He died after getting a heart transplant at Jackson. His loved ones want answers
Frank Ricigliano “had magic in him,” loved ones say. A stylist to the stars, the owner of Frankiebaby salon in Miami often played the piano between haircuts and colors. But he needed a new heart to stay alive.
Ricigliano, 56, underwent heart transplant surgery at the Miami Transplant Institute in 2021 and died less than three months later. That’s a rarity for a procedure where nine of ten patients survive after one year.
His death is one of the cases now being examined at the Miami Transplant Institute by the nonprofit agency charged with overseeing the nation’s organ transplant system, the United Network for Organ Sharing (UNOS). After the oversight agency detailed its concerns, the Miami Transplant Institute, which is part of Jackson Health System and staffed with University of Miami doctors, abruptly suspended its adult heart transplant program about three weeks ago.
Sources familiar with the complaints said the agency’s concerns dealt not just with patient deaths, but organ matches and infections.
Earlier this week, the national organ network sent a team of doctors from other transplant centers, along with federal regulators, to investigate. The team is expected to issue a report with its findings by April 20.
For the most part, survival rates of Jackson heart recipients are in line with national numbers, according to data published by the Scientific Registry of Heart Recipients. But variations have occurred. Data published in 2022 show Jackson lagging in one-year survival rates — about 87% versus 92% nationally. Because of a lag in reporting, that data would not have included Ricigliano’s transplant. Data published the next year, which would include Ricigliano, showed improvement, with a one-year survival rate of 93%, a little better than the national average.
Ricigliano’s friends told the Miami Herald they wonder if a poorly picked heart or disagreements among the medical teams might have led to Frank’s complications, which included a staph infection, pneumonia and sepsis. His health surrogate said he asked for answers on why things went wrong but felt frustrated and stymied. Jackson would not discuss details of Ricigliano’s treatment with the Herald.
Those who were close to Ricigliano say they remain angry and traumatized by how Ricigliano was treated at Jackson.
Ricigliano “saved animals, saved human beings in recovery and was the most amazing soul ... This man was a musician, a stylist, a makeup artist. He could dance like you’d never see anyone dance. He could sew, he could bake. He was the most joyful soul — talk about getting robbed,” said Heidi Welsby, a friend since childhood. “That place robbed the world. That’s what it did.”
His treatment
Since 2002, Ricigliano had lived with ventricular tachycardia, an abnormal heart rhythm, according to loved ones. About 2004, a defibrillator and a pacemaker were implanted in his chest. But his heart condition worsened over time. In March 2021, a few months after having COVID-19, Ricigliano, who had end-stage heart failure, was admitted into Jackson to get a balloon pump and wait for a new heart, his friends said.
In spring 2021, Ricigliano underwent the heart transplant surgery. His new heart came from a crash victim. Ricigliano had agreed to meet the family of the donor at some time in the future. He didn’t make it.
Complications began immediately.
The left ventricle, which pumps blood to the body, failed and Ricigliano was put on a pump. The next day, the right ventricle failed, Welsby recalls. Welsby remembers the doctors saying they would get him another heart in 24 hours. They later said he didn’t qualify for a new heart because he was too frail and had infections, Welsby said.
Welsby described her frustration at what she described as him falling ill to infection after infection while at the hospital. No one could answer her questions, she said, not even Dr. Matthias Loebe, who was chief of the heart transplant program, and the leader of Ricigliano’s surgery team, she said. Loebe was unavailable in the days after the surgery, she added.
His feet turned black, “just like you would see someone who had been dead for several years like a mummy,” said Ricigliano’s partner Chuck Ellis. So did his hands. Splotches of black damaged skin covered his body.
“He got gangrene in his left foot, his right toes were going to have to be amputated, his fingers on both hands were going to have to be amputated. They had turned black and were literally falling off,” said Michael Hamilton, Ricigliano’s roommate and healthcare surrogate.
After the transplant surgery, Ellis remembers Ricigliano mouthing to him, “Take me home.”
But Ricigliano never got back home. He died on July 4, 2021, in the intensive care unit at Jackson.
In his final days, his skin was so badly damaged, he bled when a clergy member used holy water during the last rites, according to Hamilton and Welsby.
The Dade Medical Examiner’s Office said hospital deaths that occur under the supervision of an attending physician are not subject to autopsies by its staff.
Loebe declined to discuss any details about Ricigliano’s diagnosis, operation and outcome.
When asked by a Herald reporter about the friends’ allegations, Jackson e-mailed a statement that did not include any specifics about his case.
The statement, in part, said “... Every day, the clinical team has to make difficult decisions together to achieve the best outcome. We grieve every loss, and we take every case as an opportunity to improve and ensure the best quality of care for all patients.”
Loebe acknowledged that he was “probably out of town” in the days after Ricigliano’s heart transplant, but said his absence would not affect the patient’s care after surgery. He noted that internists, cardiologists and others on the heart transplant team can provide medical advice and updates.
“There are plenty of people covering for me when I am not there,” Loebe said. “There’s always a doctor in the unit looking after the patient.”
Separately, Loebe said that he would have been involved in a “majority of the cases” cited in the UNOS letter questioning heart transplant outcomes at Jackson-MTI.
MTI undergoes peer review
MTI’s transplant program — like the publicly owned Jackson Memorial Hospital — consists almost entirely of physicians and other staff from the University of Miami’s medical school. They have a joint operating agreement.
The University of Miami has declined to comment about the Miami Transplant Institute and the partial suspension of its adult heart transplant program.
Loebe said there is a benefit to a peer-review panel conducting an investigation, which should provide a “fuller picture” of the “functionality” of the facility.
“These reviews are very helpful because they always try to identify how we can make a program better,” said Loebe, who was among the doctors questioned by the visiting UNOS-led team.
Loebe, 65, was hired to run Jackson-MTI’s heart transplant program in 2015 after running a major transplant facility in Texas. He was notified in October by the Miami Transplant Institute’s executive director, Dr. Rodrigo Vianna, that he would be replaced as chief of the heart transplant program, effective the end of February.
Loebe will stay on as a heart transplant surgeon, but he will no longer receive a $150,000 administrative stipend.
“We are confident that they will give us the green light,” said Loebe, “We’re optimistic that we can reopen our program very soon for patients.”
If the program does reopen, that would be of little solace to those who knew Ricigliano. They described asking Jackson for answers while visiting their loved one but not being satisfied with the responses. They say they are still reeling.
“I’m going in there every day and every time I talk to somebody, I’m getting a different story,” said Hamilton, recalling what his visits to Ricigliano were like. “No one’s stories are straight. Everyday is something different. So I was really, really frustrated.”
