Bundesärztekammer test report shows the extent of the transplant scandal
The accused surgeon in the process of the Göttingen transplant scandal had stated several times that he only wanted the best for his patients. However, the test report now published by the German Medical Association comes to completely different conclusions.
Policy violations in three quarters of the cases The accused surgeon in the process of the transplant scandal at the University Hospital in Göttingen had repeatedly indicated that he always wanted and did the best for his patients. As reported by “NDR 1” last summer, the accused said that he was “ready for the day and night for the patients” and regarded his profession as a doctor as “a life's work”. But a recently published report by the German Medical Association (BÄK) is difficult to reconcile with this self-portrayal. The examination board of the Medical Association examined a total of 105 cases from the time when the accused was head of transplant surgery in Göttingen. The investigators found violations of the guidelines in 79 patients. This is more than three quarters of the cases.
Not always for the benefit of the patient As the report shows, the violations were by no means always for the benefit of the patient, but on the contrary. For example, a number of patients who, according to the investigators, should not have had donor liver at all, experienced a dramatic deterioration in their health after the transplant. The Medical Association had all 24 liver transplantation programs examined at German clinics and presented the results in September 2013. However, with the exception of the report on Göttingen University Medicine, which has only just been published. The doctor is charged with attempted manslaughter in eleven cases and intentional bodily harm resulting in death in three cases. However, the test report lists significantly more cases than are negotiated in the process. The surgeon is accused of reporting manipulated medical data as making patients more sick than they actually were, so that they could be allocated donor liver more quickly. He is also said to have transplanted a liver into three patients, although they did not need any.
Patients were not even in the hospital with alleged blood collection. The extent and the system of the manipulations are clear from the report. The investigators base their suspicions on several pieces of evidence. For example, there were large inexplicable leaps in laboratory values in affected patients that could not be reconciled with the other clinical picture. Despite the values that indicated a significant deterioration in health, nothing was done by the doctors. Some patients were at home even though they were so sick on paper that they would have needed inpatient treatment. The commission assumes that the medical professionals knew that the values did not reflect the actual state of health. In addition, the values were suddenly back to the previous level shortly before the transplant. Another oddity that was found was that several patients whose alleged values were reported to Eurotransplant were not at the hospital on the day of the alleged blood draw. It is also suspected that two patients who were transplanted on the same day were given the same foreign blood from a third patient.
Medical qualities questioned In cases in which laboratory staff pointed out the unusual values, they were informed that the blood samples had been mixed up. Then the documents were corrected, but only internally. There was no notification to Eurotransplant and so the patients there were still listed with the high values. In addition, the examiners encountered numerous false statements about dialysis. In many cases, alcohol withdrawal periods had not been checked. The report also raises questions about the medical qualities. Accordingly, there were apparently significant shortcomings in the anamnesis, such as the fact that findings were not collected and symptoms were not clarified, or that a nine-centimeter carcinoma was overlooked in one patient. As the report says, this is "hardly understandable". In some cases, the alleged quality defects had dramatic consequences. According to the investigators, one should have improved the “absolutely inadequate” medication in one case. Instead, the patient had been given a new liver unnecessarily. He then had to be transplanted again and later died.
Patient receives fatty liver. In another case, too, the patient only became very seriously ill through the transplant. He had a liver transplant that was 90 percent fatty. The patient's own liver was better than the fatty liver that he received. In addition, according to the investigators, a patient who had even been transplanted three times and died of multi-organ failure should never have been reported because she had a clear contraindication. Given her path of suffering, "the question of the meaning of medical behavior" would arise.
Donor numbers plummet due to scandal But not only the patients at the time fell victim to the transplant scandal, but also the people who are still waiting for a donor organ. Because of the scandal, donor numbers in Germany had plummeted. Confidence in transplant medicine has been shaken overall. Figures from the German Organ Transplantation Foundation (DSO) show that only 876 people who died last year donated organs. Compared to the last 23 years, this represents a new negative record for the Federal Republic. The situation is precarious for the approximately 11,000 patients who are currently waiting for a donor organ, because three people die every day while waiting for a donor organ. (sb)
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