A former cardiac surgeon at Vassar Brothers Medical Center in Poughkeepsie claims that the hospital retaliated against him for complaining about mishandling of complex procedures that led to high mortality rates.
Dr. Jason Sperling accused Nuvance Health Medical Practice — a network of seven hospitals in New York and Connecticut, including Vassar Brothers — of ignoring standard surgical procedures, in a complaint filed Oct. 26 in U.S. District Court, White Plains.
“This is a case about a hospital who put profits and physician egos above patient safety,” the complaint states, and about “a doctor who was punished for speaking against it.”
“We take allegations of this nature very seriously,” Nuvance spokesman John Nelson stated in an email, “especially when they pertain to the safety and well-being of our patients. At Vassar Brothers Medical Center, our top priority has always been and will continue to be the safety and care of our patients.”
Sperling was hired as Chief of Cardiovascular Surgery in 2018. He reported to Dr. Mark Warshofsky, an interventional cardiologist who was the head of Nuvance’s Heart and Vascular Institute.
The difference between their cardiac specialties lies at the heart of Sperling’s complaint.
Interventional cardiologist use catheters to diagnose and treat coronary heart disease, for example, placing stents in clogged arteries to restore blood flow. Cardiac surgeons perform more invasive procedures, such as coronary artery bypasses.
By mid-2000, Sperling claims, he became concerned about how two types of risky medical procedures were being handled.
The ECMO procedure — extracorporeal membrane oxygenation — uses an external machine to pump and oxygenate blood when the patient’s heart or lungs are damaged.
Cardiac interventionists can start the procedure and then co-manage it with cardiac surgeons in some situations, according to Sperling, but the best practice is for surgeons to be involved.
Sperling claims that some interventionists used ECMO to “rescue treatment failures and possibly avoid mortalities that could be associated with their care,” summoning surgeons to the cardiac catherization lab or to the intensive care unit and demanding that patients be placed on ECMO “in a hurried manner.”
Often the patients were in full cardiac arrest or were already unsalvageable, Sperling claims, or their vascular injuries would blossom into fatal bleeds.
He says that ECMO procedures initiated in an operating room or after heart surgery had a high success rate, but procedures initiated in the catherization lab “had a near 100% mortality rate.”
Sperling also criticizes the hospital’s handling of TAVR procedures — trans-catheter aortic valve replacement — where a catheter is inserted in an artery, guided to the heart and deploys a new valve.
The Centers for Medicare and Medicaid Services requires a cardiac surgeon and an interventional cardiologist to co-manage the procedure, according to the complaint. But Nuvance permitted two interventionist to perform the procedure without active participation by a surgeon.
Surgeons who were present during the procedures purportedly told Sperling that they essentially sat in a corner or “might as well have not even been there.”
Vassar Brothers finished dead last for risk-adjusted mortality rate for TAVR from 2016 to 2019 among New York hospitals ranked by the state Department of Health, the complaint states.
Nuvance allegedly billed Medicare as though the surgeons had participated, to receive the full reimbursement of about $60,000 per procedure.
Sperling says Warshofsky downplayed or dismissed his concerns about patient safety, and higher-ranking hospital officials he went to did nothing.
Nelson, the Nuvance spokesman, said the hospital’s cardiac surgery and interventional program have been recognized for excellence by the Society of Thoracic Surgeons and by U.S. News & World Report.
“Our commitment to a culture of safety and continuous improvement,” he said, “has been the cornerstone of our success.”
In November 2021, Sperling was told that Nuvance was searching for a new chief of cardiac surgery, according to the complaint, because he had created a hostile environment and the cardiac interventionists had lost confidence in him.
In October 2022, he was placed on paid administrative leave. This past August, he went to work for a hospital in Cincinnati, Ohio.
Sperling claims that Nuvance breached his contract and still owes him $77,000. He is also demanding back pay, benefits and other unspecified damages.
He is represented by Manhattan attorney Robert Glunt.
