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In 2018, Darryl Young was hoping for a new lease on life when he received a heart transplant at a New Jersey hospital after years of congestive heart failure. But he suffered brain damage during the procedure and never woke up.

The following year, a ProPublica investigation revealed that Young’s case was part of a pattern of heart transplants that had gone awry at Newark Beth Israel Medical Center in 2018. The spate of bad outcomes had pushed the center’s percentage of patients still alive one year after surgery — a key benchmark — below the national average. Medical staff were under pressure to boost that metric. ProPublica published audio recordings from meetings in which staff discussed the need to keep Young alive for a year, because they feared another hit to the program’s survival rate would attract scrutiny from regulators. On the recordings, the transplant program’s director, Dr. Mark Zucker, cautioned his team against offering Young’s family the option of switching from aggressive care to comfort care, in which no lifesaving efforts would be made. He acknowledged these actions were “very unethical.”

ProPublica’s revelations horrified Young’s sister Andrea Young, who said she was never given the full picture of her brother’s condition, as did the findings of a subsequent federal regulator’s probe that determined that the hospital was putting patients in “immediate jeopardy.” Last month, she filed a medical malpractice lawsuit against the hospital and members of her brother’s medical team.

The lawsuit alleges that Newark Beth Israel staff were “negligent and deviated from accepted standards of practice,” leading to Young’s tragic medical outcome.

Defendants in the lawsuit haven’t yet filed responses to the complaint in court documents. But spokesperson Linda Kamateh said in an email that “Newark Beth Israel Medical Center is one of the top heart transplant programs in the nation and we are committed to serving our patients with the highest quality of care. As this case is in active litigation, we are unable to provide further detail.” Zucker, who is no longer on staff at Newark Beth Israel, didn’t respond to requests for comment. His attorney also didn’t respond to calls and emails requesting comment.

Zucker also didn’t respond to requests for comment from ProPublica in 2018; Newark Beth Israel at the time said in a statement, made on behalf of Zucker and other staff, that “disclosures of select portions of lengthy and highly complex medical discussions, when taken out of context, may distort the intent of conversations.”

The lawsuit alleges that Young suffered brain damage as a result of severely low blood pressure during the transplant surgery. In 2019, when the federal Centers for Medicare and Medicaid Services scrutinized the heart transplant program following ProPublica’s investigation, the regulators found that the hospital had failed to implement corrective measures even after patients suffered, leading to further harm. For example, one patient’s kidneys failed after a transplant procedure in August 2018, and medical staff made recommendations internally to increase the frequency of blood pressure measurement during the procedure, according to the lawsuit. The lawsuit alleges that the hospital didn’t implement its own recommendations and that one month later, “these failures were repeated” in Young’s surgery, leading to brain damage.

The lawsuit also alleges that Young wasn’t asked whether he had an advance directive, such as a preference for a do-not-resuscitate order, despite a hospital policy stating that patients should be asked at the time of admission. The lawsuit also noted that CMS’ investigation found that Andrea Young was not informed of her brother’s condition.

Andrea Young said she understands that mistakes can happen during medical procedures, “however, it’s their duty and their responsibility to be honest and let the family know exactly what went wrong.” Young said she had to fight to find out what was going on with her brother, at one point going to the library and trying to study medical books so she could ask the right questions. “I remember as clear as if it were yesterday, being so desperate for answers,” she said.

Andrea Young said that she was motivated to file the lawsuit because she wants accountability. “Especially with the doctors never, from the outset, being forthcoming and truthful about the circumstances of my brother’s condition, not only is that wrong and unethical, but it took a lot away from our entire family,” she said. “The most important thing to me is that those responsible be held accountable.”

ProPublica’s revelation of “a facility putting its existence over that of a patient is a scary concept,” said attorney Jonathan Lomurro, who’s representing Andrea Young in this case with co-counsel Christian LoPiano. Besides seeking damages for Darryl Young’s children, “we want to call attention to this so it doesn’t happen again,” Lomurro said.

The lawsuit further alleges that medical staff at Newark Beth Israel invaded Young’s privacy and violated the Health Insurance Portability and Accountability Act, more commonly known as HIPAA, by sharing details of his case with the media without his permission. “We want people to be whistleblowers and want information out,” but that information should be told to patients and their family members directly, Lomurro said.

The 2019 CMS investigation determined that Newark Beth Israel’s program placed patients in “immediate jeopardy,” the most serious level of violation, and required the hospital to implement corrective plans. Newark Beth Israel did not agree with all of the regulator’s findings and in a statement at the time said that the CMS team lacked the “evidence, expertise and experience” to assess and diagnose patient outcomes.

The hospital did carry out the corrective plans and continues to operate a heart transplant program today. The most recent federal data, based on procedures from January 2021 through June 2023, shows that the one year probability of survival for a patient at Newark Beth is lower than the national average. It also shows that the number of graft failures, including deaths, in that time period was higher than the expected number of deaths for the program.

Andrea Young said she’s struggled with a feeling of emptiness in the years after her brother’s surgery. They were close and called each other daily. “There’s nothing in the world that can bring my brother back, so the only solace I will have is for the ones responsible to be held accountable,” she said. Darryl Young died on Sept 12, 2022, having never woken up after the transplant surgery.

A separate medical malpractice lawsuit filed in 2020 by the wife of another Newark Beth Israel heart transplant patient who died after receiving an organ infected with a parasitic disease is ongoing. The hospital has denied the allegations in court filing. The state of New Jersey, employer of the pathologists named in the case, settled for $1.7 million this month, according to the plaintiff’s attorney Christian LoPiano. The rest of the case is ongoing.