Jackson overhauls top staff at heart transplant program, amid patient deaths, investigations
Jackson Memorial Hospital’s heart transplant program, suspended since mid-March amid multiple investigations involving deaths, infections and other bad outcomes, has a new leadership team.
Hospital leaders revealed the overhaul Monday during a staff meeting, although no announcement was made publicly. Dr. Joshua Hare was named the new interim chief of heart failure for both Jackson and the University of Miami Health System. Dr. Leonardo Mulinari is set to be the new interim chief of heart transplants.
Responding to questions from the Herald, which learned of the shakeup independently, Jackson officials confirmed the moves Thursday.
Hare and Mulinari replace Dr. Anita Phancao and Dr. Matthias Loebe, respectively, who have been the focus of complaints that spurred multiple investigations on the federal and state level. The complaints led to Jackson suspending its adult heart transplant surgeries in March at the insistence of the United Network for Organ Sharing, the nonprofit that manages the U.S. organ transplant system under contract with the federal government.
The heart transplant program is part of the Miami Transplant Institute, housed within the publicly funded Jackson Memorial and staffed by University of Miami medical school physicians.
Hare, a cardiologist, is head of the University of Miami’s Interdisciplinary Stem Cell Institute and a pioneer in stem-cell research. Prior to joining UM, he led the heart failure program as director of cardiac transplantation at Johns Hopkins University.
Mulinari is chief of pediatric and congenital heart surgery at UM’s Miller School of Medicine and co-director of the Comprehensive Heart Center at Holtz Children’s Hospital, located at Jackson.
Luke Preczewski, the institute’s vice president, and Dr. Rodrigo Vianna, the institute’s executive director, made the internal announcements while discussing changes to the hospital’s heart failure program at the transplant institute. Phancao was also at the meeting, attended by Miami Transplant Institute administrators, surgeons and other staff who work with heart transplant patients, according to a Jackson source who attended the meeting.
Jackson not saying what led to shakeup
No specific reason was given at the meeting about the leadership changes, sources told the Herald. But Preczewski did mention the need for better teamwork, process management and communication following the program’s suspension, according to one Jackson source at the meeting.
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A Jackson spokeswoman did not answer the Herald’s questions about Phancao, 46, no longer being the chief of heart failure and transplant cardiology. She said the changes were part of the hospital’s process to improve its performance, but did not answer questions about whether the investigations influenced the staff changes.
“Both Dr. Mulinari and Dr. Hare are renowned experts in their field, and with their guidance, we will reinstate the heart transplant program as soon as it is appropriate,” Jackson said in a statement Thursday morning.
The hospital’s decision to suspend the heart transplant program came after the organ sharing network signaled to Jackson that it had received anonymous, detailed complaints regarding patient deaths and infections, complaints that led to the network’s investigation of the Jackson/UM transplant center.
Jackson told the Herald at the time that the organ sharing network would oversee a peer review of the program, involving a visit by experts from the field to the Miami Transplant Institute. The visit occurred the week of April 4, generating a report with findings on April 26.
Three separate investigations
A week after the April 4 visit, the federal Centers for Medicare and Medicaid Services and the Florida Agency for Health Care Administration, which regulates Florida hospitals, each sent teams to the transplant institute.
A report detailing patient safety concerns, reviewed by the Herald, had previously been sent to the Medicare and Medicaid agency. The report highlighted complaints about the heart failure team, then led by Phancao, and the implantation of Left Ventricular Assistance Devices — a type of heart pump that can keep a patient alive while waiting for a heart transplant or even eliminate the need for a transplant.
READ MORE: This heart pump can be a better option than a transplant. But it’s not for everyone
The anonymous report also detailed complications and patient deaths following heart transplant procedures performed by Loebe, 64, who had been chief of the institute’s heart transplant program until recently. The heart surgeon had been stripped of his administrative duties in October, although he was allowed to remain as chief through the end of February. In April, Jackson gave him a new restriction: He would no longer be allowed to treat patients. Jackson did not elaborate when the Herald asked about Loebe’s changes.
Phancao is still seeing patients, Jackson said. The doctor, a graduate of the University of California and Boston University’s School of Medicine, did her residency and fellowship at Cedars-Sinai Medical Center in Los Angeles. Her practitioner profile with the Florida Department of Health indicates she’s also licensed to practice medicine in California, Nevada and Oklahoma.
Jackson has refused public records requests from the Herald to provide the letter sent by the organ sharing network to the Miami Transplant Institute urging it to suspend the program, and the report detailing the findings of the peer-review team. Jackson cited a legal exemption that makes the documents “not subject to inspection and copying.”
The Miami Transplant Institute, one of the oldest and largest transplant centers in the country, has continued to transplant other organs, including lungs, kidneys and livers.
