A Bad Place to be Broken-Hearted

Kerry Howley | February 14, 2005

Small hospitals in Massachusetts and elsewhere are battling for the right to remove blockages from their patients' arteries. Non-emergency angioplasties, which are becoming a vastly more common way to deal with blocked arteries, are currently only legal in Massachusetts hospitals with open-heart surgery programs. The risk of complications has fallen to less than one percent thanks to improved technology, but the restrictions remain. The Boston Globe reports on a doctor who found a blockage but was forbidden to touch it:

Marks had more bad news for his patient: Massachusetts regulations forbid him to perform the procedure at the suburban hospital in Weymouth. So he left the 4-inch tube holding open an entryway to the artery in her thigh, told her not to move, summoned an ambulance, and transferred her to Tufts-New England Medical Center in Boston, where later that day he did her angioplasty.

Whole thing here.

Comments

|2.14.05 @ 3:30PM|#

One of the few remaining good things about living in MA is that we have some of the best medical care in the world. Nice to see they're trying to ruin that too. How far is VA again?

Xmas|2.14.05 @ 3:38PM|#

Hey! South Shore Hospital!

I'll be driving by there later today.

|2.14.05 @ 3:43PM|#

Eryk Boston,

I am sure that your fellow Taxachusetts comrade can explain the wonderful effects of this particular regulation. :)

|2.14.05 @ 4:12PM|#

Well I'm not a resident of Mass. but I can tell you that occasionally that 1% complication rate requires emergent (read: within minutes) surgery or you die. One of my surgery professor's favorite stories (he told it over and over) was how he rode a gurney down to the operating room, sucking blood out of patient's chest with a big needle in the pericardium, trading syringes with another resident who would push the blood back into a vein. The patient had a ruptured coronary artery from angioplasty. Now if you are a believer in no regulation, fine, this is just another example of the gov. getting involved where they shouldn't -- caveat cardiac (I know it doesn't actually make sense in latin, but it's so alliterative). But the rule is in place to prevent small hospitals from opening cardiac cath suites and boxing people because they can't get them to the OR in an emergency. The law may be outdated if risks are low enough but knowing what I know, I wouldn't get an angioplasty where there was no possibility of an emergency bypass. YMMV.

|2.14.05 @ 4:15PM|#

My ears are burning.

Eryk, "ruin?" These regulations have been in place for decades, and they are common throughout the developed world. The purpose is to ensure that procedures that have a high chance of causing a side effect are only carried out in hospitals that have the capacity to threat that side effect.

Though the advancements in angioplasty techniques seem to overtaken said purpose. But if you want you surgery done by the best pair of hands in Roanoke, knock yourself out! Seriously - they haven't filled their nurse/anesthetist position.

|2.14.05 @ 4:32PM|#

Go South Shore Hospital!!!

1995 - diagnosed with persistent heartburn. Ended up being a hole in my esophagus.
1998 - diagnosed with a broken third carpal. 6 weeks of full forearm/hand immobilization, 6 more weeks of rehab. Follow-up sez no scarring, never broke it.

Got jury duty once, case was malpractice against said hospital.

Needless to say, I was dismissed WITHOUT HAVING TO LIE - whoohoo!!!

|2.14.05 @ 4:34PM|#

Meaning - of course - I wouldn't trust any doc there that said I had a blockage. Doc would prolly replace my aorta with a piece of pvc...

|2.14.05 @ 4:36PM|#

Hey, a chance for the citizens of the Peoples' Republic of Taxachusetts to look foolish in the eyes of the Reason world. I'm a south shore boy myself.

|2.14.05 @ 5:19PM|#

"Less than 1%" doesn't sound that impressive for heart surgery complications. How MUCH less? If you're doing, say, one of those procedures per day that's potentially one dead patient every 3-4 months or so? And I'm sure the families won't be at all inclined to pursue malpractice suits...