By A Houston hospital has temporarily stopped liver and kidney transplants after it says it learned one of its physicians altered patient records in a government database, which may have prevented them from getting new organs.
Memorial Hermann-Texas Medical Center in Houston confirmed that it is investigating “inappropriate changes” to liver donor acceptance criteria for patients added to a national waitlist through its hospital. Donor acceptance criteria refers to factors such as the age and weight of a person whose liver would be acceptable for a given transplant.
In a statement to the Houston Chronicle, the hospital said “inappropriate changes … effectively inactivated the candidates on the liver transplant waiting list. Subsequently, these patients did not/were not able to receive organ donation offers while inactive.”
The US Department of Health and Human Services said that several branches of its agency, including the Centers for Medicare and Medicaid Services and the Health Resources and Services Administration, had been engaged to investigate.
“We acknowledge the severity of this allegation. We are working across the Department to address this matter now. We are committed to protecting patient safety and equitable access to organ transplant services for all patients,” the statement said.
In a written statement, the organization that runs the transplant waitlist said it couldn’t comment on an ongoing investigation.
“The Organ Procurement and Transplantation Network (OPTN) takes patient safety very seriously. Per its bylaws, the OPTN cannot comment on any potential or ongoing review of a member organization,” the statement said.
A spokesperson for Memorial Hermann said the physician involved in the investigation had been removed from leadership roles in the liver and kidney transplant programs, and that the physician’s status with the hospital would depend on the outcome of its investigation.
Memorial Hermann did not confirm the name of the doctor under investigation.
The New York Times, citing an unnamed official familiar with the investigation, reported Thursday that the physician who made the changes to patient records was Dr. Steve Bynon Jr., a transplant surgeon who had overseen both the kidney and liver transplant programs. The Times reached Bynon by phone on Thursday and he referred questions to his employer, UT Health Houston. Bynon did not say he had altered the donor acceptance criteria, the Times said.
In a written statement sent to news outlets on Friday, Bynon’s employer, UT Health Houston, called him “an exceptionally talented and caring physician, and a pioneer in abdominal organ transplantation.”
“According to the Scientific Registry of Transplant Recipients, Bynon’s survival rates and surgical outcomes are among the best in the nation, even while treating patients with higher-than-average acuity and disease complexity,” the statement said.
“Our faculty and staff members, including Dr. Bynon, are assisting with the inquiry into Memorial Hermann’s liver transplant program and are committed to addressing and resolving any findings identified by this process.”
“UAB processes do not allow any single physician to do what is alleged to have taken place in Texas. A multidisciplinary team makes decisions regarding donor acceptance criteria for our waitlisted candidates and collectively manages that system, which is reviewed on a continual basis,” Rohan said.
Cathy Ingram, who worked with Bynon as a nurse practitioner at UAB, said she had been stunned by the allegations.
While liver transplant patients at Memorial Hermann had above-average outcomes compared with other programs nationally, a higher-than-expected number of patients have died while waiting on their list in recent years, according to data from the Scientific Registry of Transplant Recipients (SRTR). Based on pre-transplant mortality rates at programs across the country, SRTR predicted Memorial Hermann should have seen about 14 deaths from July 2021 through June 2023; instead, the program had 19 deaths, giving the program a pre-transplant death rate approximately 28% higher than would have been expected, said Jon Synder, who is director of the Registry.
Synder noted that while Memorial Hermann pre-transplant death rate was elevated, it was not as high as some others.
Memorial Hermann said that it only saw the irregularities for patients who were waiting for a new livers, but that both the kidney and liver programs were put on hold because they shared the same leadership.
The hospital also said it was seeking to quickly reactivate its kidney transplant program under a different leadership structure.
Dr. Art Caplan, a professor of bioethics at New York University, said it was almost impossible to explain why a physician would make “inappropriate changes” to patient records, and it’s especially concerning that patients might not know they were no longer candidates for organ transplants.
“If for any reason somebody is going to fall off the list, you need to be notified so you can go somewhere else and see if they’ll take you,” Caplan said.
Memorial Hermann said it was individually contacting patients to review their options.
One of those patients was Mandy Sears, 46, who lives in Childress, Texas.
Sears went through cancer treatment in her teens, which led her kidneys to fail when she was 19.
She got her first transplant through Hermann in 2003 and said the experience was “wonderful.” That led her back to the same hospital in 2018, when her first donor kidney reached the end of its lifespan.
Sears said she had been waiting six years for a kidney when the hospital called her on Tuesday to let her know it was temporarily shutting down the kidney transplant program. She said the news was a blow.
Sears said every time her phone rang, she would get excited, hoping it would be the news that a donor had been found.
“I know as of right now, I will not be getting a call,” she said.
Sears said the hospital said she could go to another program or wait for it to restart its kidney transplants. She says she’s unsure of what to do, and worried about her status.
“It makes me nervous,” Sears said of the allegations of changing patient records. “I’m hoping he hasn’t done anything on my side.”
She says she got a call for a kidney in 2022, and she was admitted and being prepped for surgery when doctors came in to tell her there was something wrong with the kidney and they couldn’t give it to her. They sent her home.
Sears says she understands that not all organs are suitable for transplant, but the new allegations about inappropriate changes to records have cast that episode and her long stretch on the waitlist in a different light.
“Did I do something wrong that made it look like I wasn’t a good candidate?” she said. “I’ve done everything I’m supposed to do.”
Sears said when the program shut down, she was working on arrangements for a transplant from a living donor, a man who heard her story at his church.
Now, she says, she’s afraid they’ll have to start over.
