Report Slams UCI’s Kidney Transplant Care

The kidney transplant program at UCI Medical Center failed to provide adequate training to staff, monitor the diets of organ recipients or regularly review the care provided to patients as required, according to a federal inspection report released Wednesday.

The 11-page report by the U.S. Centers for Medicare and Medicaid Services is the latest to raise concerns about transplant services at UCI.

The Orange County hospital shut down its liver program in November after The Times reported that more than 30 patients died on its waiting list in 2004 and 2005, even as the hospital turned down scores of organs that might have saved some of them. Subsequently, the kidney program came under scrutiny as well.

The release of the federal report comes as UCI Medical Center is struggling to recover from a series of troubles in its transplant programs and beyond.

A task force appointed by university Chancellor Dr. Michael V. Drake will issue a far broader report today on what’s gone wrong, along with recommendations to fix the shortcomings.

“Whatever changes are necessary are going to be made, period,” said Drake, who took over in July and has said he was caught off guard by the transplant problems.

The Medicare agency found that UCI did not ensure nurses and others completed their training or that their training was comprehensive, according to the report. A nurse manager and another nurse couldn’t provide basic information on how to evaluate a transplant patient’s diet, which is important because kidneys are crucial for removing impurities from the blood.

The report also faulted the hospital for failing to review the care provided to transplant patients, a routine quality-control procedure in hospitals known as peer review.

One member of the medical staff explained to an inspector that “there was no member of the medical staff who either had the expertise or competency” to do the reviews.

The document was based on an inspection in December that was released Wednesday under the Freedom of Information Act.

In its response, UCI said it had improved training and oversight and had put in place a system for reviewing transplant care. The problems were not deemed serious enough by regulators to pull the program’s certification, officials have said.

UCI officials said that none of the deficiencies caused patient harm and that the program was thriving under Dr. Clarence Foster, a kidney transplant surgeon hired in July.

Before Foster began work, UCI’s kidney program suffered from some of the same problems that doomed its liver program.

UCI accepted only 8.7% of the kidneys offered on behalf of its patients from July 2000 to June 2005, one of the lowest rates in the nation. Many of the patients on UCI’s waiting list would have had a far greater chance of receiving a transplant had they gone to other hospitals, data showed.

To satisfy regulators, UCI has pledged to provide a written explanation for every kidney turned down for patients on its transplant waiting list. Those refusals would be reviewed by top officials, including the university chancellor.

Data submitted by UCI to the Medicare agency showed that the hospital accepted more than two-thirds of the kidneys offered between July and October.