Lawmaker urges investigation on obesity surgery

Senator Richard T. Moore is asking public health officials to investigate mortality and complication rates for weight-loss surgery at hospitals that fail to meet patient safety guidelines issued more than a year ago.

Moore, cochairman of the Legislature's Joint Committee on Health Care Financing, requested the investigation yesterday in a letter to Paul Cote, commissioner of the Massachusetts Department of Public Health, and asked him ''to take strong corrective action if any of [the hospitals'] patients were harmed in any way as a result of the failure."

Moore said he was responding to an article in yesterday's Globe, which reported that at least five Massachusetts hospitals continue to perform increasingly popular obesity surgery, though they don't do enough of the operations to meet voluntary safety guidelines issued by a DPH committee.

The guidelines include a recommendation that hospitals handle at least 100 cases a year, because studies show that such programs get better results.

Moore said that if any of the low-volume hospitals also fail to meet other safety guidelines, they should be prohibited from performing the surgery.

This week, Blue Cross and Blue Shield of Massachusetts said it will stop paying for obesity surgery at hospitals that fall short of these standards starting in January 2007. Moore said he will ask Blue Cross to move up the effective date to October 2006, when hospitals begin their fiscal year, and he will request that the state's other major insurers adopt a similar policy.

''This surgery has had a lot of deaths in the past few years; that's why we set up this panel to recommend specific practices," Moore said. On average, the surgery has a 1 percent mortality.

The hospitals defended their programs and said they have low complication and mortality rates. According to a Globe survey, at least five hospitals -- Caritas St. Elizabeth's Medical Center in Boston, Morton Hospital in Taunton, Beverly Hospital, Tobey Hospital in Wareham, and Winchester Hospital -- don't meet the caseload recommendations. Executives and surgeons at the hospitals said they need time to build their programs.

Cote said that he wants to talk with Moore, but that he has no immediate plans for an investigation. He said his department's primary responsibility is to investigate complaints from patients, family members, and hospital employees.

Moore, however, said DPH ''shouldn't wait until someone gets hurt." If a smaller hospital needs time to build an obesity surgery program, he said, public health officials should take an approach similar to the requirements for heart surgery, under which a large academic medical center closely monitors a smaller hospital.