For most of this year, University of Kentucky officials have stonewalled questions about the decision to halt pediatric cardiothoracic surgeries and the mysterious sidelining of Dr. Mark Plunkett, the high-profile surgeon UK hired in 2007 to rebuild that program.
Throughout, UK's line has been that it simply decided to make a "self-critical" examination of the program. When the results of that process were made public, they implied, all would be clear.
UK recently released the 100-page report, and nothing is clear.
Written, as far as we can tell, by people from within UK, with heavy input from legal staff, the report offers no explanation about what went wrong. In fact, Plunkett's name never appears in the report.
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It is instead a battle plan for rebuilding the program, the very task that Plunkett was hired, as one of the highest-paid people at UK, to accomplish six years ago.
Remarkably, the document cites as one of the biggest challenges "the fact that there are several excellent congenital heart centers in close proximity."
That would make it hard to capture patients under any circumstances, but UK acknowledges that it faces a particular challenge: "In some cases we must regain the trust of our referring providers."
No surprise, since UK fought for months to avoid releasing information about the mortality rates and other aspects of Plunkett's surgeries, defying an attorney general's opinion that it had no grounds to withhold the information and going so far as to sue the reporter at WUKY who requested the data.
UK finally changed course after CNN reported in August on two babies who had died after surgeries at UK and two others who struggled with complications after surgery.
Faced with national embarrassment, UK released the mortality information, which it said showed that UK's rate is similar to that of programs like it nationally.
So, it seems this is where things stand in the upside-down world of UK HealthCare:
After two unsuccessful, no doubt very expensive, efforts to build this program, UK wants to try again even though, by its own admission, it would be duplicating care available at excellent programs nearby.
And it wants to regain trust of referring physicians and families with very sick, very young children even though it has consistently undermined trust by refusing to answer legitimate questions.
UK has agreed to pay a lot of money to avoid a public discussion of what went wrong. Even though he was no longer doing surgeries, Plunkett remained on staff at his salary of $700,000 a year, until August, when it was announced that he had accepted a job in Florida, a position that later fell through, again with no real explanation.
What did come to light last week, as the result of an open-records request, was UK's severance contract with Plunkett. In exchange for a pledge of silence on both sides, UK agreed to pay Plunkett $1.05 million. Additionally, if Plunkett can't find work at his level — which, let's face it, is pretty high — UK could pay him $700,000 more. Bottom line: $1.75 million to go away and stay quiet "to the maximum extent permitted by law."
"Doesn't that make the public think this is suspicious?" asked Tabitha Rainey, whose son was operated on at UK by Plunkett. Rainey, one of the parents who appeared in the CNN segment, has become a spokeswoman for disgruntled families of UK pediatric heart patients. "They're trying to regain trust, but they don't want to give anything to us. They don't want to say anything, because they know if they do, lawsuits could happen. It's aggravating."
It is aggravating that UK, a public land-grant institution in a very sick state, is intent on carving out a specialized, expensive health-care niche that's already filled when there are so many needs that are not being met.
It is also deeply disturbing that UK's energy and treasure are aimed at maintaining a shroud of secrecy over this program.
We still don't know much about what happened in Plunkett's operating rooms, but it is clear that UK botched this opportunity to regain the public's trust.