Frank Pallone Asks Doctor How To Restore Confidence In OPTN And Encourage People To Be Organ Donors

Forbes Breaking News

During a House Energy and Commerce Committee hearing on Tuesday, Rep. Frank Pallone (D-NJ) spoke about restoring confidence in the organ procurement and transplant network.

Transcript

00:00The chair recognizes the ranking member of the entire committee, Mr. Pallone, for his five minutes of questioning.

00:10Unlike our hearing last September, we have the benefit of HRSA in attendance as a witness,

00:15and we have solid evidence-based examinations conducted by HRSA that's also directed the OPTN

00:21to make a monitoring plan for the Kentucky organization that is the focus of its investigation

00:26and a system-wide policy and protocols to pause the organ procurement process

00:31when there are concerns about the patient's status.

00:34And these actions, I think, will better protect patients across the country during the pre-donor phase

00:39and increase confidence for would-be donors that their safety and interest will be addressed in the process.

00:44But, Dr. Lynch, does the corrective action plan, which is now public,

00:48send a message to all OPOs and relevant OPTN members involved in patient care

00:53that OPTN oversight is becoming stronger?

00:56And what do you hope the impact of that shift will be on the culture at OPOs and the OPTN?

01:02I have four questions, though, so please be brief.

01:08Oh, your mic is not on. Mine wasn't either.

01:11I'd like to emphasize the vast majority of providers are doing this in good faith,

01:15and every day they show up trying to do a good job.

01:17This shows that HRSA is doing the same and that we are committed to maintaining a safe environment,

01:22and so if they see something that is wrong, that they can plan for a future where we are doing that better.

01:28All right.

01:28And then what was it that you saw in your investigation that made you believe more safeguards were needed

01:33specifically for potential donations after circulatory death?

01:37The primary problem in Kentucky related to them failing to reevaluate their initial neurologic exam

01:46and failing to see that instead of somebody slowly getting worse

01:49or staying at a very low level of brain function, that they were in many cases recovering.

01:54I see.

01:55Now, Hearst's report concludes that the Kentucky OPO disregarded or dismissed any indication

02:00that a patient who was identified as a potential donor would ultimately not be eligible for donation.

02:06And from the report, the OPA appears to have been determined to proceed with the donation protocol

02:11until it was forced to stop by a physician's refusal to do the procurement operation.

02:17And various hospital staff do not appear to have stepped in to stop the process either until the very end.

02:22And despite this, some organizations argue that discussing concerning cases like this

02:27openly leads to fewer donations and harm to the donation and transplant system.

02:31So, Dr. Lynch, I can't believe I'm asking you this because it seems absurd,

02:36but what is Hearst's response to criticism that identifying and discussing lapses in patient safety

02:42in the OPTN is harmful to the system?

02:46I mean, I don't agree with that, but go ahead.

02:48I'll keep it brief for your other questions.

02:50It's twofold.

02:51The first is that trust is earned.

02:53It's not to be expected.

02:55It's earned every day.

02:55And the second is that no system ever improved in the dark.

03:00We need to have good data.

03:01We need to show that we are paying attention.

03:04And look, the bottom line is transparency is everything.

03:07You know, I mean, I've been here a long time.

03:09And if you don't have transparency, ultimately, you know, things don't work.

03:15So I totally agree with you.

03:18Last question, though you can take time on this.

03:20What are specific ways that improved oversight of the system will help restore confidence that the OPTN is safe and effective

03:28and that people should be organ donors?

03:31You have almost two minutes to answer that one.

03:34So, again, the adequate collection of data.

03:37The OPOs already collect these data on the patients with whom they interact,

03:42making sure that that's relayed to the government and that, in turn, is able to be used for analysis and for public use.

03:49The OPTN already is a leading example of making all data that we have available to researchers and policy advocates,

03:56adding in all the data on either end.

03:58The individuals with whom OPOs interact before they are organ donors and the individuals with whom transplant centers interact

04:06before they are on the wait list will help us to really understand the system

04:10and make sure that we're providing consistent, good care.

04:14All right.

04:15I mean, if the goal is trust in the system, there has to be consistent standards for all OPOs

04:21to avoid disparate treatment for patients based on where they live and receive care.

04:27And HRSA's corrective action plan, I think, is a step in that direction.

04:31And the OPTN and OPOs should welcome a constructive response from HRSA

04:35to prevent egregious incidents that put patients at risk.

04:38It's very important.

04:40So, with that, Mr. Chairman, thank you.

04:42I yield back.

04:43The gentleman yields.

04:44The chair now recognizes the vice chairman of the committee, Mr. Balderson, for his five minutes of questioning.

Category

Transcript

Recommended