Secretary Cohen calls for investigation into NC Children's hospital

North Carolina’s secretary of health on Friday called for an investigation into a hospital where doctors had suspected children with complex heart conditions had been dying at higher than expected rates after undergoing heart surgery.

Dr. Mandy Cohen, the secretary, said in a statement that a team from the state’s division of health service regulation would work with federal regulators to conduct a “thorough investigation” into events that occurred in 2016 and 2017 at North Carolina Children’s Hospital, part of the University of North Carolina medical center in Chapel Hill.

“As a mother and a doctor my heart goes out to any family that loses a child,” Dr. Cohen said in the statement. “Patient safety, particularly for the most vulnerable children, is paramount.”

The investigation is in response to an article published by The New York Times on Thursday, which gave a detailed look inside the medical institution as cardiologists grappled with whether to keep sending their young patients there for surgery. 

The article included discussions among doctors that were captured on secret audio recordings provided to The Times, in which the physicians talked openly about their concerns, including that some might not feel comfortable allowing their own children to have surgery at the hospital. The physicians also discussed unexpected complications with lower-risk patients.

While the doctors could not pinpoint what might be going wrong, they considered everything from inadequate resources to misgivings about the chief pediatric cardiac surgeon to whether the hospital was taking on patients it was not equipped to handle.

“It’s a nightmare right now,” Dr. Tim Hoffman, the hospital’s chief of pediatric cardiology, said in a 2016 meeting. “We are in crisis, and everyone is aware of that.”

In a later meeting, Dr. Kevin Kelly, the head of the hospital at the time, told cardiologists to “do what your conscience says” when considering where to refer patients, according to one of the recordings.

But, he warned, performing fewer surgeries at UNC could hurt revenues and could cost the cardiologists their jobs. “If it reduces the volume of things,” he said, “I’ll just —— we’ll just reduce the number of people that we have.”

On Thursday, Dr. Wesley Burks, the chief executive of UNC Health Care, which runs the state-owned hospital, emailed employees about The Times’s article.

“While this program faced culture challenges in the 2016-2017 time frame, we believe the Times’ criticism is overstated and does not consider the quality improvements we’ve made within this program over many years,” he said.

A local newspaper, The News & Observer in Raleigh, posted an editorial Thursday evening in response to The Times article that said “it will take leaders outside of the self-serving ranks of UNC’s leadership to crack its culture of arrogant denial and bring it back to being a servant of the people.”

UNC Health Care has defended its surgery program, describing it as “very strong” while denying any past problems affecting patient care. Administrators said there was “a dysfunctional group” in 2016 that sowed mistrust, creating “team culture issues,” and they maintain that there is a different team at the hospital today.

Administrators told The Times it had conducted a “thorough internal investigation” of its heart surgery program in 2016 and had determined “criticism of the program was found to be unsubstantiated.”

The Times is suing the hospital for mortality data related to pediatric heart surgeries that the hospital has refused to provide under the state’s open records law.