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Records Show Mortality Rates at Pittsburgh Area Hospitals Getting Worse

From Harry S. Cohen & Associates: This case involved John Cox, he was 67 years old when he presented to the UPMC McKeesport emergency department with complaints of chest pain and shortness of breath. The standard in emergency departments across America is for patients who present to the emergency department with complaints of chest pain to get an EKG within 10 minutes. Despite this, Mr. Cox was not taken to get an EKG for an hour and a half. By the time they did get to him, he went unresponsive as the medical staff was preparing him for the EKG.

John ultimately passed away of a myocardial infarction (heart attack) after multiple failed resuscitation attempts. This was a direct result of not diagnosing and treating his condition in a timely manner.

The following article is a re-print written by Paul Van Osdol for WTAE. Click here for the original article.

SEWICKLEY, Pa.

Death rates at some Pittsburgh-area hospitals are going up. At some hospitals, mortality rates for certain conditions more than doubled in five years.

Action News Investigates spoke to Jamie Toth, whose father John Cox died at McKeesport Hospital in February 2022.

“It’s something I’ll never forget, and it’s very hard to speak about, but it’s not right how he was treated,” Toth said.

Cox went to the hospital complaining of chest pains. According to Toth’s lawsuit, he waited 1.5 hours before a doctor saw him.

“I didn’t understand their lack of urgency to somebody that is sitting here clearly distraught,” Toth said.

When Cox finally saw a doctor, he had a heart attack and died. He was 67.

In court papers, UPMC denied any negligence or recklessness and said their records show Cox was treated earlier than the lawsuit alleges.

“This was his time to be retired and enjoy family and enjoy life and to finally relax and that opportunity was taken from him,” Toth said.

A report by the Pennsylvania Health Care Cost Containment Council said the hospital mortality rate for 11 conditions, ranging from heart failure and stroke to sepsis and pneumonia, increased from 2017 to 2022, the most recent year data is available. The report did not include COVID-19 cases.

Liam Migdail of the Pennsylvania Hospital and Healthsystem Association said: “Any increase in in-hospital mortality is concerning and we are working to dig deeper and meet with hospital quality leaders to better understand the cause and what can be done to address it.”

“The mortality data looks like it’s inching in the wrong direction,” said Dr. Paul Phrampus, UPMC’s medical director of patient safety. One reason, he said, is patients are sicker.

“We’re seeing a population that’s sicker because they’ve had things that weren’t caught in screening, or they’ve had little problems that have become bigger problems. So, the people that are actually inside the hospital now are sicker than they have been before,” Phrampus said.

One of the biggest concerns is sepsis, an infection that left untreated can lead to death.

“The sepsis problem is really challenging,” Phrampus said.

State records show the sepsis mortality rate from 2017 to 2022 doubled at Butler Memorial Hospital and Heritage Valley Beaver and tripled at Heritage Valley Sewickley. 

Dr. David Rottinghaus, chief clinician at Independence Health, owner of 
Butler Memorial, said “nearly all cases involved patients with severe chronic medical conditions coupled with a sudden affliction. This combination results in a very high severity of illness and an ensuing poor prognosis.”

Heritage Valley Beaver nurse Lisa Colitruglio said early detection is critical to treating sepsis.

“The clinical signs that lead to sepsis can be missed if you’re not focusing on essentially the patient’s vitals and looking at the patient and seeing how they’re acting,” Colitruglio said.

Experts said staff shortages can impact sepsis treatment.

“We’re elevating and putting less experienced people into positions that previously were filled by very experienced people. It makes it very challenging to intervene early when we’re looking for sepsis, for example,” Phrampus said.

Mortality rates for respiratory failure have also increased, up 50 percent at UPMC Mercy and nearly doubling at UPMC Passavant.

Phrampus said he and others at UPMC are working on it, using simulations so medical staff can respond to a crisis quickly.

“We have been as a system looking at all of our protocols, all of our algorithms that do two things. One is, prevent people from getting worse once they have a minor respiratory infection to progress to a significant respiratory infection that lands them in the ICU. And then secondly, adjusting our ICU care to make sure it is always aligned with best practice,” he said.

A Pittsburgh group that monitors patient safety said increased hospital mortality rates are not just a local problem.

“Right now, we have somebody dying from a preventable error every minute,” said Karen Feinstein of the Jewish Healthcare Foundation.

The foundation is leading an effort to create a national patient safety board modeled after the NTSB. Instead of failures like the Fern Hollow bridge collapse or the East Palestine derailment, the patient safety board would investigate chronic problems that lead to patients dying.

“We need to start looking at our major categories of harm and preventing harm before it occurs,” Feinstein said. “It is a moral imperative. Safety isn’t optional. It should be the mission of healthcare.”

Toth said she likes the idea, especially if it can prevent a death like her father’s.

“A group or a team to hold hospitals accountable for how they react and how they run their operations would definitely benefit not only the hospital but the patients,” she said.

Republican and Democratic members of Congress have introduced bills to create a national patient safety board.