Attorney general says UK should hand over records on children's heart surgeries, which have been suspended pending review

Attorney General Jack Conway has ruled that the University of Kentucky hospital violated the state Open Records Act by refusing to give a reporter for the university-owned radio station records relating to the work of the chief of cardiothoracic surgery, who has stopped doing surgery on children. UK refused to let Conway's staff examine the records to evaluate UK's claimed need for confidentiality.

After inquiries by Brenna Angel of WUKY, "UK announced that the hospital had stopped performing pediatric cardiothoracic surgeries pending an internal review," John Cheves writes for the Lexington Herald-Leader. Angel reports that she sought records on Dr. Mark Plunkett, left, who was also director of the pediatric and congenital heart program: "the date of Plunkett’s last surgery, the mortality rate of pediatric heart surgery cases, and documentation related to the program’s review." She sought no patient-specific information.

UK denied her request, citing the federal Health Insurance Portability and Accountability Act and arguing that release of the information could lead to the identification of one or more patients because Plunkett was doing so few surgeries on children. It also cited HIPAA in refusing to let Conway's staff review the records. Conway rejected that argument, noting that HIPAA does not supersede state laws and even make allowances for them.

Because it deals with the Open Records Act, Conway's decision has the force of law. UK can appeal the decision to circuit court within 30 days of March 27, the date of the decision. "UK spokesman Jay Blanton says officials are considering whether to file an appeal," Angel reports. The decision was publicly released Monday, the same day UK held a press conference about "the progress UK Healthcare has made in cardiology," she notes. "Yet the pediatric cardiothoracic surgery program remains under review, and patients from Central and Eastern Kentucky are being referred to hospitals out of state. Dr. Mark Plunkett remains on staff."

When Angel asked Dr. Michael Karpf, UK's executive vice president for health affairs, to comment, he replied, “We’ll have something to say about that in a little while.” Cheves notes, "UK recruited Plunkett, a noted surgeon at the University of California at Los Angeles, in 2007 to strengthen its pediatric heart program. He makes $700,000 a year, one of the highest salaries at UK." (Read more)

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UK has its pediatric heart program under review; chief is on leave, and patients are being referred to other hospitals

Kentucky Children's Hospital at the University of Kentucky is reviewing its cardio-thoracic surgery program and referring surgical patients to other hospitals, "but the reasons why are unclear," Brenna Angel reported Dec. 21 for WUKY-FM, the university-owned station.

Angel did identify "the surgeon at the center of the review," Dr. Mark Plunkett, left, who is on a leave of absence but "remains on staff at UK with a $700,000 annual salary," as chief of cardio-thoracic surgery. "UK denied an open-records request for the date of his most recent surgery and his patient mortality rate," citing privacy rules in the federal Health Insurance Portability and Accountability Act. It was unclear how release of such statistics, without any personally identifying information, would compromise privacy. Plunkett and officials of the medical center refused to be interviewed.

"It's been pretty hush-hush," Tabitha Rainey of Lexington, the mother of a Plunkett patient, told Angel, who reported: "Plunkett and his assistant Dr. Deborah Kozik operated on Waylon seven days after he was born. Tabitha was later told that Dr. Plunkett was taking a leave of absence." Rainey told Angel, "Months went past and they lost another patient, who was a dear friend of mine, and it was pretty heavy in the unit at the time. Then soon after I guess they decided to stop doing the surgeries and review the entire program."

Angle was able to get some records from UK and reported they showed that "The number of children Dr. Plunkett operated on this year is down around 43 percent from two years ago." UK Trustee Dr. Charles Sachatello, a surgeon who sits on the Board of Trustees' health-care committee, told Angel, "I was not aware of that, and that was never announced at the Board of Trustees meeting." Sachatello told Angel that UK should merge its pediatric heart program with the one at the University of Louisville because of the high operational costs of such programs. (Read more)

UK study: Old, perhaps obsolete heart drug increases deaths in patients with atrial fibrillation

A drug widely used against heart disease can increase the possibility of death when used by patients with atrial fibrillation, a common heart rhythm problem, according to a study by University of Kentucky researchers. Digoxin, a derivative of the foxglove plant, is an old yet controversial heart drug. Though considered obsolete by some, it is still widely used.

The study, published in European Heart Journal, analyzed data from 4,060 atrial-fibrillation patients. It was led by Dr. Samy Claude Elayi, associate professor of medicine at UK HealthCare's Gill Heart Institute. The results of the study indicate that further review by the Food and Drug Administration is warranted to determine if stronger warnings about its use should be required. (Read more)

U.S. preterm birth rate goes down but Kentucky's maternal smoking rate still second highest, putting preterm babies at risk

For the fifth year in a row, the preterm birth rate in the United States has dropped. Which is great news. But Kentucky again had a significantly high smoking rate for expectant mothers -- at 32.2 percent, putting us behind only West Virginia (at 36 percent) of pregnant women who gave birth preterm and smoked.

Being born before full term puts babies at undue risk. Still, nearly half a million babies in the United States are born prematurely, many unnecessarily, according to the March of Dimes' 2012 Premature Birth Report Card. Serena Gordon of HealthDay reports that "those risks include breathing difficulties, heart defects and bleeding in the brain. Some conditions are only temporary while others can persist." A premature birth is anything that occurs before 37 weeks gestation. Maternal smoking is a major factor respiratory difficulties for the child and in an inability for the mother to go full term.

It is also been found that women without health insurance also have a higher incidence of preterm birth. Texas had the worst rates of uninsured women with 34.2 percent without insurance. Florida and New Mexico had rates of uninsured women of about 30 percent. Kentucky had rates of uninsured women of 21.7 percent. (Read more)

To see the full report and to see how Kentucky fared compared to other states in a number of other categories, go here.

18 Kentucky hospitals cited as 'top performers' on accreditation board's annual list

Eighteen Kentucky hospitals have been included on the annual list of hospitals that have excelled at adhering to basic procedures for surgery and other treatment of common illnesses such as heart attacks, heart failure and pneumonia. The Joint Commission, the nation’s major hospital accreditation board, has released this year's list of 620 hospitals considered to be “top performers” for following recommended protocols at least 95 percent of the time. The top 18 percent of accredited hospitals make the list.

Among the Kentucky hospitals that qualified on all four measurements were Greenview Hospital in Bowling Green, Ephraim McDowell Regional Medical Center in Danville, St. Elizabeth Medical Center in both Florence and Fort Thomas, Central Baptist Hospital in Lexington.

Those qualifying in three categories were the Robley Rex Veterans Affairs Medical Center in Louisville (not in surgery) and the Appalachian Regional Hospitals in Harlan and Middlesboro (not in heart attack).

Qualifying in two categories were Twin Lakes Regional Medical Center in Leitchfield, Frankfort Regional Medical Center, the Hospital of Louisa and Jackson Hospital Corp., all for pneumonia and surgical care.

Recognized for pneumonia care were Parkway Regional Hospital in Fulton, Paul B. Hall Regional Medical Center in Paintsville, Logan Memorial Hospital in Russellville and the KentuckyOne Health Hospital in Martin.

Among behavioral-health hospitals, ranked on their in-patient psychiatric care, the Kentucky facilities on the list were the Universal Health Services facility in Bowling Green, the new Cumberland Hall Hospital in Hopkinsville.

According to Kaiser Health News, the Leapfrog Group, a nonprofit organization devoted to patient safety, aided in the rankings process, as did Consumer Reports. The Commission has its own metrics. It's worth noting that next month, Medicare will start using hospital quality rankings on its Hospital Compare website to set reimbursements. (Read more)

U of L researcher gets $3.4 million to replicate studies of stem cells for heart treatment

Dr. Roberto Bolli of the University of Louisville has received a $3.4 million grant from the National Institutes of Health to test the validity of several recent studies by replicating them. The studies examine whether certain types of stem cells are safe and effective in treating heart failure, heart attacks and other cardiovascular disorders.

"Replicating studies in several locations with a large number of patients is necessary for researchers to ultimately determine which ones can be submitted to the Food and Drug Administration for approval," Jill Scoggins reports in a U of L press release.

Bolli has received more than $100 million in grants for basic research for NIH. This is the first grant he has been awarded for clinical research. (Read more)

UK doctors first to perform triple ablation, a special form of cardiac catheterization

Ollie Whitaker of Whitesburg is the first known patient to have undergone triple ablation surgery, in which a catheter is inserted through a patient's blood vessels to remove a faulty electrical pathway and tissue from the patient's heart. The procedure was performed at the University of Kentucky's Gill Heart Institute.  (UK photo of Whitaker, Dr. Sammy Claude Elayi and Dr. Gustavo Morales)

"Typically, the catheter is placed into the patient's femoral artery, internal jugular or subclavian vein. The catheter is guided toward the heart, and high-frequency electrical impulses are used to induce the arrhythmia and then destroy (or ablate) the abnormal tissue causing it," reports Jodi Whitaker for UK Public Relations.

"Performing two ablations during one procedure is commonly done, but three with this complexity is basically unheard of," said Dr. Sammy Claude Elayi, a UK cardiologist. "But in this patient's case, despite the risk, I believed that we could perform three ablations."

"I'm so very pleased," said Whitaker, who had a massive heart attack 30 years ago at age 42 and had been suffering severe after-effects ever since. "I can work in my flower bed outside and do more around the house." (Read more)

Jewish Hospital of Louisville becomes national leader in removing heart pumps from patients with heart failure

Eleven patients with advanced heart failure were able to have their heart pumps removed thanks to a combination of medication administered at Louisville's Jewish Hospital.

Texas Heart Institute is the only other institution that has removed heart pumps, also known as left ventricular assist devices. Twenty of the devices have been removed in 10 years there. At Jewish, all 11 have been taken away in the past 18 months, Laura Ungar reports for The Courier-Journal.

The program at Jewish uses a cocktail of medicines, including ACE inhibitors, beta blockers and others, in combination with the heart pump. The medication helps strengthen the heart, allowing the pump to be eventually removed. "These patients have a very good quality of life, much better, in fact, than if they continued with the LVAD alone or received a heart transplant," said Dr. Emma Birks, director of the Jewish Hospital Heart Failure, Transplant and Mechanical Support Program.

The treatment could mean "some patients with advanced heart failure may be able to forgo a heart transplant, while others can delay having one," Ungar reports. "That could mean a longer life for younger heart failure patients with LVADs; life expectancy after a transplant averages 10 years."

Nationwide, about 5 million Americans have heart failure, which translates to 300,000 deaths a year, National Heart, Lung and Blood Institute figures show. (Read more)

Red wine, dark chocolate make for heart-healthy Valentine's

Those seeking to stay heart healthy even on the most romantic day of the year won't have to look much farther than the wine rack, scientific research source Newswise reports. Experts from the Loyola University Health System have found red wines like Pinots and merlots all contain a healthy amount of catechins, which help improve "good" HDL cholesterol.

Dark chocolate with a 70 percent-plus cocoa content is likewise heart friendly, thanks to its resveratrol, which helps lower blood sugar. "You are not even choosing between the lesser of two evils, red wine and dark chocolate have positive components that are actually good for your heart," said Susan Ofria, clinical nutrition manager at Gottlieb Memorial Hospital.

In honor of National Heart-Healthy Month, which is being celebrated this month, Ofria also recommends eating: salmon or tuna; flax seeds; oatmeal; black or kidney beans; walnuts and almonds; and blueberries, cranberries, raspberries and strawberries. (Read more)