Rubio said the Kuhn case is “certainly isn’t the reason Medicare is going bankrupt. He had insurance — government-provided insurance through Medicare and Medicaid. He was caught in an inflexible, bureaucratic system that didn’t take into account that he’s a patient, not merely a number.”
The hospitals would not comment on the Kuhn case, apparently to protect patient privacy, but according to Rubio’s office, Jackson Chief Executive Carlos Migoya contacted the senator last week and told him a four-doctor panel that reviewed the Kuhn case concluded he was not eligible for the procedure.
Last week’s developments — Jackson and University of Florida’s Shands hospitals told Borzak that finances were no longer a barrier — have given Kuhn’s family and doctor a flicker of hope. “They haven’t completely closed the door,” Borzak said.
A Medicare spokesman in Washington said Friday that the agency has been in touch with Kuhn’s family and is “assisting this beneficiary in any way we can,” but on Monday Medicare’s regional office in Atlanta told the Kuhn family that Jim had no days available.
The son of a Chicago area firefighter, Jim Kuhn moved to Boynton Beach in the 1980s and worked as a truck driver before his heart condition became too severe. Single, with no children, he has been hospitalized five times in the past year alone. He has had four defibrillators inserted, including one in December.
This year , while he was hospitalized at JFK Medical Center in West Palm Beach, he twice became infected with MRSA, a serious staph infection that doesn’t clear up with ordinary antibiotics. In February, Kuhn’s cardiologist team decided he needed a Left Ventricular Assist Device (LVAD), a $90,000 heart pump that former Vice President Dick Cheney used while awaiting a heart transplant. The pump is implanted in the chest, with an external cord connected to a computer and power supply. Kuhn didn’t qualify for a heart transplant for reasons including being considered overweight , said Borzak, but LVAD devices also work for heart-damaged patients like Kuhn. In Kuhn’s case, Thoratec, maker of the LVAD, has agreed to donate the device, Borzak said.
“There’s a growing number of patients that have this as a permanent treatment,” said Joseph Rogers, a Duke University physician who has studied the devices. He said studies have shown that 80 to 90 percent of patients with advanced heart failure die within a year without LVADs. Patients like Kuhn who are given the device as a permanent solution show 63 to 75 percent chance of surviving at least two years.
JFK Medical Center doesn’t implant LVADs, which are generally handled at transplant centers. Kuhn’s doctors called Jackson Memorial, Tampa General, Shands Gainesville and the Mayo Clinic in Jacksonville to see if any would implant the device.
“Shands was the first one to let us know that Jim was running out of Medicare days,” said Fred Kuhn. Kuhn’s lengthy and frequent hospitalizations meant he encountered a rare problem with Medicare. Regulations limit pay to 90 days in the hospital for “one spell of illness.” A patient has another 60 “lifetime” days that can be used only once. After that, a patient must be out of the hospital for 60 days straight before a new “spell of illness” begins.