Missed Blood Test and Kidney Transplant Cause Malpractice Case

By Kerrie Spencer, staff writer – January 25, 2012

This complex case started out with good intentions, but somewhere along the way things went awry, and now a man may pay for those good intentions with his life.

This case involves a Pennsylvania couple suing a high profile medical center after doctors transplanted the woman’s kidney to her significant other, in spite of tests showing she had hepatitis C. But the story gets worse from here. [1][2]

Michael Yocabet and Christina Mecannic of Greene County, Pennsylvania say Michael does have the potentially fatal liver disease due to his April 6, 2010 transplant at the University of Pittsburgh Medical Center. The idea of the transplant, because she was compatible, was to save his life. Ironically, it may ultimately kill him as treatment for hepatitis C could harm his new kidney, leading to organ failure and death.

Yocabet, a Type 1 diabetic with diabetes related kidney disease, was in dire need of a kidney before his operation as his dialysis was not doing what it should for him. Christina stepped in to help, and that is when their world blew up. She made the decision to donate her kidney, after doctors indicated a kidney from a living donor was often more successful than a kidney donated by a deceased person. There are now two medical malpractice lawsuits pending for medical negligence against the staff at the hospital’s kidney transplant center that involve a nurse, four doctors and the University of Pittsburgh physicians and UPMC Presbyterian.

The suit indicates the transplant team missed a critical blood test taken January 26, 2010; this test clearly showed Meccanic had the hepatitis C virus. They also apparently did not make a note of the results of that blood test before the transplant. In fact, the hospital did not tell her the results or dismiss her as a donor. One of the transplant surgeons noted that Meccanic would be an excellent candidate to donate a kidney.

Over the three month time period between the blood test and positive hepatitis C results, the hospital did not add this critical information to his or her file, nor discuss the results of the test. What were they doing? Why was the information not entered? And, here is another strange thing, the second blood test taken April 22, 2010 (remember the transplant was April 6) confirmed Meccanic had hepatitis C.

She was still not told the results of the test. Instead, the hospital analyzed her viral load, and called Yocabet in on April 29, 2010 for blood tests. It was not until May 6, 2010 that the hospital called her to a meeting where they suggested she was having an affair with another man, took drugs and told her she had hepatitis C. The reality is that Meccanic, a retired licensed practical nurse, was exposed to blood while working in nursing homes. She did not manifest any symptoms and was not a drug user.

Here is where things went from bad to worse. The hospital doctors began asking Meccanic if she cheated on her significant other, then suggested she used cocaine and said she could make a choice to keep the results of the diagnosis secret from Yocabet. Meccanic and Yocabet had been in a stable relationship for 21 years, and he had fathered her 18-year-old son. [3][4]

Stunned into shock, Mecannic told the hospital and the surgeon she was going to let Yocabet know immediately about the diagnosis as it played a huge part in not only the success of the transplant operation but his continued good health. There was more upsetting news to come when the couple was accused by the hospital of telling the media about the egregious mistake the hospital made. Whether they had or not was really not the point of this case.

The hospital insisted there was no attempt to cover the situation up, yet they shut their transplant center down for two months, demoted a surgeon, suspended a nurse and called in investigators from the United Network for Organ Sharing. These were all good decisions but the one decision that would have likely saved this man’s life by giving him a healthy kidney was not made. Instead, the surgeon chose to transplant a kidney infected with hepatitis C; a situation which compromises the UPMC hospital’s assertion that their only priority is the well-being of their patients.

During the course of a year close to 6,200 kidneys are donated to others in the U.S. by living donors and about 10,400 from deceased donors. Even though at least 28,000 kidneys are donated, there are close to 113,000 people waiting for one. At least 6,500 people die while they are waiting for a kidney transplant. [5][6][7]

It is relatively rare that people die later from an infected kidney. In fact, in checking the statistics for the longest living kidney transplant, the world record may well go to two Americans, Denice Lombard and Bill Thompson. Lombard, who hails from Washington, D.C., received a kidney from her dad in 1967 when she was 13-years-old. Thompson received his in 1966 when he was 15-years-old. [8]

Following closely behind Thompson and Lombard is the second longest living kidney transplant recipient, Annemarie Grosskopf of Johannesburg, South Africa. She received a kidney from a deceased donor when she was 21-years-old in 1981.

What happened in this instance? Living donors may be screened for a wide variety of infections that include rare diseases, HIV and even syphilis. However, even though the standard is to test for HIV, there are no other stated prerequisites for testing living donors, which means screening may be different at various transplant centers.

Ironically, this lawsuit’s timing is almost serendipitous, as the Centers for Disease Control and Prevention are working on draft guidelines that mandate even more thorough donor screening and testing. Part of the new mandate includes testing for HIV, hepatitis B and C. [9][10]

It will be interesting to see how a jury reacts to the evidence and what their verdict will be. It is a shocking case, but the circumstances could happen to anyone more often than previously realized.

Sources
[1] http://www.msnbc.msn.com/id/44599555/ns/health-infectious_diseases/t/couple-sues-hospital-after-he-gets-her-infected-kidney/

[2] http://www.msnbc.msn.com/id/37624303/ns/health-infectious_diseases/t/infected-organs-pose-deadly-transplant-risk/

[3] http://www.msnbc.msn.com/id/44599555/ns/health-infectious_diseases/t/couple-sues-hospital-after-he-gets-her-infected-kidney/

[4] http://www.illinoisinjurylawyerblog.com/2011/12/hospital_liable_for_medical_ma.html

[5] http://www.ustransplant.org/

[6] http://kidney.niddk.nih.gov/kudiseases/pubs/kustats/

[7] http://www.unos.org/

[8] http://en.wikipedia.org/wiki/Kidney_transplantation#Statistics

[9] http://www.msnbc.msn.com/id/44599555/ns/health-infectious_diseases/t/couple-sues-hospital-after-he-gets-her-infected-kidney/

[10] http://www.msnbc.msn.com/id/37624303/ns/health-infectious_diseases/t/infected-organs-pose-deadly-transplant-risk/

Background Sources
http://www.msnbc.msn.com/id/45310341/ns/health-health_care/t/probation-program-transplanted-infected-kidney/

http://www.ncbi.nlm.nih.gov/pubmed/18510639

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