who went to the Ambulatory Care Center in Vineland for a seven-minute endoscopy to address stomach pain. He never woke up.

And not for Veronica Gates, 51, who scheduled surgery at the New Horizon Surgical Center in Paterson to relieve neck pain. Soon after she was put under, her family’s lawsuit says, she suffered a heart attack and died.

The three cases constitute just a fraction of the thousands of procedures performed each day at New Jersey’s same-day surgical centers — freestanding operating facilities that increasingly take on complex cases without the safety net of a fully-equipped hospital. Dozens of patients have died at the centers since the state began safety reporting in 2008, and more than a thousand patients have become comatose or suffered serious preventable injuries, state records show.

New Jersey has 298 such centers. Until a 2010 state moratorium on creating new ones, it was easier to get permission to open a same-day surgery center in New Jersey than in most other states. But soon, all New Jersey surgery centers will be playing by the same rules. Under a law signed by Chris Christie on his last day in office, centers that currently operate without state licenses will be required to get them, they will be inspected more often, and the inspection results will be posted online.

About half of New Jersey’s same-day surgery centers have been exempt from such oversight because they have only one operating room. They are considered extensions of the doctor’s office and registered with the physician licensing board, which does not make information about complaints public. Two-thirds of the unlicensed facilities – compared with one-third of the licensed facilities – surveyed in 2015 received “immediate jeopardy” citations, according to Medicare data.

Doctors usually tell a patient where to have a procedure — whether in or outside of a hospital. And doctors like surgery centers because of their efficiency, ease of scheduling, and higher reimbursement from insurance companies and Medicare. Most are owned by physicians, who receive a share of the “facility fee” as well as payment for procedures they perform.

Higher out-of-network payments have been an added enticement, although many surgery centers now are included in insurance networks.
Patients and their insurers like surgery centers, too, because they promise lower costs, less risk of infection and greater convenience. They count on the centers to offer the same protections and quality of care as hospitals.

But the two settings are different — in resources, regulations and oversight. And that can mean the difference between life and death.

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