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Controversial surgeon will move to Houston

A controversial surgeon forced to stop open-heart surgery because of his high mortality rate is reportedly leaving the Tampa Bay area.

Dr. Javier Ruiz, whose heart surgery technique got both himself and Morton Plant Hospital in trouble, told officials at the hospital where he now practices that he will be moving to Houston in April.

"He didn't go into any details as to who he was going to be working with or what he was going to be doing," said Rick Katzeff, executive director of Clearwater Community Hospital.

Ruiz, 52, could not be reached for comment.

Meanwhile, a state agency says it has begun keeping statistics on hospital death rates with an eye toward making them public. The theory is that if hospitals know the data are going to be made public they'll have a powerful incentive to protect patients.

The St. Petersburg Times reported Sunday that administrators at Morton Plant knew as far back as 1979 or 1980 that Ruiz had an unusually high mortality rate compared to other heart surgeons. But no restraints were placed on him until 1985, when the death toll soared and nurses revolted.

In addition, Morton Plant never notified the families of six patients who died that their deaths had been termed "potentially preventable." Attorneys for the hospital persuaded a judge to seal court records but the Times obtained the names, alerted the families and published the information.

Ruiz left Morton Plant in August 1987 and moved to Clearwater Community, which has no heart-surgery program. He has been operating on people with clogged neck and leg arteries.

The surgeon came to Clearwater in 1974 from the Texas Heart Institute in Houston, where he worked for famous heart surgeon Denton Cooley. Some who heard he was returning to Houston assumed he was going back to the institute.

But institute spokeswoman Kathy Huebner said Ruiz will not be working there.

Hospital coverups of "lethal doctors" are not uncommon, said Charles Inlander, executive director of the People's Medical Society.

"We the public think we're the customers," Inlander said. "But the reality is the doctor is the customer. Nobody goes in the hospital unless a doctor admits them. That's why the hospital is not your best friend, they're the doctors' best friend."

Inlander's group, a nationwide patients' rights organization based in Pennsylvania, has scored a coup in its home state with passage of a program that publicizes death rates by procedure of all Pennsylvania hospitals (statistically corrected to take severity of illness into account).

Pennsylvania next year will begin releasing mortality rates for each doctor, by procedure.

"This will be the only place in the country this has ever been attempted," Inlander said. "We broke the back of the medical lobby on this."

Fred Bodendorf, acting executive director of Florida's Health Care Cost Containment Board, helped set up the Pennsylvania program before moving to Florida. He said the board in Tallahassee may follow suit.

On Jan. 1, he said, the staff began gathering information on hospital death rates and has developed a way to adjust them for severity of illness. He doesn't know when the board will make that information public but said it will likely be in a year or two.

"Our philosophy is that we need to get the information out to the patients so they can make good decisions," he said.

Bodendorf said he hasn't approached the board about making individual doctors' death rates public but it could be done with information already in the agency's data base. "It will be interesting seeing how Pennsylvania does it," he said.

The American Hospital Association said about 20 states collect hospital mortality information, translate it into a usable form and feed it back to the hospitals that sent it in. In most states the information is kept secret from the public.

A few times the Health Care Financing Administration, Medicare's parent agency, has released mortality statistics. Hospitals have protested loudly.

"There needs to be some support in helping the public interpret the information," said Joanna Deporter, policy analyst for the hospital association. "Throwing the data out there by itself isn't the best thing to do."

But Inlander of the People's Medical Society thinks patients are entitled to life-and-death information. And the knowledge that mortality rates will be published, he said, will push hospitals to act when dangerous doctors are identified.

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