The Cleveland Clinic Foundation Isn’t the Hospital System It Says It Is

October 30, 2017 | Crandall & Pera Law
The Cleveland Clinic Foundation Isn’t the Hospital System It Says It Is

The Cleveland Clinic right here in Ohio enjoys a certain reputation for excellence. In fact, U.S. News & World Report ranks them second in the nation for overall care. If you weren’t from the area, you might think that having the Cleveland Clinic right around the corner would be a boon, if you ever needed care. We are, however, from the area. And we also know that the U.S. News ranking is an outlier. The fact is, when you look at every other ranking system, the Cleveland Clinic Foundation has a long and storied history of problems, is frequently cited for its dangerous processes and environments, and is repeatedly subject to lawsuits alleging medical negligence and malpractice. We should know; Steve Crandall won a $7.7 million jury verdict against the Cleveland Clinic Foundation in 2014 for malpractice, on behalf of one of its own neurosurgeons – and that is not the only case our firm has taken.

How bad are the Cleveland Clinic Foundation’s safety scores, really?

In December of 2014, Kaiser Health News released a penalty chart for every hospital that accepted Medicare patients, with scores regarding their ability to eliminate hospital-acquired infections. Each facility was given a score of 1-10 (1 being the best, and 10 being the worst) for central-line associated bloodstream infections, catheter associated urinary tract infections, and serious complications, like blood clots, falls and bed sores. Each of these conditions, remember, are largely preventable. Here are the Cleveland Clinic Foundation’s scores:  
    • Serious complications: 10
    • Central line infections: 8
    • Urinary tract infections: 7
    • Total HAC score: 8.375
  Even though the CCF has been routinely ranked as one of the best hospitals in the country, they were penalized by Center for Medicare and Medicaid Services (CMS) for how poorly they handled HACs. And that is only one group.

Recent rankings from “respected” databases

Here is how the Cleveland Clinic Foundation measures up now, according to three popular data collators. Leapfrog Group The news about the CCF’s problems started really making headlines in 2012, when the Leapfrog Group gave the Clinic a safety score of “D.” Its most recent grade is an “A,” so it looks like the Clinic made a massive improvement in only 5 years – pretty impressive, no? Well, actually, no. And here is why: Leapfrog Group, like U.S. News, relies entirely on what is voluntarily given, as well as what can be found publicly, to grade its hospitals. Furthermore, with a little digging into that safety score, you realize that Leapfrog’s scores are modal: they rely on whatever grade is earned the most often, not an average of the grades. Here is how that plays out in the real world, using the category “Problems with Surgery.” There are 7 areas of that particular category. The Cleveland Clinic earned a ranking of “above average” in four of them:  
    1. Surgical wound splits open: someone monitors surgery patients to ensure that their stitches stay intact.
    1. Death from treatable serious complications: patients are monitored to ensure that no complications arise, and if they do, those patients are treated correctly so the patient doesn’t die.
    1. Collapsed lung: they can treat a collapsed lung.
    1. Accidental cuts and tears: surgeons don’t cut where they’re not supposed to cut.
  Note that these “above average” scores don’t indicate how often collapsed lungs happen, or how quickly patients are treated if they develop a complication. All we know for sure is that the surgeons can treat the condition, and that people don’t die from complications that often. Now, let us look at the other three areas:  
    1. Serious breathing problem: a complication that sometimes develops after surgery. CCF is ranked “average” in this category.
    1. Dangerous object left in patient’s body: the textbook example of a “never event.” CCF is ranked “below average” in this category.
    1. Dangerous blood clot: clots can form when tissue is damaged during surgery. If the clots travel into the brain or heart, they can be fatal. CCF is ranked “below average” for the number of their patients who develop clots.
  If you took an average of these categories, the grade would not be an “A.” But Leapfrog doesn’t average its scores, and that is why a hospital like the Cleveland Clinic Foundation, which scores below average when it comes to leaving foreign objects inside of a body during surgery, can still be rated as an “A” hospital. And to add insult to injury? The Clinic didn’t supply any data at all when it came to infections. GuideStar GuideStar bills itself as “the world's largest source of information on nonprofit organizations.” Since the Cleveland Clinic Foundation is a non-profit teaching hospital (with a budget of $4.5 billion), GuideStar includes it in its database. But just like Leapfrog, GuideStar relies on entirely self-reported information. The data and information you see has been written by the CCF, and provided to GuideStar. Its financials and operations are behind a paywall, but there is a section titled “Board Leadership Practices,” which reviews things like CEO oversight, and assessment of the Board’s performance. This section also covers ethics and transparency, and is, interestingly enough, is left blank. Consumer Reports Consumer Reports also offers a ranking system for the Cleveland Clinic Foundation. Their overall Safety Score is a 54, and their rankings are based on information provided by the CMS, and “from scientifically-based data on patient experience and outcomes as well as certain hospital practices gathered from public sources. Some of that information is available elsewhere.” That data includes information about:  
    • Hospital-acquired infections (central line infections, surgical site infections, MRSA, diff and catheter-associated urinary tract infections)
    • Childbirth (and avoiding C-sections)
    • Safety scores (hospital acquired infections, readmissions, mortality – and its avoidance – scans, medication and communication)
    • Heat surgery (bypass, aortic valve and congenital)
    • Patient experience
  The also review cleanliness of rooms and bathrooms, communication, and pain control, among others. In the Consumer Reports review, Cleveland Clinic Foundation is all over the map, scoring “better” than average for chest scanning, but “worse” than average when it comes to the readmissions of Medicare patients.

Medical negligence lawsuits in Ohio

There is no one database that contains the exact number of medical malpractice lawsuits have been filed against the Cleveland Clinic Foundation, or how many people have died as a result of poor care. Because of the National Practitioner Data Base, we can tell you that there were 216 medical malpractice payments made by Ohio doctors in 2016, and that there were 2,283 adverse actions reported. We can tell that you 2,088 doctors had state licensure actions taken, but only 24 doctors were involved in anything regarding their clinical privileges. To recap: there were 2,283 cases of adverse actions, but only 24 doctors had their clinical privileges revoked.

Why all of these numbers matter

We know that most people rely on reviews – either from friends or from online – when they want to try a new service or product. We’ve even recommended looking at the reviews ourselves, as part of your research. But you have to take them with a grain of salt, especially when they come from databases where self-reporting is necessary. The Cleveland Clinic Foundation may have an “A” grade from one source, or a high rank from another, but the doctors and medical personnel there are just as fallible as any other, and, in some cases, more than others. If you sustained an injury because of medical malpractice, you shouldn’t be afraid to come forward, just because it’s a nationally known facility. The right malpractice attorney knows how to stand against up against the “big guys,” and will have the skills, experience and financial resources necessary to take them on when you’ve been hurt. Crandall & Pera Law is a premier medical malpractice law firm serving clients throughout Ohio and Kentucky. We invite you to read more about our successful cases, and to contact us if you have any questions. To schedule an appointment in Ohio, please call 877-686-8879. For our Kentucky team, please call 877-686-8879.