The American Association for Accreditation of Ambulatory Surgery Facilities Board President Foad Nahai, MD, authored a letter to the Becker's ASC Review editorial staff in response to coverage about the death of Joan Rivers at Yorkville Endoscopy Center
Dear Becker's Editorial Staff,
I'd like to address a statement in your January 27 article entitled, "Melissa Rivers to sue Yorkville Endoscopy: 5 things to know."
In the final paragraph, you allege in a quote from attorney Ben Rubinowitz, that office-based surgery facilities are unregulated and unsupervised.1 Nothing could be further from the truth.
For 30 years, the American Association for Accreditation of Ambulatory Surgery Facilities has inspected facilities on hundreds of important criteria concerning patient safety. AAAASF constantly assesses surgery center performance through a thorough inspection process and Internet submitted data from our facilities to show outpatient facilities are safe and convenient for patients of all ages.
• Since 1999, AAAASF has collected aggregate data on all adverse events that occur in its accredited facilities, which is stored in its data collection system. Periodic reporting is mandatory for all AAAASF facilities. There is no other database with this type of extensive statistical data for analysis of outpatient surgery procedures and outcomes.
• Analysis of data of more than 12 million cases has demonstrated a low rate of mortality with an incidence of death in about one of 50,000 procedures performed. This incidence of death is mostly due to pulmonary embolism, a blood clot to the lung that can occur in any postoperative patient regardless of whether the surgery was performed in a hospital or outpatient facility. Another large percentage of deaths that occur were in patients who die from other disease, unrelated to surgery, such as those patients who suffered from chronic renal failure. Deaths occurred intraoperatively at a rate of one in 478,000 procedures.
• The data demonstrates low infection rates of one in 2,400 procedures. No deaths were attributed as a direct result of infection.
Outpatient surgery is safe for patients of all ages, provided that the surgeon and anesthesiologist have assessed their medical suitability to the outpatient setting. The Yorkville Endoscopy incident was not a problem resulting from lack of regulations or oversight but poor medical judgment, which everyone involved concedes was the case.
More government regulation of office-based surgery facilities is not necessary. In fact, it may needlessly raise costs, lower access and as data shows, would not improve safety. Although there is always room for improvement, our data of more than 12 million procedures has demonstrated the efficacy of outpatient surgical care.
Thank you for your consideration,
Foad Nahai, MD, AAAASF Board President.
Footnotes:
1. The quote NBC News report quotation in the Becker's ASC Review article was as follows: "Our client Melissa Rivers couldn't be more disappointed and disheartened by this outrageous medical conduct," said attorney Ben Rubinowitz, according to the NBC News report. "Our goal is to make sure real change comes about in regulation of ambulatory surgery centers to ensure patient safety and health."