A little known children’s program at Jackson Memorial Hospital run by University of Miami doctors has sparked two contentious memos to the county’s political leaders.
Speaking about the pediatric bone marrow transplant program, Marcos Lapciuc, the Jackson board chairman, fired off an email late Thursday to the mayor and county commissioners complaining about UM “wishing to cease” providing such services at Jackson.
Jackson Chief Executive Carlos Migoya quickly responded with a “clarifying” memo to the politicians that “we have every indication” that UM will continue to providing such services at Jackson,” but might also provide those services elsewhere. Migoya added that, if UM also undertook such services at another hospital, it would “clearly raise a host of complex issues.”
On Friday Pascal Goldschmidt, dean of the UM Miller School of Medicine, said UM has “the only oncologist experts in a large region with the training and expertise to perform pediatric bone marrow transplant.” He said UM was committed to its program at Jackson. “In fact we are in the process of admitting patients this month. At the same time, we have an obligation to bring this life-saving treatment to others in our community. While we have no intention of performing the procedure at University of Miami Hospital, we are not going to abandon children anywhere in our community.”
Board member Joaquin del Cueto noted Friday that UM providing services elsewhere appears to require Jackson approval. He cited a paragraph in the entities’ Basic Affiliation Agreement that “additional affiliations by either party shall be entered into only after consultation with and consent of the other.”
In his memo, Lapciuc complained that UM’s “maneuver will affect our most vulnerable population -- our children. This is clearly a violation of the bilateral duties and obligations that the University of Miami has under its annual operating agreement with Jackson.”
Lapciuc said Jackson’s board has “a fiduciary duty to protect and enforce all binding obligations” between Jackson and its vendors. “If this issue is not promptly addressed, then I will consider a range of options to present to the ... board.”
UM doctors working at Jackson do about 10 to 20 bone marrow transplants on children each year, said Jackson spokesman Edwin O’Dell.
What concerns Jackson board members is that, as with any operating room procedure, staff needs to do quite a few each year in order to remain competent and hone their skills. If a program’s annual number of procedures gets too low, the state could withdraw certification.
Del Cueto, a veteran Jackson board member, told The Herald Thursday that the small program is symbolic of larger tensions between UM and Jackson. When UM purchased the 560-bed Cedars Medical Center, across the street from Jackson Memorial, in 2007, there was an understanding that UM pediatric services and transplants would remain services performed at Jackson, del Cueto said.
Earlier this week, a Jackson attorney told the board that there was nothing in the agreements with UM in which UM promised to keep transplants exclusively at Jackson.
Nevertheless, board members thought they had an understanding. Joe Arriola called the UM possibility of taking the pediatric program elsewhere “a stab in the back to our feelings,” to which fellow board member Darryl Sharpton added, “not to our feelings: Our viability.”
Board member del Cueto told The Herald that the spreading of the bone marrow program is “not in our best interests” because “we’ve invested millions of dollars to be the regional provider of transplant services” and Jackson has developed “highly trained professionals,” nurses and others, to do the procedures..
Del Cueto said he believes that Jackson’s basic operating agreement with UM requires UM to support the Jackson transplant program. He said he understands that Migoya is trying to calm the waters, to keep negotiations open with UM, but “I can’t sit by quietly” while UM is undermining Jackson.
In his memo to county commissioners, Migoya said, “We are continuing conversations with university leaders to find solutions that address both institutions’ long-term goals.” He said that UM has provided no notice that it plans to terminate these pediatric procedures at Jackson, but if it did, that “could be viewed” as a violation of the Jackson and UM signed agreements.
“Our professional recommendation is to continue our conversations with university leaders,” Migoya wrote.