Has a hospital refused a cardiac transplant patient because of a lack of funds?

A woman from Grand Rapids, Michigan, requiring a heart transplant, who was rejected for lack of funding for her follow-up care, drew the country's attention when she released the rejection letter. on social media. The letter – which advised her to raise the funds needed to pay for postoperative immunosuppressive drugs – has become viral, with many commentators suggesting that it is indicative of the difficulties patients face with a profit-driven health system.

Hedda Martin suffers from congestive heart failure resulting from chemotherapy for breast cancer that she suffered in 2005, according to the Detroit Free Press. A letter sent by a nurse to Martin on November 20, 2018, from the Spectrum Health Medical Network, informed her of her referral because the transplant committee found her unable to pay for drugs that would prevent her immune system from rejecting the transplanted heart. after the surgery. . The letter suggested that Martin raise $ 10,000 for this purpose.

In response, his son Alex Britt did just that and in three days he collected almost three times the amount mentioned in the letter via the crowdfunding platform GoFundMe. Britt wrote that her mother had been hospitalized twice in just over a month because of heart failure: "She is resting and hoping for a [left ventricular assist device] as a bridge to heart transplant, "he said," imagine [her] disappointment when she was told that she had been refused for financial reasons. "

The story caused great public outrage and drew the attention of US Representative Alexandria Ocasio-Cortez, who tweeted it to nearly 1.4 million subscribers with comments on the state of the American health care system:

Some readers wondered if the letter was real and we found no indication that this was not the case. Although patient privacy laws prevent Spectrum Health from confirming its truthfulness, the health care provider responded to requests by providing a statement in support of the reported version of events:

Each transplant candidate is evaluated by our highly qualified multidisciplinary team of doctors, nurses, social workers, clinical ethicists, dieticians and other experts. Eligibility for transplantation is a complex process. This requires taking into account a multitude of factors based on established best practice standards used by transplant centers across the country. Physical health, psychological and social well-being and financial resources are among the factors taken into account for each patient. The ability to pay for post-transplant care and lifelong immunosuppressive drugs is essential to increase the transplant's chances of success and longevity. We help patients understand the long-term implications of a transplant for health, as well as their total financial commitment, such as post-transplant drug expenses paid to pharmacies of their choice.

Our clinical team maintains an ongoing dialogue with patients about their eligibility, holding frequent meetings and informing patients in-person to make sure they fully understand their current and future specific situation. We are continually improving how we communicate these decisions to our patients in a caring and consistent manner, consistent with our approach to exceptional care.

the Detroit Free Press announced that the Spectrum Health Registry Committee will meet in the coming days to review Martin's eligibility in light of his fundraising success:

Hedda Martin, 60, wrote in an article on Facebook that a heart transplant committee with Spectrum Health, the Grand Rapids-based hospital system, could come together [within days] to decide if she is now eligible for a new heart.

The committee had previously ruled his candidacy ineligible, citing his lack of financial means to pay for drugs, given the annual deductible of $ 4,500 in his Medicare plan. Martin's 20% drug contribution is about $ 700 a month until the deductible is reached.

published November 28, 2018

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