Texas Surgeon Accused of Manipulating Government Database to Deny Liver Transplants

A respected Houston transplant surgeon has been accused of altering database information for patients waiting on a new liver — and now, his former employer is admitting that parts of the allegations are true.

As the New York Times reports, surgeon J. Steve Bynon of Memorial Hermann-Texas Medical Center in Houston allegedly changed government database records to preclude his own patients from getting liver transplants, and many of them died while on the waiting list.

Following the NYT's initial publication of the claims, Memorial Hermann admitted that a doctor in the teaching school's kidney and liver programs had changed patient records, in effect denying them transplants. Someone familiar with the situation told the newspaper that the doctor in question was Bynon.

Because transplant surgeries are both dangerous and expensive, hospitals have criteria for who will be the best fit for one, and often exclude patients based on health factors such as weight, smoking, alcohol use, and age.

While each department has leeway about how it chooses to handle these cases, there are general guidelines — and authorities at Memorial Hermann found, based on a tip-off, that there were some serious irregularities on its liver transplant waiting list. In one instance, as the NYT reports, it listed a toddler as being a whopping 300 pounds — which, of course, is medically impossible.

Over the past week, both programs abruptly shut down as the University of Texas began looking into the allegations against Bynon, who has led the school's abdominal transplant department since 2011. Later, both the US Department of Health and Human Services and the United Network for Organ Sharing, which governs our country's organ donation and transplant services, said they were investigating the matter, too.

When reached by the newspaper, Bynon did not confirm that he had tampered with patient records, and referred the NYT to his employer. It remains unclear why he would have changed the data.

If the records and waiting lists were indeed tampered with, other doctors say that patients would not be informed that their status had changed.

"They’re sitting at home, maybe not traveling, thinking they could get an organ offer any time, but in reality, they’re functionally inactive, and so they’re not going to get that transplant," Sanjay Kulkarni, the vice chair of the ethics committee at the United Network for Organ Sharing, told the NYT. "It’s highly unusual, I’ve never heard of it before, and it’s also highly inappropriate."

Despite being a relatively small program, the NYT and experts its reporters spoke to say that Memorial Hermann's liver transplant department seemed to be disproportionately small based on the number of surgeries it had performed. Indeed, last year it only performed 29 transplants, which made it one of the smallest such programs in Texas — and in that same time frame, 14 people were taken off the transplant list because they either became too sick to undergo surgery or died.

According to the Scientific Registry of Transplant Recipients research group, the mortality rate for people waiting for livers at Memorial Hermann was higher than expected, too.

Because the liver and kidney programs have been suspended — which according to medical experts the newspaper spoke with is quite rare, especially over ethical issues — hundreds of patients on the hospital's waiting list are now being referred to other programs.

More on medical ethics: Startup That Selects Embryos with Good Genes Says It's Not Doing Eugenics