TX - Surgeon accused of manipulating medical records to make patients ineligible for liver transplants - April 13, 2024

[Clearsky]

Texas Surgeon Accused of Manipulating Medical Records to Deny Patients Liver Transplants

Memorial Hermann-Texas Medical Center has shut down its liver and kidney transplant programs and launched an investigation after a surgeon, Dr. Steve Bynon, allegedly made “inappropriate changes” to medical records that made patients inactivate on the transplant waiting list

people.com

The doctor has been identified as Dr. J. Steve Bynon Jr., a surgeon at the University of Texas Health Science Center in Houston.

 

[Diddian]

I wonder what his PERSONAL criteria were for excluding those who otherwise should have been eligible from the active list. OR, did he do it to move favored others UP the list, and if so, was there some personal benefit to him?

ETA: By “personal” benefit, I do not necessarily mean the surgeon was paid or otherwise compensated; the manipulation may have been done to ensure those allowed to remain on the eligible for transplant list were patients more likely to experience long term successful survival, so that survival statistics for the program this surgeon headed remained high.

Was this surgeon on the board or committee of those who determined eligibility criteria? And if so, was he known to object to certain criteria that the majority favored?

 

[I am not Sherlock H.]

Is there any reported indication as to what and how this supposed surgeon / doctor JSBJr was manipulating health records? What criteria or classifications or health indications were being affected or falsified perhaps?

IMO I find it appalling that the supposed contractor or provider of the identified doctor JSBJr is apparently coming to his defense and support of him? Have to wonder what they are protecting or possibly worried about being revealed?

This is frightening and appalling. IMO I hope that any affected can readily recover any damages for any harm and malpractice. And wonder how many affected might have suffered or possibly even have died from his actions? (Many articles are behind paywall and not available.)

Have any licenses or board certifications for ‘doctor’ JSBJr been suspended, revoked, or invalidated while this is investigated? Seems that TX state and federal authorities need to get in on this and quickly IMO. MOO

 

[GoBuckeyes]

Texas Surgeon Accused of Manipulating Medical Records to Deny Patients Liver Transplants

Memorial Hermann-Texas Medical Center has shut down its liver and kidney transplant programs and launched an investigation after a surgeon, Dr. Steve Bynon, allegedly made “inappropriate changes” to medical records that made patients inactivate on the transplant waiting list

people.com

The doctor has been identified as Dr. J. Steve Bynon Jr., a surgeon at the University of Texas Health Science Center in Houston.

Wow, there's been no mention of charges, but wouldn't they be appropriate? (After reading the article, it sure seems so.)

 

[SleutherGirl]

That's horrible. There is no reason possible for this, this is just cruelty for kicks.

 

[Vern]

This is frightening and appalling. IMO I hope that any affected can readily recover any damages for any harm and malpractice. And wonder how many affected might have suffered or possibly even have died from his actions? (Many articles are behind paywall and not available.)

RS&BBM

I find this bit particularily stressing (what was he up to!!??):

Officials reportedly launched an investigation after noticing “irregularities” with donor acceptance criteria that were limited to the center’s liver transplant program. Records also show a disproportionate number of patients who have died at the center while waiting for a liver.

Texas Surgeon Accused of Manipulating Medical Records to Deny Patients Liver Transplants

Memorial Hermann-Texas Medical Center has shut down its liver and kidney transplant programs and launched an investigation after a surgeon, Dr. Steve Bynon, allegedly made “inappropriate changes” to medical records that made patients inactivate on the transplant waiting list

people.com

 

[Diddian]

According to this article, the data that was manipulated included specifying impossible criteria for donor characteristics for particular patients (such as “liver donor must be a 300 lb toddler”), effectively eliminating ANY possibility that the patient would ever be chosen for transplant. The patient would be on the transplant list and would believe themselves to be waiting for a possible donor, but given the impossible criteria specified on their record, there would NEVER be an acceptable donor organ for that patient.

Texas surgeon accused of secretly blocking patients from getting transplants

The motive for the alleged data manipulation is unknown.

arstechnica.com

This is a truly terrible betrayal, if it has been accurately presented. Patients would have been led to believe they were among those approved to be waiting for a donor when in fact there could not possibly be a donor who would match the criteria specified in association with them. They were effectively EXCLUDED from the list by the criteria specified.

While of course necessary, offering patients the service of helping them find another transplant program does not return the months or years and the quality of health lost to the time some of them were on the list with no chance they’d find a donor, courtesy of this betrayal. According to the article, some of these patients died while in that state of betrayal.

Assuming the manipulation has been accurately reported, this seems very serious medical malpractice.

HOW could this manipulation of criteria NOT have been detected before now?

 

[I am not Sherlock H.]

According to this article, the data that was manipulated included specifying impossible criteria for donor characteristics for particular patients (such as “liver donor must be a 300 lb toddler”), effectively eliminating ANY possibility that the patient would ever be chosen for transplant. The patient would be on the transplant list and would believe themselves to be waiting for a possible donor, but given the impossible criteria specified on their record, there would NEVER be an acceptable donor organ for that patient.

Texas surgeon accused of secretly blocking patients from getting transplants

The motive for the alleged data manipulation is unknown.

arstechnica.com

This is a truly terrible betrayal, if it has been accurately presented. Patients would have been led to believe they were among those approved to be waiting for a donor when in fact there could not possibly be a donor who would match the criteria specified in association with them. They were effectively EXCLUDED from the list by the criteria specified.

While of course necessary, offering patients the service of helping them find another transplant program does not return the months or years and the quality of health lost to the time some of them were on the list with no chance they’d find a donor, courtesy of this betrayal. According to the article, some of these patients died while in that state of betrayal.

Assuming the manipulation has been accurately reported, this seems very serious medical malpractice.

HOW could this manipulation of criteria NOT have been detected before now?

Thank you Diddian for that helpful research. And as noted, that makes this all the more appalling and IMO medically and ethically wrong, as well as criminal IMO.

I imagine being on some of these recipient lists is not cheap or free? And add in the medical insurance angle too. And how was this individual JSBJr or others choosing who ‘gets the goods’ or doesn’t? And how as you question weren’t the discrepancies and manipulations found sooner? I can’t believe the records are kept in a 3x5” file card in a file index box in a key-locked drawer? Something seems rotten deep.

I hope some investigative journalists in TX and / or the medical community get on this and quickly. IMO perhaps 60 Minutes ought to take this on? MOO

 

[bombardier]

sounds like something that would happen on house MD
First I was thinking that maybe he was affecting criteria to stop those with alcohol cirrhosis from getting a transplant, if he was ethically opposed or didn't believe they had truly gotten clean. But the fact that he was making it so that ~nobody~ qualified...really baffling stuff.

 

[vls12345]

Sounds like a doctor who believes in his own god complex.

If he's in jail, maybe someone needs to manipulate his criminal record to ensure he sits in a supermax with no chance at bail while he awaits trial. Imo.

 

[azure]

sounds like something that would happen on house MD
First I was thinking that maybe he was affecting criteria to stop those with alcohol cirrhosis from getting a transplant, if he was ethically opposed or didn't believe they had truly gotten clean. But the fact that he was making it so that ~nobody~ qualified...really baffling stuff.

I think you actually may be correct. The doctor manipulated the matching criteria such that nobody would match with certain patients. That may have been patients he felt were undeserving, ie cirrhosis patients.

Organ donation waiting lists are one of the most fascinating areas in American society where ethics are actually applied vs theoretical. It will be interesting to watch this case play out.

 

[ChatteringBirds]

It sounds like he just made up his own "rules" to play God. The hospital is also to blame for having nothing in place to catch this for so long. JMO.

Horrifying all around. And there's no getting past how cruel that is to do to your patients.

 

[Diddian]

Thank you Diddian for that helpful research. And as noted, that makes this all the more appalling and IMO medically and ethically wrong, as well as criminal IMO.

I imagine being on some of these recipient lists is not cheap or free? And add in the medical insurance angle too. And how was this individual JSBJr or others choosing who ‘gets the goods’ or doesn’t? And how as you question weren’t the discrepancies and manipulations found sooner? I can’t believe the records are kept in a 3x5” file card in a file index box in a key-locked drawer? Something seems rotten deep.

I hope some investigative journalists in TX and / or the medical community get on this and quickly. IMO perhaps 60 Minutes ought to take this on? MOO

I have a very close friend who was on the liver transplant list in another program than this Houston one, and who eventually was fortunate to receive a liver transplant. She had become quite ill, and was wasting away by the time she was blessed with the gift of a liver. I was one of a few members of her “caretaking team” - attending meetings with her and the social worker, driving her to medical appointments, being on call to help as needed if and when she got the call for a transplant, and assisting with home care after she returned home after she’d stabilized after the surgery, and providing moral support to keep her spirits up as she waited for a donor. The process is so life-encompassing that the programs encourage patients to have a team (whether family or friends) made up of members who have been made fully aware of and are prepared for the commitment and who are willing to be on call when the patient receives the call that a donor is available and they need to report for the presurgical prep.

A person doesn’t pay a fee to be on the list; it is their medical condition that puts them into the transplant program and their insurance that covers it, after they are referred by the doctors who have been treating them for the health impacts of their failing livers. Once in the program, they undergo not just medical testing, but also counseling with a social worker as the treatment is a lifelong change, requiring antirejection drugs, regular testing, and a commitment to certain lifestyle changes (such as avoidance of alcohol as well as certain foods) even after stabilizing post-surgery. Besides determining that a patient is well enough to survive surgery, tests also produce something called a MELD score that involves various factors that determines whether a patient’s condition has reached the point where their medical need is so great that they can be placed on the list. So, as I understand it, to be placed on the list, the patient has to be sick enough to warrant transplant but well enough to survive surgery and there has to be a donor who is a match (I’m not sure of all the requirements for a match, but size is one of them…my friend is quite petite and it was an older child’s liver that was determined a good match for her.)

The patient works with an entire team of medical professionals, before and during the transplant, and for the remainder of their life, with the frequency of visits declining after the patient stabilizes, but increasing again if stress or illness or other conditions upset stability and require closer monitoring and/or medication changes.

Having seen the huge commitment of time and trust involved through my friend’s experience, it sickens me considerably to consider what has been alleged in this case. This should never happen.

 

[grannygates]

17 people have been removed from the transplant list in 2023 and 2024 so far because they have died or become too sick to receive the organ. He’s held this contract since 2011, so possibilities of many more victims.

Will this doctor be held criminally liable for these deaths ? I see no arrest but IMO appears to me like a negligence issue. I guess we will wait and see.

I just don’t get WHY anyone would do this? Why does he care who gets a transplant. Doesn’t he get paid the same no matter who gets it ? I haven’t seen a motive yet in MSM. All MOO

Texas Surgeon Accused of Manipulating Medical Records to Deny Patients Liver Transplants

Memorial Hermann-Texas Medical Center has shut down its liver and kidney transplant programs and launched an investigation

ca.news.yahoo.com

 

[vls12345]

I just don’t get WHY anyone would do this? Why does he care who gets a transplant. Doesn’t he get paid the same no matter who gets it ? I haven’t seen a motive yet in MSM. All MOO

I think he has a god complex. He wants to determine who lives and who dies. He considers some worthy and others not worthy. And he is the ultimate controller of their fates. I don't see it as a money issue but a power issue. MOO.

 

[HMSHood]

That is really disturbing.

 

[Diddian]

A more recent article, although not much new information, except that it says the hospital is considering reopening their kidney transplant program soon with a new leadership structure. That program reportedly did NOT experience the irregularities uncovered in the liver program, although the same surgeon is on both teams and was the program’s leader.

Houston hospital investigating whether doctor manipulated data to deny organ transplants

Memorial Hermann Hospital had halted liver and kidney transplants after finding evidence of "irregularities" in donor acceptance criteria.

www.texasstandard.org

 

[NCWatcher]

sounds like something that would happen on house MD
First I was thinking that maybe he was affecting criteria to stop those with alcohol cirrhosis from getting a transplant, if he was ethically opposed or didn't believe they had truly gotten clean. But the fact that he was making it so that ~nobody~ qualified...really baffling stuff.

But from what I know about the listing process the chances of anyone with self-induced liver damage even being on the list is pretty small these days (whether the liver failure is from alcoholic cirrhosis or from a suicide attempt with Tylenol.)

I wonder if he was trying to keep up his supposedly stellar record of success in transplant surgery. Anyone who might be surgically difficult and/or might be less likely to survive he didn't want to be matched.
MOO

 

[ch_13]

Will this doctor be held criminally liable for these deaths ? I see no arrest but IMO appears to me like a negligence issue. I guess we will wait and see.

Rsbm.

If the allegations are true that eligible patients weren't receiving livers because of Bynon's manipulation of records and then were dying during their futile wait, then IMO that's not negligence. It's straight-up murder.

 

[bombardier]

But from what I know about the listing process the chances of anyone with self-induced liver damage even being on the list is pretty small these days (whether the liver failure is from alcoholic cirrhosis or from a suicide attempt with Tylenol.)

snipped by me
i dont directly deal with the transplant process but i dissect organs removed for transplant; at our hospital, about half of the liver transplant cases are due to alcohol induced liver disease! We also see transplants for drug-induced damage. that alone is not a reason to be denied a place on the transplant list. however, you have to prove a certain length of sobriety (can vary 6 months-1 year) before you are legible, as well as promise to attend therapy/counselling etc. Of course, a minority of these patients WILL relapse after their transplant, which is why some clinicians are unsure about taking on these patients. but then again, there is nothing saying that more ""worthy"" transplant recipients take stellar care of their new organs, either!