March 12, 2002
Hospital Faces Fine in Death of Liver Donor
By DENISE GRADY
ount Sinai Hospital in Manhattan will be fined and subjected to other enforcement action by the state for its treatment of a patient who died on Jan. 13, three days after donating part of his liver to his brother, the State Health Department said yesterday.
The state health commissioner, Dr. Antonia C. Novello, is scheduled to announce the findings from a two- month investigation of the death at a news conference today. But a person who had already seen the 10-page report on the investigation said it blamed the death not on the surgery itself, but on deficient postoperative care by doctors at Mount Sinai.
The patient who died was Mike Hurewitz, 57, a reporter for The Albany Times Union and a former reporter for The New York Post. His brother, who recovered, is Adam Hurewitz, 54, a physician from Long Island.
Mount Sinai, a world leader in using healthy people as live donors for adults who need liver transplants, halted the operations after Mr. Hurewitz's death and said it would not resume them until its own investigation and the state's were finished. Although no adult-to-adult procedures have been performed since then, the hospital has continued to hold informational meetings for prospective donors and recipients. And it has continued to perform less risky operations in which adults donate parts of their livers to children.
Mr. Hurewitz was the first liver donor to die at Mount Sinai, which performs about 35 adult-to-adult living donor operations a year and has done about 100 since 1998, under the leadership of Dr. Charles Miller, a highly regarded transplant surgeon and one of Mr. Hurewitz's doctors.
Mr. Hurewitz's death is the second reported in a liver donor in the United States; the first occurred in North Carolina in 1999. Several others have been reported from Europe. Surgeons estimate the risk of death at 0.5 to 1 percent.
Live donor liver transplants are increasing because of the growing need for transplants and the shortage of organs from cadavers. In adult-to-adult operations, surgeon remove the right lobe of the donor's liver, 60 to 70 percent of the organ. Most donors are siblings, adult children, spouses or friends of the recipient. If all goes well, the pieces in both the donor and recipient grow to full- size organs in about a month. When the recipient is a child, surgeons take all or part of the donor's left lobe, about 30 percent of the liver. Possible complications from the operation include infections, bleeding and leaks from the bile ducts, which may require additional surgery to repair.
Live donor operations have been controversial, because they subject a healthy person to all the risks of surgery for someone else's benefit. But many donors say they benefit, too, by saving a loved one's life. And surgeons say they would not perform the operations if they had any other means of saving their patients.
But many doctors also acknowledge that live donors, desperate to help a dying relative, may not fully understand what they are getting into. Dr. Jay Hoofnagle, director of the division of digestive diseases and nutrition at the National Institutes of Health, said that when the risks are explained, "it's clear they're not listening, they've made the decision to donate and they don't hear anything after that about side effects."
The amount of the fine was not released yesterday. Details of the report will be discussed at a news conference today at 11:00 a.m. at the Health Department's offices at 5 Penn Plaza.
