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Texas Surgeon Is Accused of Secretly Denying Liver Transplants

For decades, Texas transplant surgeon Dr. J. Steve Bynon Jr. has earned accolades and national notoriety for his work, including helping to uphold professional standards in the nation’s sprawling organ transplant system .

But authorities are now investigating allegations that Dr. Bynon secretly manipulated a government database to make some of his own patients ineligible to receive new livers, potentially depriving them of life-saving care.

Memorial Hermann-Texas Medical Center in Houston, where Dr. Bynon oversaw the liver and kidney transplant programs, abruptly closed those programs last week while it investigated the allegations.

On Thursday, the medical center, a teaching hospital affiliated with the University of Texas, said in a statement that it found evidence that a doctor in its liver transplant program actually denied patients transplants by altering records. Authorities identified the doctor as Dr. Bynon, who is employed by the University of Texas Health Science Center at Houston and has been contracted to run Memorial Hermann’s abdominal transplant program since 2011.

It is not clear what might have motivated Dr. Bynon to falsify the records. Reached by phone Thursday, he referred questions to UTHealth Houston, which declined to comment.

Founded in 1925, Memorial Hermann is a major hospital in Houston, but it has a relatively modest liver transplant program. Last year, it performed 29 liver transplants, according to federal data, making it one of the smallest programs in Texas.

In recent years, a disproportionate number of Memorial Hermann patients have died while waiting for a liver, data shows. Last year, 14 patients were removed from the center’s waiting list because they died or became too ill, and the mortality rate for people waiting for a transplant was higher than expected, according to the Scientific Registry of Transplant Recipients, a research group.

This year, since last month, five patients have died or become too ill to receive liver transplants, while the hospital has performed three transplants, records show. The investigation is in its early stages and it was unclear whether possible changes to the waiting list actually resulted in a patient not receiving a liver. A hospital spokeswoman said the center treated more seriously ill patients than average.

The U.S. Department of Health and Human Services said in a statement that it was also investigating the allegations. So is the United Network for Organ Sharing, the federal contractor that oversees the nation’s organ transplant system.

“We recognize the seriousness of this allegation,” the HHS statement said. “We are working diligently to address this issue with the attention it deserves.”

The authorities opened an investigation after being alerted by a complaint. An analysis later revealed what the hospital called “irregularities” in the way patients were placed on a liver transplant waiting list. When doctors put a patient on the list, they must identify the types of donors they would consider, including the person’s age and weight.

Hospital officials said they discovered that patients had been listed as only accepting donors of impossible ages and weights — for example, a 300-pound toddler — making them incapable to receive a transplant.

Other transplant surgeons said that if the list was manipulated in this way, patients would not be aware of changes in their status.

“They’re staying home, maybe not traveling, thinking they might get an organ offer at any time, but in reality they’re functionally inactive so they’re not going to get that transplant,” said Dr. Sanjay Kulkarni. , vice-president of the ethics committee of the United Network for Organ Sharing. “It’s very unusual, I’ve never heard of it before, and it’s also very inappropriate.”

The hospital said in its statement that it did not know how many patients were affected by the changes, or when they began. He said the problems were only with the liver transplant program, but the hospital also closed the kidney transplant program because it was run by the same doctor.

Dr. Bynon, 64, has devoted his career to abdominal transplants and is considered one of the premier practitioners of advanced liver transplants. He spent nearly 20 years at the University of Alabama at Birmingham before moving to Texas in 2011.

Some former colleagues described Dr. Bynon as off-putting and arrogant, while others called him talented and dedicated.

“In my experience, everything he did was about the patient,” said Dr. Brendan McGuire, medical director of liver transplants at that Alabama program, who worked with Dr. Bynon for more than a year. decade. “When he transplanted someone, that person was his patient for life. »

On its LinkedIn page, the University of Texas Health Science Center posted a photo of a billboard with Dr. Bynon on it. The sign read: “Dr. Bynon gives new life to transplant patients.

Dr. Bynon also served on the Membership and Professional Standards Committee of the United Network for Organ Sharing, which investigates wrongdoing in the transplant system.

Most recently, in December, Dr. Bynon made headlines for performing a kidney transplant for former Lt. Gov. Ben Barnes of Texas.

The closure of Memorial Hermann’s programs came as a surprise to many in the transplant community because it is extremely rare for a program to be suspended for ethical reasons.

At the time it ended its programs, Memorial Hermann had 38 patients on its liver transplant waiting list and 346 patients on its kidney list, according to the hospital.

Officials said they are contacting these patients to help them find new providers.

Roni Caryn Rabin reports contributed. Susan C. Beachy And Kirsten Noyes contributed to the research.

News Source : www.nytimes.com
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