Valley hospitals rated average for heart surgery deaths

Hospitals in the central San Joaquin Valley have death rates from heart bypass surgery within accepted ranges, according to a state report released last week.

One Valley hospital — Fresno Heart & Surgical Hospital — had a lower death rate than the statewide average, and Kaweah Delta Medical Center in Visalia improved its rating from two years ago when it was listed as one of only four hospitals statewide with a worse-than-average death rate.

The report by the Office of Statewide Health Planning and Development covers heart bypass procedures performed at hospitals in 2012.

The report also showed a controversial Fresno heart surgeon was the busiest in California.

Dr. Pervaiz Chaudhry performed 344 bypass surgeries in 2011-12, according to the report. Only four other doctors in the state performed more than 300 surgeries. Chaudhry was rated average for patient deaths. No heart surgeon in the central San Joaquin Valley was rated “better” than average.

Chaudhry has been embroiled in high-profile lawsuits in the past two years, with one family accusing him of leaving an operating room before a patient’s chest was closed. Chaudhry has challenged the lawsuits. Two years ago, the Office of Statewide Health Planning and Development said Chaudhry was one of seven doctors who were rated worse than average for patient deaths. Chaudhry contested that report’s findings. He was on vacation Friday and could not be reached for comment on the latest report.

State officials said overall, the surgery mortality rate in California remained relatively low and stable for 2012 at a rate of 2.11. There were 247 deaths in the state after 11,720 procedures.

Valley hospitals had 21 deaths out of 802 surgeries, according to the report.

Fresno Heart & Surgical had one death after 187 procedures for a rate of 0.66. Saint Agnes Medical Center had the most deaths, with 10 after 240 procedures for a rate of 4.25. Community Regional Medical Center had seven deaths after 234 procedures for a rate of 3.0, and Kaweah Delta had three deaths after 141 procedures for a rate of 2.41. The death rate includes all deaths that occurred during hospitalization and those within 30 days after surgery. The risk-adjusted rates take into consideration gender, age and other factors, such as severity of illness.

Kaweah Delta showed the most improvement since a report released two years ago. Hospital officials said then that the report reflected procedures done in 2009-10 and they had already made changes in the heart surgery program. Those changes would be reflected in the next report, they said. The hospital’s death rate dropped from 4.18 to 2.41.

Dr. Leheb H. Araim, a surgeon with Golden State Cardiac & Thoracic Surgery at Kaweah Delta, said in an email that the hospital’s heart surgery program has “undergone dramatic improvements in clinical outcomes over the last four years.”

The hospital was recently ranked as the only “high performing” hospital in heart bypass surgery from Bakersfield to Fresno by U.S. News & World Report, Araim said. “This prestigious ranking was given only to the top 14% of hospitals in the nation,” he said. “We want our community to be informed about our outstanding results and continued commitment in providing superb care for heart patients, right here at home.”

State officials said verifying information takes time and acknowledged that it means the reports contain data that is not current.

Saint Agnes CEO Nancy Hollingsworth said in a written statement Thursday that the report for procedures done in 2012 “may not accurately depict the level of care that is presently provided.”

In 2012, Saint Agnes made “significant changes in the leadership of its cardiothoracic surgery program,” she said.

The changes include new heart surgeons.

Two surgeons who operated at Saint Agnes in 2012 received ratings of “worse” than average for deaths in the report released last week. Drs. Joe Bolton and Ashraf Osman no longer practice at the hospital. The two had been part of a Stanford University Medical Center-affiliated cardiac-surgery program at Saint Agnes. The Fresno hospital’s relationship with Stanford came under scrutiny in 2007 when state and federal investigators probed an increase in cardiac-surgery infections and found the majority could be associated with a Stanford doctor. That surgeon left his Fresno practice in 2008.

Hollingsworth said that in 2012 Saint Agnes “chose not to renew its affiliation with Stanford.” Instead, she said, the hospital recruited two Fresno-based heart surgeons, Richard Gregory and Peter Birnbaum, to lead its program.

“Our heart program is thriving under their leadership,” she said.

Birnbaum said changes were put in place, including formation of a cardiology collaborative to focus on improving quality, which has “translated into excellent patient outcomes, which is our goal.”

Birnbaum and Hollingsworth said risk-adjusted death rates for the hospital for 2014 show a death rate of 1.5. The rate, from the Society of Thoracic Surgeons, is lower than the society’s average rate of 2.1, Birnbaum said. And Saint Agnes’ rate is lower than the rate of 1.9 for hospitals with similar numbers of procedures, he said.

Hollingsworth said Saint Agnes has low rates for stroke after heart bypass surgery and low numbers of patients readmitted to the hospital within 30 days of the surgery.

According to the state report, in 2012 Saint Agnes had a stroke rate of 0.90 and readmission rate of 10.15, which were the lowest of the four Valley hospitals and below statewide averages. Hollingsworth said that according to the Society of Thoracic Surgeons, the hospital has a low stroke rate of 0.6 and a readmission rate of 3.6, which are less than the society’s average rate of 1.3 for stroke and 9.7 for readmission.

State officials said hospitals and surgeons listed in the report were given an opportunity to review the results.

The goal of the state report is to educate patients and to foster discussion between patients and doctors, said Merry Holliday-Hanson, manager of the administrative data program.

“A patient can take a look at the data we have and go back and talk to their primary care provider or if they’re going in for (bypass surgery), they can talk to their cardiac surgeon or their cardiologist.”

This story was originally published August 1, 2015 at 2:19 PM with the headline "Valley hospitals rated average for heart surgery deaths."