Tyree death put U. of C.’s Medicare funding at risk

By Bruce Japsen
Posted Thursday at 5:40 p.m.

The federal government threatened to strip a key financial lifeline at University of Chicago Medical Center in the wake of a medical error that contributed to the death last month of Chicago Sun-Times Chairman James Tyree.

Following an investigation into Tyree’s death, the U.S. Centers for Medicare and Medicaid Services, which administers the Medicare program, said in a public notice this week that it determined “deficiencies…so serious they constitute an immediate threat to patient health and safety.”

The notice did not mention Tyree by name, but the Tribune has confirmed that the error described in the March 14 incident was linked to Tyree, who died two days later from an air embolism following the removal of a dialysis catheter while he was being treated for pneumonia.

The U. of C. said it received a notice today that the medical center’s “participation in the Medicare program remains intact” after submitting a “thorough plan of correction to demonstrate continued and sustained compliance with the Medicare conditions of participation.”

Most health facilities that face the loss of Medicare funding eventually address government inquiries before funding is stripped.

Nevertheless, the government’s move shows the increasing seriousness those who pay for health care place on the quality of medical care. The error at the U. of C. that contributed to Tyree’s death falls into a category known as a “never event,” which means it is a preventable situation.

Medicare and most private health insurance companies have escalated their focus on medical errors, refusing to pay for medical care that has been of poor quality, particularly when never events are involved, such as the one linked to Tyree’s death, or others such as a doctor leaving a sponge in a patient following heart surgery or when the wrong limb is amputated.

Just this week, the Obama administration announced a major initiative with insurers, hospitals and business leaders to reduce certain medical errors by 40 percent over the next three years. The Obama administration also seeks to cut readmissions to hospitals by 20 percent.

Tyree, who was 53 when he died, was also chairman and chief executive at Mesirow Financial and a noted Chicago philanthropist. He was diagnosed last year with stomach cancer and had been admitted to the U. of C. hospital with pneumonia. The Cook County medical examiner last month said his death was due to the procedure, but also listed pneumonia and metastatic cancer as secondary causes.

In a statement today to the Tribune, the Medicare program’s administrator said an investigation by the Illinois Department of Public Health and hospital accrediting agency the Joint Commission resulted in a “finding of immediate jeopardy due to the hospital’s failure to ensure that facility staff were adequately trained and showed competency in conducting such procedures.”

Such problems uncovered by government health officials at a hospital mean the facility’s payments from the Medicare health insurance program for the elderly — a primary revenue source for the U. of C. as well as almost any hospital — can be put at risk.

On March 25, the Chicago office of the Centers for Medicare and Medicaid Services issued a notice of termination from the Medicare program for the hospital.

“Documentation, which was at the center of the investigation, has been improved and centralized,” the medical center said in today’s statement. “The investigations confirmed that all related personnel have appropriate training, experience, competency and credentialing.”

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  1. Ella Thursday at 3:40 pm

    Errors like this should not be tolerated, but stripping U of C of it’s Medicare funding will only harm thousands of other patients who benefit from the care that is provided there.

  2. Linda Thursday at 4:14 pm

    I am very sorry for Mr. Tyree’s family to experience this loss. However, I agree with Ella, stripping U of C funding will harm thousands of people who do not have the financial backing Mr. Tyree did. Also I wonder if one of these Medicare funded persons had died of the same thing, would this even be an issue. Is it an issue because of the man that died?

  3. tricia Thursday at 4:16 pm

    Wonder how many other patients died WITHOUT medicare threatening withholding funds. Interesting that Tyree was 53, so was not on Medicare, yet they withhold funds? There is far more to this story and a great investigative news story for a good reporter. Oh, sorry, HIPPA will prevent the full story to be ever known. Be careful patients of the hospital you choose.

  4. John Thursday at 4:36 pm

    Geez…if this is how the U of C treats its trustees…what can the rest of us expect!

  5. tom Thursday at 4:42 pm

    The trib confirms that “the medical center’s ‘participation in the Medicare program remains intact’, so where’s the story? And you need to be careful no matter where you go. You are mistaken if you think this hasn’t happened at other equally prestigious institutions and it will continue to happen as long as human beings are in charge of medicine. Try as they might, nobody is perfect, including doctors and nurses.

  6. You've gotta be kidding Thursday at 5:04 pm

    Glad to see that the federal government is following the lead of the private sector in taking medical errors seriously

  7. Jim Schuh Thursday at 5:04 pm

    It makes me wonder how many “accidents” are covered up, or at least never publicly known. Once again, the hospital is the worst place to go if you’re sick!

  8. Vera Thursday at 5:23 pm

    I brought my daughter to U of C emergency room 3 years ago with an open wound, bleeding – she fell off the bike really bad. Our experience there was total nightmare. Students and residents assisting my daughter hardly knew what they were doing. It took 3 hours to take care of her!!! And there were 2 or 3 patients there, it was not busy at all. It was extremely slow, unprofessional and irresponsible. I would never go there again!

  9. juan govea Thursday at 6:27 pm

    It’s really hard for the average consumer to assess the quality of a medical center. I agree with Tom that poor care can occur anywhere. My guess is that care quality is based largely on the leadership of particular divisions (e.g., the emergency room, the cancer wing, the neurology dept., etc.). The hospital leadership needs to see to it that the best leadership is in place in each of its divisions. The hospital administrators should also ask all patients to rate the quality of care they received and how well they felt they were treated by hospital staff. Then, they should read the patient feedback and make any necessary improvements.

  10. North Sider Thursday at 7:03 pm

    Medicare also covers people who are on long-term kidney dialysis so that’s how it became involved in the investigation of this relatively young man’s death.

  11. Greg Thursday at 7:13 pm

    Don’t look for UCMC to return to the US News “Honor Roll Hospitals” any time soon. This place just continues to slide and management leaves in droves for a reason.

  12. Carole Thursday at 7:25 pm

    Why on earth was Tyree covered by Medicare? He was a multi-millionaire, at least. If anything demonstrates beyond cavil the need for health care reform within the government, it’s coverage of people who are neither old nor poor. And, I am very sorry for the man, but he was a train wreck, medically speaking.

  13. critic1952 Thursday at 8:09 pm

    We’re dealing with a science that is very complicated. The science of medicine is embracing the utilization of best-practice protocols to enhance the quality of care. On the one hand, there is no excuse for hospital errors that contribute to the death or debilitation of a patient. On the other hand, the current practice of determining the root cause of deaths will, almost by definition, highlight human errors that have been part of health care for centuries. Only by such a process will we be able to improve the quality of care. We should embrace the practice of determining what really caused an outcome. Only then can the health care professions, which are populated with incredibly dedicated and intelligent personnel, develop and implement protocols to minimize the risk of human error adversely effecting patient care. As the Bible says, let he who is without sin cast the first stone. People make mistakes. There is a difference between gross negligence and an “honest error.”

  14. hmmmm Saturday at 9:56 a.m.

    Wasn’t Tyree a big tort reform supporter? I’m sure his family won’t sue, right?

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