French Hospital has high heart surgery death rates

April 29, 2013

French_HospitalA state report ranks San Luis Obispo’s French Hospital Medical Center — and a doctor who performs surgeries there — as having some of the highest adjusted mortality rates for heart bypass surgery patients in the state, according to a report released last week by the Office of Statewide Health Planning and Development.

French Hospital ranks 115 out of 120 for hospitals in California that host Coronary Artery Bypass Graft (CABG) surgeries. Pismo Beach based surgeon Stephan Freyaldenhoven has the fourth highest adjusted mortality rate, ranking 268 out of 271.

In 2010, of 93 isolated CABG surgeries performed at French Hospital, five patients died.

French Hospital officials did not respond to an email query from CalCoastNews.

CalCoastNews focused on the state’s 95 percent confidence interval for risk-adjusted mortality rates. These rankings are adjusted from the observed mortality rate by factoring in the patient’s specific health indicators and the number of surgeries performed.

For example, even though a physician may have lost one out of two patients, which would be an observed rate of 50 percent, the surgeon may have a better factored rate than a doctor who lost three out of 30 patients.

The state’s reported hospital rates are based on 2010 data, while surgeon grades are based on data from 2009 and 2010. The mortality rates include all deaths which occurred during hospitalization in which the CABG surgery was performed, and any deaths within 30 days after the surgery.

Catholic Healthcare West, a not-for-profit that operates French Hospital, became San Luis Obispo’s only cardiac surgery provider in 2010 after several doctors with a financial interest in French Hospital refused to perform surgeries at other local hospitals.

 







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  1. mimislo says:

    The inevitable result of greed and for-profit healthcare. We get what we pay for and since few of us can pay for our own healthcare we are in the hands of greedy insurance companies and Drs. who are compelled by need or greed to spend more time worrying about their bottom line than their patients.

    (0) 10 Total Votes - 5 up - 5 down
  2. FineWine says:

    I am always skeptical of any “adjusted” numbers. The government uses the term to manipulate financial data all the time. They never explain how they adjust and neither does this article. Having said that I am concerned at how they are trying to make certain hospitals in the area specialty hospitals. French heart and sierra vista trauma. It seems to me you are reducing the overall care in the county by concentrating specialties in hospitals that may be some distance from where you live. I also think it is a way to a some point close some of the hospitals once obama care and total government care which is next takes hold. They will have to do something to reduce costs once they start skrocketing.

    (-1) 15 Total Votes - 7 up - 8 down
    • onceknown says:

      If you look at the report, it encompasses doctors and hospitals throughout the state. There a very few “worse” ratings, the rest are “average”. Taking emotion and bias out of the discussion, it would seem the report does raise questions about the hospital and the doctor. Also, the doctor had an average rating at a different facility.

      (7) 9 Total Votes - 8 up - 1 down
    • Truth Seeker says:

      You bring up an excellent point. Competition always creates better care and better results. The opposite of what the French Hospital Board members where trying to express in their scare tactic letter written to the Tribune on the 24th of April.

      (6) 10 Total Votes - 8 up - 2 down
  3. onceknown says:

    I’ve slammed CCN for shoddy reporting in the past, but this article is based on fact. Check out the report. You can interpret the report anyway you want. Me, I’d be looking for another doctor. Good job, CCN.

    (6) 20 Total Votes - 13 up - 7 down
  4. roxanne22 says:

    Have any of you ever had a procedure at French? If not,Shut the hell up

    (-9) 33 Total Votes - 12 up - 21 down
    • ironyman2000 says:

      I have and I ain’t shuttin’ up. Possibly the worst experience of my life. Not a perception. A fact.

      (11) 25 Total Votes - 18 up - 7 down
    • MaryMalone says:

      I HAVE. Read my post at 04/29/2013 at 6:06 pm on this page of posts.

      (1) 5 Total Votes - 3 up - 2 down
  5. MaryMalone says:

    It is not just the “hospitalist” physicians, and it is not just what goes on in the OR. French Hospital, the last time I was admitted for orthopedic surgery, had MAJOR, MAJOR problems. In fact, I felt I was at such a danger being there that, while I should have been hospitalized 5 days, I begged for discharge after two-and-a-half days, and they discharged me.

    Any poor outcomes of all the surgeons who use French may very well be because of French Hospital’s terrible patient care.

    These were the problems:

    *Patient rooms were dirty.

    *Bathroom was not set up for patients who have undergone orthopedic surgery (this was in their orthopedic-surgery part of the hospital). Had I not had a prior similar surgery, I may very well have had a poor surgical outcome because the problem with the bathroom set-up was compounded for tall people.

    *The hospital rooms were VERY crowded. There were three beds crammed into a room that was built for two beds. This is how crowded it was. An elderly woman in the bed next to me had been admitted for a repair of a very, very bad femoral fracture. For the kind of surgery I had, they wanted you as mobile as possible and as quickly as (supposedly safely) possible, so the first out-of-bed movement was usually sitting upright in a chair. My bed and the bed of the woman who had surgery for a very bad femoral fracture were so close that, the only place for a chair for me to sit in was between our beds, and the chair touched BOTH beds. I actually encouraged her to eat and helped her eat–she was so out of it because of pain medications and the hospital provided NO assistant to help feed her, even though I told nursing staff about the risk of aspiration (she was trying to eat laying flat on her back, and that is very dangerous because of the possibility of aspiration of the food into the lungs, especially when the patient is heavily sedated).

    *HIPPA patient-confidentiality regulations? They didn’t even TRY. The beds were crammed so close together that there was absolutely no way to have a confidential conversation with your nurse, surgeon, family members, case manager, or anybody else.

    *They showed very poor judgment in keeping patients as inpatients following surgery who were so frail that they required nearly 24/7 nursing staff care. It was impossible to sleep at night because of the constant upset coming from the patient (she was elderly and very confused). She should have been in a rehab unit or facility because the level of care she required post surgery was at too high of a level for nursing staff to provide, unless there was someone sitting by her side 24/7.

    *The nurses who had night shifts slept on shift. I know this because I was awake all night because of the one patient who required constant nursing care, and nurses were in and out of the room many times of the night…..until after midnight. Then the ability to get a nurse if you needed one was very spotty and when they showed up, they clearly had just gotten up from sleeping. So, until a nurse could get up and get to the confused patient’s bedside, the other two patients in the room were up because of her crying out, confused, trying to get out of bed, defecating in her bed, etc.

    (-3) 29 Total Votes - 13 up - 16 down
  6. tomsquawk says:

    in emergency situations some surgeons take on difficult cases/procedures that others won’t do. they might be “go to guys”. others may stretch on electives and often the hospital admin discourages aggresiveness and sometimes censures. who is this surgeon?

    all i had was a shattered leg. the surgeon (not in front of me but to my wife) was not encouraging. he told me only that it would be a tough fight for me. well, it wasn’t, i’m ahead of schedule and he earned his bragging rights. he shows off my x-rays and points to me walking down the hall.

    you have numbers but does one have the specifics? not saying right or wrong just that more evaluation is needed. as i told the surgeon; “i really don’t have much choice, do i?”.

    (9) 17 Total Votes - 13 up - 4 down
  7. r0y says:

    OK, I did some brief digging, and of the three (3) surgeons listed in the Surgeon Risk-Adjusted Operative Mortality Results, 2009-2010 report on OSHPoD’s site, it does look as if Dr. Freyaldenhoven has a higher percentage of Risk-Adjusted Mortality Rate (RAMR) than the other two:

    Canvasser, David A. (3.04% RAMR) “Average”
    Faber, Luke A. (1.55% RAMR) “Average”
    Freyaldenhoven, Stephen J. (8.15% RAMR) “Worse”

    However, the trick is how this RAMR value is calculated (this link is the best definition/calc of it that I could find); even still, if it is calculated the same for all doctors (which we have to assume it is), it is not looking too swell for Dr. Freyaldenhoven. Take it with a grain of salt, though (or not, as too much sodium is not heart-friendly).

    A solid report would have tracked that down from OSDPD itself, so it could be unbiased. As the article it written, for me anyway, it almost does feels like a “hit piece” on a specific surgeon. I mean, if I was going to point out how someone may not be performing as well as others, I would damn well make sure I had the methodology used in the metrics of the data to be well-explained.

    (8) 18 Total Votes - 13 up - 5 down
  8. r0y says:

    You are shooting the messenger. Why not write a letter (or visit the OSHPD website and look at their data, of which I can only see 2010 as the latest year they have a Mortality Report for, and French is “Average”).

    Not sure where CCN got their data, usually in an article such as this, they hyperlink their source (since it’s public). I will agree that this does not initially pass the “smell test” as I could not locate the “fourth highest adjusted mortality rate” that the article mentions.

    Anyway, there’s your OSHPoD link and happy browsing. Let us know what you find (and we promise not to shoot *you*).

    (4) 10 Total Votes - 7 up - 3 down
    • r0y says:

      It looks like the comment section broke (again). This was a reply to roxanne’s comment (as was Ted’s above). Silly back-end intr0netz failures.

      (-3) 3 Total Votes - 0 up - 3 down
  9. roxanne22 says:

    Dr Flayadenhovan did a aortic valve replacement on me less than a year ago. Different procedure but knowing
    his commitment to perfection for my procedure, I believe this story is a bunch of crap. French hospitals care
    was perfect. So screw CCN for another attempt to bring down just another innocent person.

    (-14) 50 Total Votes - 18 up - 32 down
    • Ted Slanders says:

      Rox,

      Do the simple math, It was the California “Statewide Health Planning and Development” office that gave Dr. Stephan Freyaldenhoven the statistics from their records, not CCN; they are just reporting the findings as a news source. Get it?

      I am trying to visualize you screwing CCN, quite a picture in my mind, ewwwwwww.

      (26) 38 Total Votes - 32 up - 6 down
      • Ted Slanders says:

        Rox,

        Neither. I just have this affliction about posters here at CCN that don’t know, or can apply, logic 101 in their posts even if it bit them in their @ss! You are guilty of this fact.

        Isn’t the Tribune forum waiting for your eventful return?

        (1) 9 Total Votes - 5 up - 4 down
        • roxanne22 says:

          I don’t post this crap unless I feel the need! The Trib sucks too!
          You are guilty of just being an ass. I might not be as informed as you but I have a job and
          don’t have the time to post to every freakin comment on this dump!!!!

          (-6) 12 Total Votes - 3 up - 9 down
        • smiley says:

          Another half assed Central Coast business that gets first class big city fees

          (1) 9 Total Votes - 5 up - 4 down