Popularity Of Outpatient Surgery Centers Leads To Questions About Safety
By By Sandra G. Boodman
KHN and Washington Post
Wendy Salo was alarmed when she learned where her doctor had scheduled her gynecologic operation: at an outpatient surgery center.
“My first thought was ‘Am I not important enough to go to a real hospital?’ ” recalled Salo, 48, a supermarket department manager who said she felt “very trepidatious” about having her ovaries removed outside a hospital.
Before the Sept. 30 procedure, Salo drove 20 miles from her home in Germantown, Md., to the Massachusetts Avenue Surgery Center in Bethesda for a tour. Her fears were allayed, she said, by the facility’s cleanliness and its empathic staff.
Salo later joked that the main difference between the multi-specialty center and Shady Grove Adventist Hospital — where she underwent breast cancer surgery last year — was that the former had “better parking.”
Salo’s initial concerns mirror questions about the safety of outpatient surgery centers that have mushroomed since the highly publicized death of Joan Rivers.
The 81-year-old comedian died Sept. 4 after suffering brain damage while undergoing routine throat procedures at Yorkville Endoscopy, a year-old free-standing center located in Manhattan.
Federal officials who investigated Rivers’ death, which has been classified by the medical examiner as a “therapeutic complication,” found numerous violations at the accredited clinic, including:
- a failure to notice or take action to correct Rivers’ deteriorating vital signs for 15 minutes;
- a discrepancy in the medical record about the amount of anesthesia she received;
- an apparent failure to weigh Rivers, a critical factor in calculating an anesthesia dose;
- and the performance of a procedure to which Rivers had not given written consent.
In addition, one of the procedures was performed by a doctor who was not credentialed by the center.