Anesthesia Management: Joan Rivers’ death renews scrutiny of office-based surgeries

The recent high-profile death of Joan Rivers after an outpatient endoscopy procedure has brought more attention to safety concerns at surgical centers and other ambulatory settings, though it’s an issue that has been on regulators’ radar for some time, according to an article from Crain’s New York Business.

Although data on adverse events occurring outside of hospitals is not as meticulously recorded, preliminary statistics gathered by health officials indicate that of 2,202 adverse events reported between 2010 and 2013 at New York medical practices accredited to perform surgery, 257 were deaths.

Had any of these post-surgical deaths occurred in connection with a hospital, the response would be swift and certain, Jeffrey Kraut, senior vice president for strategy at the North Shore-LIJ Health System, told Crain’s. “This would be a day-and-night priority [focusing on] what happened and why it happened–‘Give me the data, it has to change.’ ”

But change from a regulatory standpoint has been slow. Changes proposed by the New York state Health Department’s advisory body, the Public Health and Health Planning Council that would boost reporting requirements for office-based surgeries failed to pass during the 2014 legislative session. The recommendations would also require office-based surgical practices to register with the Health Department and limit the duration of procedures that could take place in offices, the article noted.

Nonetheless, in light of the proliferation of office-based surgery practices–up 55 percent in New York since 2011–the state has created a group commissioned to collect and analyze data on adverse events. The group plans to complete its review within the next six to 12 months and issue policy recommendations to improve safety at office-based surgical sites.