Lester Coleman 
Nov. 19, 1992 
Lester E. Coleman, Formerly Of Marlboro Avenue, Wilkes-barre, Died Thursday.

Erma Parry 
Nov. 17, 1992 
Mrs. Erma L. Parry, 73, Of Mill Street, Parsons Section Of Wilkes-barre, Died 
Tuesday In Strongsville, Ohio.

By LEANORA MINAI; Times Leader Staff Writer
 Friday, November 20, 1992 &nbsp;&nbsp;&nbsp;&nbsp;Page: 1A/12A QUICK WORDS: MERCY SCRANTON
WILKES-BARRE GENERAL HOSPITAL 





Mercy Hospital in Scranton was one of seven hospitals in the state with a
greater number of deaths than expected from one type of heart surgery, while
Wilkes-Barre General Hospital and its doctors received an average rating in a
report released Thursday by a state council. &nbsp;&nbsp;&nbsp; 
 Doctors from 35 hospitals in the state are named and rated in the Health
Care Cost Containment Council's report as to patient mortality after coronary
artery bypass graft surgery. &nbsp;&nbsp;&nbsp; The report, which graded doctors on how many of their patients died
compared to what was expected in 1990, drew mixed reviews from hospital
officials and doctors Thursday. &nbsp;&nbsp;&nbsp; 
 The council erred in the analysis by not calculating high risk factors,
such as patients with diabetes, obesity or a history of smoking, said Mercy
spokesman Robert M. Costello, who blasted the controversial report as
"foolishness", "science fiction" and "nonsense." &nbsp;&nbsp;&nbsp; 
 "Someone should give the Health Care Cost Containment Council a good swift
kick in the pants," Costello said. "At no time did the state look at medical
records. At no time did the state observe patients before, during or after
surgery. At no time did the state talk to a surgeon or even a doctor." &nbsp;&nbsp;&nbsp; 
 The report, which is the first of its kind in Pennsylvania and only the
second in the nation, lists 170 surgeons by name and rates their performance
according to state mortality data adjusted for a variety of factors, such as
age and gender. &nbsp;&nbsp;&nbsp; 
 In 1990, 415 patients were admitted to Mercy for coronary artery bypass
graft surgery, the report states. Of those patients, 27 died. &nbsp;&nbsp;&nbsp; 
 Coronary artery bypass graft surgery involves making an alternative path
for blood around a narrow or blocked part of the coronary artery. This is
accomplished by using a graft of a blood vessel from another part of the body. &nbsp;&nbsp;&nbsp; 
 Also included in the report are average charges for the surgery.
Wilkes-Barre General's average charge is $29,746 while Mercy's is $23,885, the
report states. &nbsp;&nbsp;&nbsp; 
 Joe Martin, spokesman for the Pennsylvania Health Care Cost Containment
Council, said the report is meant to make the public ask questions and compare
and identify the most efficient and effective health care providers. He could
not assess how much it cost the state for the report. &nbsp;&nbsp;&nbsp; 
 "Does it mean Scranton is a bad hospital? No," he said. "We're talking
about one procedure. Does it raise questions? I would think it would. &nbsp;&nbsp;&nbsp; 
 "If I'm a consumer and I look at this, it's going to raise some questions
for me that I want to discuss. Why should I be referred to Mercy? Perhaps I
should be referred to another that has a better statistical batting average." &nbsp;&nbsp;&nbsp; 
 The risk factors that Costello wished were used in the analysis were not
used because they wouldn't have made a difference, Martin said. &nbsp;&nbsp;&nbsp; 
 "Scranton would still have a minus," he said. &nbsp;&nbsp;&nbsp; 
 Costello said 17 of the 27 patients who died at Mercy were transferred to
the hospital from other institutions. &nbsp;&nbsp;&nbsp; 
 "Either the patient came to us or that patient was going to die," Costello
said. "Every one of them had extensive coronary heart disease." &nbsp;&nbsp;&nbsp; 
 Dr. Lear Von Koch, chief of cardiovascular surgery at Mercy, received a
rating that indicated the number of deaths was average or not different than
expected. Of 185 of Von Koch's patients in 1990, nine died. &nbsp;&nbsp;&nbsp; 
 Von Koch was in surgery Thursday and could not be reached for comment. &nbsp;&nbsp;&nbsp; 
 Dr. Siamak Hamzavi, of Mercy, was rated as well. &nbsp;&nbsp;&nbsp; 
 His statistical rating for treatment effectiveness indicated more deaths
than expected. Of 187 patients of Hamzavi's patients in 1990, 16 died, the
report states. &nbsp;&nbsp;&nbsp; 
 Costello said Mercy may take a second look at whether they'll accept high
risk patients. &nbsp;&nbsp;&nbsp; 
 "We're a Catholic hospital," he said. "We would not turn anyone down
knowingly. Maybe we have to take a second look. We'll have to start saying we
won't do certain patients. We won't do high risk patients and those patients
will die." &nbsp;&nbsp;&nbsp; 
 As an example of what Costello called the council's inaccuracies, Costello
pointed out that the council listed Mercy's Von Koch as having operated at
Wilkes-Barre General Hospital, where he has never performed open heart
surgery. &nbsp;&nbsp;&nbsp; 
 General was pleased with its results, which placed the hospital among 23
other institutions in the state with an average number of patient deaths
expected. &nbsp;&nbsp;&nbsp; 
 In 1990, 214 patients were admitted to General for coronary artery bypass
graft surgery, the report states. Of those patients, four died. &nbsp;&nbsp;&nbsp; 
 Dr. George Eugene Cimochowski, chief of cardiac surgery for General,
received a rating that indicated the number of deaths was not different than
expected. &nbsp;&nbsp;&nbsp; 
 Of 42 patients in 1990, none died, the report states. &nbsp;&nbsp;&nbsp; 
 Cimochowski called the report "sound" and fair because it assessed 14
variables, such as age and artery approach, to determine a hospital's expected
mortality. However, he doesn't "live and die by this kind of report," he said. &nbsp;&nbsp;&nbsp; 
 General will continue to operate on high risk patients, Cimochowski said. &nbsp;&nbsp;&nbsp; 
 "We tend to do high risk patients," he said. "I'm not afraid of taking on
that kind of patient. The worst thing that can happen is patients not get
operated on because they're high risk." &nbsp;&nbsp;&nbsp; 
 Martin, of the council, said the report, which is available to the public,
provides essential statistical information. &nbsp;&nbsp;&nbsp; 
 "If it's the bottom of the ninth and the end of the line who do you want
coming to the plate?" asked Martin. &nbsp;&nbsp;&nbsp; 
 The report can be obtained by writing to the Health Care Cost Containment
Council, Harrisburg Transportation Center, Suite 2-F, Fourth and Chestnut
streets, Harrisburg, PA 17101.

Mercy Calls Mortality Report `nonsense' 
Report Card Rating Heart 
Surgeons On Patient Deaths 
Gives Mercy Poor Marks 
And Wilkes-barre General 
An Average Grade

Mercy Calls Mortality Report `nonsense' Report Card Rating Heart Surgeons On Patient Deaths Gives Mercy Poor Marks And Wilkes-barre General An Average Grade