In the last decade, Connecticut has seen an influx of Ambulatory Surgical Centers (ASC) providing same-day care at lower costs. Unfortunately, that doesn’t make these facilities safe. New research continues to show that lack of reporting and oversight at ASC’s is putting the health and safety of patients at serious risk, even during some of the most routine and minor procedures.
What Makes ASC’s Dangerous
In 2018, an investigation by the USA Today Network and Kaiser Health News revealed a shocking finding regarding surgical centers nationwide- they are not reporting their deaths! The investigation found that surgical centers across the country are either withholding information on patient fatalities or not mandated to report it depending on the state. These gaps allow ASC’s to continue operating even when issued the most stringent federal sanctions and to go practically unpunished for making preventable fatal medical errors.
Since 2013, investigators found that more than 260 patients have died due to complications after same-day surgeries performed at ASC’s. At least 14 of these patients were undergoing spinal surgeries, while dozens of others were undergoing minor procedures with low mortality rates. Out of the 260 fatalities, at least 10 percent of the patients died within 24 hours of being released. Because these cases were poorly recorded, it’s difficult to say whether or not these patients could have been saved if they had been treated in a hospital environment.
According to the experts in the USA Today and Kaiser Health investigation, these are the areas where surgical centers pose the most risk for patients:
- Inconsistent Regulations: There are over 5,600 surgical centers in our country and they all operate under their own rules. Without standard guidelines, it’s impossible to keep tabs on which centers are providing quality care and which are falling short and causing harm to their patients.
- Lack of Reporting: When ASC’s do not report their fatalities, it’s impossible to establish an action plan to prevent similar deaths from occurring in the future. Surgical centers could be participating in medical negligence or making simple mistakes that might easily be corrected with accurate reporting and data.
- Patients Are Too Sick: Some ASC’s are accepting patients with underlying health conditions too complicated to be treated in an outpatient facility. High-risk patients require increased monitoring and specialized post-operative care that same-day surgery centers are not equipped to provide.
- Surgeries Are Too Complicated: Most ASC’s lack the resources to properly accommodate high-risk surgeries, but that doesn’t always stop physicians from offering them. In fact, surgical centers are rapidly expanding their businesses by taking on riskier surgeries with high price points. However, between a lack of supplies, experience, and skilled staff some procedures end in an ambulance ride to the hospital instead of a ride home for recovery.
- Incompetent Staff: Surgical centers can often be a revolving door when it comes to staff. The investigation found that in many death cases, staff members involved were unaware of who was in charge or responsible for patient monitoring. ASC’s have also been known for neglecting training of employees to cut costs, which could lead to an increase in medical errors.
- Centers Are Not Prepared For Crisis: The investigation showed over 230 lapses in rescue equipment or training regulations at surgery centers since 2015. ASC’s are often not equipped with the staff or equipment to handle crisis situations and can put patients in imminent danger if a medical emergency arises.
- Doctors Interests Are Too High: What makes surgical centers unique to hospitals is that 90 percent of ASC’s are partially owned by the physicians who are completing the procedures. These doctors not only secure a share of their own fee but they also receive a percentage of the facility’s fee, creating an extra incentive to refer patients for outpatient surgery when they might not be the best candidates.
Possibly the most concerning part of the USA Today and Kaiser investigation was the difficulty it took to find information on patient deaths and medical errors. Between coverups, lack of adequate record keeping, and the 17 states who are not required to report their patient’s deaths, it took a national team to find statical information that should be open and readily available to the public at all times.
Why Patients Take The Risk
In 2014, at least 50 percent of outpatient surgeries were performed at ASC’s. With healthcare costs continuing to rise, the numbers have only grown since. According to Carrum Health, here are some reasons for why patients might choose a surgical center over a hospital for their procedure:
- Same-day service
- Shorter procedure times
- Reduced risk of hospital infections or inpatient stay
- No hospital administrators
- Less time off work and away from home
- Lower costs
- More control over the schedule
- Less waiting
Most of the reasons why patients seek services from ASC’s have to do with convenience and money. The promise of a ‘quicker’ and ‘cheaper’ surgery is enough to get the majority of patients on board, especially when their jobs and financial stability are on the line.
When it comes to deciding between a hospital and a surgical center, patients must understand that ASC’s do not have the same resources as hospitals: they are not inspected as often to ensure compliance with health and safety regulations, they are not equipped with various specialists when something goes wrong, and they do not provide the same emergency services you would receive in a hospital. If emergency arises during a procedure, ASC’s are forced to transfer patients via ambulance to the nearest hospital, during which time a patient could die from causes that would otherwise have been prevented if addressed immediately.
Most At Risk Groups For ASC
Some minor surgeries and procedures may be completely safe when performed at ASC’s while others are not a good match. If you fit any of the following criteria, a hospital may be the safer option for your surgery:
- Over the age of 65
- Obese or overweight
- Diagnosed with obstructive lung disease
- Diagnosed with Hypertension
- History of heart attack or stroke
- Pregnant
- Previous cardiac procedures
- Complications during past surgeries, including prolonged operating time
- In need of high-risk procedures typically not performed in surgical centers
Patients meeting any of the above criteria are at a higher risk of complications that can lead to the need for emergency measures during surgery. You want the best medical staff available in these cases, which surgical centers are not prepared to provide.
What To Ask Before Your Procedure
If you are still considering an outpatient center for your surgery, don’t schedule any procedures without doing your research. Not only should you be looking into your doctor and the ASC they are affiliated with, taking the extra time to ask these questions could help you decide the best course of action for your treatment:
- Look into the records and statistics available for all surgical centers in your area to compare reviews.
- Look at patient reviews to find information about the facility that might not be available through public records.
- Make sure to get a second opinion about your surgery before scheduling with a physician who has partial ownership of the facility you will be attending.
- Ask about the back-up plan available if something goes wrong during your procedure.
- Consider how long it would take to get to the nearest hospital if there was an emergency.
Connecticut Medical Malpractice Attorneys
Surgical centers have a responsibility to keep their patients safe and to screen individuals for risk factors that could make them poor candidates for outpatient surgery. If you or a loved has been injured due to the medical negligence of an ASC, you may be eligible to receive compensation for any damages suffered. Contact our expert team of medical malpractice attorneys at Jacobs & Wallace for a free consultation to explore your options.
