Willie’s Pacemaker---This post is long but very important. Please read from start to finish. Sorry about the length. It summarizes issues through 2005 using Willie and Jackson Jean-Baptiste as unwilling examples of patient abandonment.
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In 1998, one day while seeing patients in the clinic of a hospital (Hospital of Light) in southern Haiti, a smiling 10 year old boy came into my office to be checked. His name is Willie. He and his mother had made the six hour trip from their home in the capital over the bumpy mountainous roads to this rural hospital. Willie had a great smile and engaging personality. However, one could easily see that his lips were blue and his finger nails clubbed which indicated his body had not been gettng enough oxygen for many years. Most likely he had congenital heart disease.
My exam revealed that Willie’s heart rested in his right chest cavity. A normal person’s heart is on the left side. Also, there were ominous mumurs. Willie’s abdominal organs were on the wrong side of his abdomen as well. He had a complex heart lesion that he was born with. He was unable to run or play or go to school. His home in the capital had no running water or electricity and his father had abandoned the family and lived in the States. Willie’s normal day was sitting in his yard digging small holes in the dirt and filling them back up.
I obtained an echocardiogram which showed Willie’s multiple complex heart defects. I brought this echo back to Peoria and showed it to the OSF-CHOI cardiologists who viewed the echo multiple times to decide if Wille was too complex to operate. The decision was made with all of the cardiologists, including Dr. Albers, that Willie deserved a chance. Surgery would be very risky.
It took me one year to get Willie out of Haiti due to all of the paperwork and lack of communication with Willie’s mom because she had no phone.
When we arrived with Willie in 1999 in Peoria, another echocardiogram was done along with a cardiac catheterization. His echo was studied intensively by all of the cardiologists, surgeons, intensive care doctors, and anethesiologists at pre op conference. I personally talked with Dr. Albers about the pros and cons of operating on Willie and we all agreed, it needed to be done.
Dr. Geiss did a great job in surgery. Willie’s surgery took many hours and was very delicate and complex.
During the next 5 months Willie was a patient in CHOI’s pediatric cardiovascular intensive care unit. He had many complications which were not unexpected due to the severity of his problems, including gallbladder surgery, another heart surgery, and a surgery to place a permanent pacemaker because Willie’s heart did not beat efficiently enough on its own. He received great care in ICU at Children's Hospital of Illinois.
He was discharged after 5 months in ICU and walked out with his host family on his own after a big party held for him in ICU. During his five months there, the nurses brought him up snow in the winter and he had his first snowball fight. One of the intensive care docs actually cut Willie’s hair. Many, many people visited Willie during his stay at OSF.
Willie became a poster child for CHOI on their advertising magazine. Willie had survived against all possible odds.
During Willie’s long hospitalization, I was criticized by another pediatric subspecialist for bringing Willie to the United States for his surgery because of the complexity of his cardiac condition and his prolonged stay at OSF and all of his complications. Hadn’t this doctor known that he was screened intensively for over one year by OSF’s cardiac specialists to determine whether Willie was a good surgical candidate? He had asked me to bring him patients from Haiti so he could operate on the Haitian kids also. I told him he needed to talk to OSF administration to get the OK. He was too savy to do this, of course, knowing that OSF administration was not keen on the idea of Haitian kids coming in the first place. He was on his way up the ladder at CHOI and didn’t want to imperil his chances. But that did not stop him from asking me to bring him patients in the elevator where no one could hear his requests and criticizing me in other locations for bringing Willie. (He actually told the Journal Star editors that the Haitian kids I was bringing for surgery were not good “teaching cases”…i.e., the doctors and residents and medical students and nurses really didn’t learn much from operating on these kids and taking care of them afterwords. The opposite was true, of course. We all learned a lot and could use that knowledge to help local kids with their complex surgical problems.)
Willie returned to Haiti at the end of 2002 and Haitian Hearts took Willie his medicine every three months from Peoria to keep him alive in Haiti. His mother had no money and no support at all. I examined Willie frequently when I was in working in Haiti and he spoke with his host family in central Illinois via my satellite phone. They loved talking to each other.
However, when my wife and I were in Haiti in March, 2004, Willie didn’t look good. He was 16 years old and weighed 89 pounds. My exam revealed that his lungs were filling up with fluid. He was in congestive heart failure and his pacemaker generator was dying after 4 years. (The pacemaker life was approximately 53 months from the time it was put in.) Willie was not going to survive much longer if he didn’t make it back to Peoria for a new pacemaker.
I wrote an e mail to Keith Steffen on March 7, 04 begging for Willie’s life. I offered him 100% full charges to change Willies pacemaker that did not have much life left. (This would be much more than Caterpillar or Medicare/Medicaid would reimburse OSF for the same procedure.) The surgeon would do it pro bono and Medtronics has an international pacemaker program and would donate Willie’s new pacemaker (like thay had done in 1999 when the first pacemaker was put in.)
Keith Steffen immediately sent my request to OSF attorney Doug Marshall and told me to “have a nice day”. Marshall refused Willie even with full charges offered up front.
In OSF’s 125 year history, nothing like this ever occurred. They were going to let a 16 year old die from a pacemaker that was going to stop because its generator life was almost over. Willie was OSF’s poster boy several years earlier. Sister Judith Ann told me many times they would never turn down a child. Willie was OSF’s child.
This was patient abandonment in my opinion.
My wife and I were in agony. Willie’s host family called Steffen on the phone and pleaded for Willie’s life to no avail.
After several months of e mails and many phone calls, we were able to get Willie accepted into a Vanderbilt Children’s in Nashville. This is one of the best childrens hospitals in the world. Their administrator told me on the phone that it sounded like patient abandonment to him, and they operated on Willie immediately, placing a new pacemaker, and Haitian Hearts paid them $5,000 dollars. Willie had another chance.
Willie came to Peoria in May and stayed with my wife and I. We walked the Rock Island Trail with him and he could walk for several miles with his new pacemaker. His smile came back. He visited his old host family who were very tickled to see him.
In June I called the pediatric cardiology office at OSF that took care of Willie in 1999 and asked for an appointment for Willie to be checked thoroughly after his new pacemaker had been placed in Nashville. I kept getting the runaround. After many calls I finally got to speak with Dr. Shah, one of Willie’s original cardiologists. He refused to see Willie in the office. I couldn’t believe that good man like Dr. Shah was so intimidated by the forces that he would refuse to check Willie.
Willie and I picketed OSF in mid- June for OSF’s abandonment of Willie Fortune. Keith appeared at the window of his administrative office and stood behind Sister Canisisa who also gazed out at us on the sidewalk. Keith stood slightly behind Sister and threw back his head and smiled (feigning laughter) at Willie and me. Sister did not see this but Wilie and I did. Willie could not believe it nor could I. The secular “leader” at OSF was literally hiding behind the Sister who embodied the OSF mission that was being scandalized in front of her.
My brother wrote Bishop Jenky regarding OSF’s abandonment of Willie Fortune and asked for help for Willie. The Bishop did not respond.
Don Jackson, President of the Illinois NAACP, wrote a letter to OSF about their behavior regarding discrimination against Haitian Hearts children.
Willie, OSF-CHOI poster child in 2000, was never seen by a pediatric cardiologist in Peoria.
Below is my e mail to Keith Steffen on March 7, 2004 on behalf of Willie. Keith sent it to OSF attorney, Doug Marshall. As mentioned above, Marshall refused Willie and Keith e mailed back and told me to "have a nice day".
Date: Sun Mar 7 11 :33:57 2004
From: "Realname"
Subject: Willie Fortune
Dear Keith,
While in Haiti in February, I examined Willie Fortune. As you may recall,
Willie received a pacemakeer at OSF-SFMC in Febrary, 1999. The pacemaker has a life of approximately 53 months. Willie is symptomatic now. Haiti's current political status does not allow his pacemaker to be interrogated properly. The General Hospital in Port-au-Prince is not functioning. When
his pacemaker stops, Willie will die.
Unfortunately, Willie's host family in the Peoria area called you the other day and were told by you that there is no hope for Willie returning to OSF-SFMC to have this procedeure done.
Last year Haitian Hearts offered you full charges for another patient from Haiti that needed a pacemaker. That was refused also.
Keith, Haitian Hearts is offering you 100% full charges for the interrogation and any subsequent work necessary for Willie's pacemaker. A letter from you and Paul Kramer (Executive Director of Children's Hospital of Illinois) to the American Consulate in Port-au-Prince, Haiti will allow me to obtain a visa for him. (I will provide a letter and I am quite sure that the other physicians who cared for Willie at OSF in 1999 will provide a similar letter for the Consulate.)
Keith, please let me know as soon as possible whether you will allow Willie to return to OSF-SFMC and I will leave for Haiti immediately and bring him here.
Sincerely,
John Carroll, MD
cc: Dr D. Geiss, Dr. S. Bash, Dr. W. Albers, Dr. A. Torres, Dr. S. Schrader
As mentioned above, Willie was accepted at Vanderbilt and a new pacemaker was emergently placed. Willie did very well and came to Peoria and lived with my wife and I in June, 2004.
Below is an article that appeared in the Peoria Journal Star on June 16, 2004--
Haitian Hearts doctor pickets Saint Francis
June 16, 2004
By ELAINE HOPKINS of the Journal Star
PEORIA - Dr. John Carroll and Willy Fortune, a 16-year¬old heart patient, picketed OSF Saint Francis Medical Center on Tuesday because the hospital has refused to provide heart care to Fortune.
"I'm asking for a good pediatric cardiology exam," he said. Haitian Hearts is willing to fully pay for the care, Carroll added, but St. Francis has refused.
Fortune received a pacemaker at St. Francis in 2000. When St. Francis would not replace it this year, Carroll arranged for Fortune to have the surgery done May 21 at Vanderbilt Children's Hospital in Nashville, Tenn.
More care is needed, he said. "You just don't replace a pacemaker and forget about things," Carroll said.
Carroll said he should not have to take Fortune back to Nashville. "He's here. This hospital has a value system. He's a St. Francis patient." On Tuesday, Carroll carried a sign with a photograph of Fortune on a poster the hospital used in 2000. It stated "Willy, a mended Haitian Heart at Children's Hospital."
Fortune said he was feeling "good, but was hungry after a long day of picketing."
St. Francis spokesman Chris Lofgren said the hospital would not comment on Carroll, an emergency room physician for 21 years who was fired in December 2001.
Last year, Haitian Hearts became an independent foundation that can accept tax-deductible gifts, and continues to raise money to bring Haitian patients to the U.S. for heart and other care. In 2003, it brought in 16 patients. So far this year, the organization has brought in three patients, Carroll said, and others are planned.
Haitian Hearts was once a part of Children's Hospital at St. Francis, but the hospital severed ties with the group in July after the two entities could not agree on several issues. Since then, the hospital has refused to participate in Haitian Hearts' program.
Carroll also said the Illinois Attorney General's office has been investigating whether St. Francis misused funds donated to its Children's Hospital that were earmarked for Haitian Hearts. People have told him about donations which never were credited to Haitian Hearts, Carroll said. He complained to the Attorney General's Charitable Trust division, he said, and provided the office with records.
"We responded in detail" to the attorney general, Lofgren said. "As far as I know, it's over."
A spokesman for the attorney general, Scott Mulford, said Tuesday that the office is still "looking into the situation."
Carroll said people should be alarmed about St. Francis' refusal to provide care for Fortune.
For the hospital to refuse care to a former patient "is unprecedented," he said. "Where are the Catholic ethicists at St. Francis?" he asked.
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Maria King, my wife, wrote the following op-ed that appeared in the Peoria Journal Star on April 4, 2004:
What will become of Willy?
For now Haitian Hearts patient, like his homeland, hanging onto life
April 4, 2004
By MARIA KING
Flying into Haiti, I could see the poverty from the air. Rusty tin roofs mark shanty towns. Husks of cars and buses litter the landscape. Everything, including the treeless mountains, is a monochromatic dusty, grey brown. Even at 5,000 feet, I could tell that things just aren't quite right.
Four weeks after President Aristide left the country, following months of violence, Port-au-Prince is returning to normal: mangy dogs and pigs sniff through huge smoldering trash heaps in the streets, which double as sewers; the body of a toddler covered with a white terry cloth bath towel lies on a cart in the courtyard at the notorious General Hospital; the shoeshine men push their carts and ring their bells, plying their service that seems both necessary and futile given the filth.
But most of all, people have returned to the streets and, despite the U.S. helicopters roaring overhead, the tension has at least temporarily eased. A Lebanese¬Haitian hotel manager says Haiti is like a bomb that has been separated from the fuse. "But the bomb is still alive," he worries. Despite the role of the United States in the departure of Aristide, we detect no hostility as we walk the streets of Port-au-Prince. People almost always respond with "Bonsoir" and a smile when they are greeted.
Today we are in search of Willy Fortune. Willy is a 15¬year-old Haitian Hearts patient who had extensive heart and other surgeries at OSF St. Francis Medical Center in 1999-2000. As part of his medical care, he had a pacemaker implanted. The pacemaker has a 53-month battery, and this is about month 49.
When Dr. John Carroll examined him in February, Willy's heart rate never changed from 60 beats a minute no matter what his activity level. This indicates the pacemaker isn't responding to the demands of his body and needs to be checked. As far as cardiac procedures go, this is relatively inexpensive, and Haitian Hearts can pay the cost, so we are also in search of a hospital to perform the procedure.
Willy's mother has given Dr. Carroll the address Rue Pavee #2 a la interior, which translates as Pavee Street, Downtown. We hire a taxi and head through the congested streets of Port-au-Prince. Haitian drivers make New York City cabbies look tentative as they weave through the bumpy roads of the city with no traffic signals or signs to guide them. We travel down lane-less thoroughfares dodging crowded tap taps, the colorfully colored covered pickup trucks with benches in the bed that serve as Haiti's public transportation.
We turn onto a narrow side street where we come to a halt behind a large truck, which has stopped to let some tap taps from the opposite direction pass. We are surrounded by a moving crowd, as pedestrians brush by our truck, some of them balancing impossibly heavy loads on their heads, including crates of eggs. On the other side of these people stretch one of Haiti's thousands of informal marketplaces. Women squat over baskets of goods for sale: AIM toothpaste, crackers, juice, cooked chickens, live chickens. Behind them are rickety, 10-foot tall structures constructed from tin, sticks, concrete blocks, cardboard and any other materials their builders could get their hands on.
The driver drops us off on Rue Pavee, a wider downtown road, and we walk the eight blocks to #2. We cautiously enter the doorway of what looks like a regular building but leads to a winding, ceilingless corridor that takes us to a world like something from "Mad Max: Beyond the Thunderdome."
Behind the facade of the building teems an entire community. Boys and young men line the path, with some of them working on wood carvings. We have stumbled upon a place where some of Haiti's tourist souvenirs are made. The men use chisels and knives to carve wooden voodoo masks and busts of the Virgin Mary. They stack the figures against the walls to be sanded later.
As we move down the path, we come upon large piles of 20-foot, narrow tree trunks that have been debarked and cut to a point. Dr. Carroll asks a boy standing nearby what type of wood they are. "Cajou," he replies. Mahogany. This, and in the fires that cook the food for sale along the roads we traveled, is why the mountains in Haiti are denuded and cannot hold topsoil.
Dr. Carroll asks in Creole if anyone knows Junior, which is Willy's nickname. Two boys do, and they lead us deeper down the corridor until we come upon three men. They take us into a small room. "This is Junior," gestures one of our guides to the largest of the three. But not our Junior. Dr. Carroll quickly describes Willy, motioning with his hand to indicate Willy's chest scar. Big Junior's eyes brighten. "Ah!" he holds up a finger and leads us out of the room and back down the path, where it finally dead ends.
The air smells of turpentine. Dozens and dozens of small, brilliantly painted and freshly shellacked round and square boxes sit on the ground. A woman walks out of a room and, seeing Dr. Carroll, breaks into a big smile: it's Willy's mom, and this is not her home but her workplace.
She brings us up to date on Willy: "Manquey mori." The literal translation is he lacked death, but what it means is just barely. Haitian Hearts volunteers take Willy his medicines every three to four months. A cardiologist in Port-au-Prince administers the medicine. During the violence, the doctor was afraid to go to his office. Willy didn't get his medicine and nearly died. He is better now, but the cardiologist concurs; his pacemaker needs to be checked.
What will become of Willy? Most likely he will die.
Is he worth all this effort and expense, when so many more are in need?
His mother would say yes.
We feel an obligation to Willy because he is a Haitian Hearts patient. It probably seems crazy to think that Third World children are as entitled to sophisticated
heart surgery as those of us lucky enough to have insurance. We'd like to think that someday it won't. We're working for the day when everyone receiving the medical care he needs seems normal.
Maria King is an academic advisor and English instructor at Illinois Central College, as well as a Haitian Hearts volunteer.
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Mary L. Hooks Secretary
July 9, 2004
Pediatric Cardiology Associates
Attn: Dr. J.J. Shah
420 No E. Gien Oak, Suite 304 Peoria, lllinois 61603
Re: Haitian Hearts & Dr. John Carroll,
Dear Dr. Shah:
We are writing to express our concern over your and OSF's refusal to provide basic pediatric cardiology services to two young Haitian boys, Willie Fortune and Pascal St. Fleur. It has come to our attention that you have refused these two children even basic out-patient assessments, despite the willingness of Dr. John Carroll and his group, Haitian Hearts, to pay full price for these examinations. Willie Fortune, who received three surgeries at St. Francis during 1999 and 2000, needs this reassessment urgently. Likewise, Pascal St. Fleur requires additional pediatric assessment.
Given that full payment is available for the services which have been requested, we can only conclude that your refusal is based upon the race or national origin of the two young men. This is obviously unacceptable and a violation of both state and federal laws prohibiting discrimination based upon race or national origin.
If you have additional information or any justification for your denial of the requested medical services, we would like this information made available to us in the immediate future.
Very truly yours,
Illinois State Conference, NAACP
Donald R. Jackson, President
cc: Mr. Keith Steffen
Mr. Paul Kramer
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Below is a letter from Tom Carroll to Bishop Jenky--
12 December, 2004
Dear Bishop Jenky,
In this letter I describe a situation that greatly concerns me as a Catholic and devoted member of the Diocese of Peoria. I ask for your help and guidance on this matter.
I sent you a seven-page letter on 21 Sept 2003, over one year ago. In that letter, I described the treatment Haitian Hearts received at the hands of OSF and the Catholic Diocese of Peoria. I asked several specific questions regarding the reason for the diocese's decision to withdraw its support from Haitian Hearts. As a lifelong member of the diocese, I expected some answers to my questions, or at the very least, a response of some sort to my letter. To this day, I have received nothing. I am still waiting for your answers, Bishop Jenky. In this letter, I ask several more questions that I truly hope you will answer.
A review and timeline of what has happened:
1. My brother, Dr. John Carroll, was fired from St. Francis OSF Medical Center in December of 2001. At that time, an OSF spokesman told the news media that John's program, Haitian Hearts, "was not affected by his firing." John continued to bring Haitian children to OSF for heart surgery and, as he had done in the past, continued to raise money to pay OSF for these surgeries. At that time, Haitian Hearts was paying the hospital 55% of full charges for the children's surgeries ¬which is more than the government pays OSF for Medicare and Medicaid patients.
2. Less than eight months later, in July of 2002, OSF administrators announced at a Haitian Hearts meeting that the hospital was ending its $257,000 annual contribution to Haitian Hearts. This was, of course, a major financial setback for Haitian Hearts since it had several children already in Peoria for heart surgery at that time.
3. Five months later, in December of 2002, the executive director ofOSF Children's Hospital, Paul Kramer, contacted the American Consulate in Port au Prince, Haiti, and told them that St. Francis would not accept any more Haitian Hearts patients. Without the hospital's approval, the consulate immediately stopped granting medical visas for John's patients. This was a terrible blow for the children and their families since there is no hospital in Haiti that can perform these heart surgeries. When asked by the media to explain their action, hospital administrators blamed it on the debt that was owed them by Haitian Hearts. Administrators told the media on three separate occasions that Haitian Hearts owed the hospital "over $500,000" - "$400,000" - and finally "almost $400,000." These hospital administrators did not mention the fact that they had cut $257,000 from Haitian Hearts's budget five months earlier.
4. Chris Lofgren, OSF spokesman, was quoted in the Peoria Journal Star on 07 January 2003 saying the hospital charged Haitian Hearts more than actual costs to help pay for expenses and "future expansion." Does Catholic teaching on social justice imply the poor should help pay for building a larger hospital in order to receive treatment at that hospital?
5. In the month of December 2002, John and I met with Monsignor Rohlfs and Patricia Gibson at the chancery office on an unrelated topic that we had been discussing with the diocese for quite some time: the possibility of filing a Church tribunal to investigate a conflict of interest between OSF Medical Center and Advanced Medical Transport (AMT), our local ambulance company. Dr. Hevesy, the EMS Project Medical Director for many years and John's former boss at OSF, receives a salary from AMT which constitutes a serious conflict of interest. The Project Medical Director must make independent, critical decisions affecting pre-hospital care in Peoria. The public good is obviously not well served if these decisions are influenced by a salary from a private ambulance company. AMT has a complete monopoly on patient transport in the city of Peoria. Peoria firefighters can not provide advanced life support or transport patients despite having trained paramedics on staff The Peoria Fire department owns an ambulance which they are not allowed to use. Please refer to my attached Peoria Journal Star forum article on this topic. Also please refer to the attached letter obtained under the Freedom of Information Act. It details the salary Dr. Hevesy receives from AMT. In it, officials make the rather outrageous statement to the Illinois Department of Public Health that although OSF's Project Medical Director does indeed receive a "stipend" from AMT, there is no conflict of interest involved, and there is not even the potential of a conflict of interest.
6. One month later, in January of 2003, John and two other Haitian Hearts supporters picketed outside St. Francis Hospital to bring attention to the fact that, because of the hospital's action, Haitian Hearts could no longer obtain medical visas for patients. OSF administrators were publicly asked to "respect Haitian life." Several days later the Catholic Diocese of Peoria offered to adopt Haitian Hearts as a Catholic charity. John welcomed this offer and accepted it immediately.
7. Two months later John met with Monsignor Rohlfs and Patricia Gibson again on the subject of a tribunal regarding ambulance service. Monsignor Rohlfs and Patricia Gibson told John that if he pursued a tribunal regarding OSF's role in this matter, the diocese would withdraw its supportfrom Haitian Hearts. They also stated that the Diocese would blame John in the media for the failure of the program. I am still absolutely stunned by Monsignor Rohlfs' statement, Bishop Jenky. The diocese was effectively holding Haitian Hearts hostage to protect the hospital from a Church tribunal. This is still very, very hard for me to accept.
8. A few months later, on July 17th, 2003, the Diocese of Peoria officially withdrew its support from Haitian Hearts. This was one day after a meeting with the Diocese and OSF during which Haitian Hearts asked for and was denied the chance for another meeting. Within hours of the Diocese's announcement, the hospital ended its involvement with Haitian Hearts. OSF physician Dr. William Albers was quoted in the PJS saying John Carroll caused the failure of the program because Dr. Carroll was "unwilling to negotiate."
9. When John was in Haiti in early 2004, he found that a former OSF patient, Willie Fortune, who had received life-saving surgery and a cardiac pacemaker at OSF in 1999, was in dire need ofa new pacemaker. If the pacemaker was not replaced within a few months, Willie would die from heart failure. John wrote OSF administrators Keith Steffen and Sister Judith Ann Duvall from Haiti and requested that, as a former OSF patient, Willie be accepted back to have his pacemaker surgically replaced. This was not a frivolous request - Willie's picture had been used on an OSF Children's Hospital poster in 2001 and now his life depended on surgical replacement of his pacemaker. In his letters to OSF, John offered to pay 100% of medical charges for the pacemaker surgery. John never received an answer from Sr. Judith Ann. Doug Marshall, OSF's attorney, responded with a letter informing him the hospital would not accept Willie. The letter blamed John for "end[ing] the relationship" between OSF and Haitian hearts and accused him of attempting to "embarrass OSF and the Sisters of the Third Order of St. Francis." In a quite callous manner, Mr. Marshall's letter stated that "I am sure the [other] hospitals you are now working with would be more than happy to accept 100% of full charges [for Willie's care]." Mr. Marshall concluded his letter by threatening John with legal action if he continued to "defame" the hospital.
10. In May of this year, John and another doctor were able to get Willie accepted at Vanderbilt Children's Hospital in Nashville. Vanderbilt is not a Catholic or a religious-based hospital but they responded admirably and urgently to Willie's precarious medical condition. Willie received a new pacemaker in May of this year. Haitian Hearts paid Vanderbilt $5000 for that surgery. Willie has not been seen by an OSF cardiologist since his May surgery despite many attempts on John's part to obtain a follow-up appointment. Incredibly enough, an OSF cardiologist said he would not examine Willie even though he was one of Willie's pediatric cardiologists in 2000. He also said he would not meet with John about Pascal (another Haitian Hearts patient) if anyone else, including John's wife Maria, were present at the meeting. Maria has been very involved with several of the Haitian patients' medical care on a day-to-day basis. OSF cardiologists typically do not refuse to meet with caregivers, foster parents, etc. Cardiology referrals from other doctors are commonplace
and typically do not require any formal meeting or meetings with the referring physician. I suspect this cardiologist was strongly influenced by OSF administrators' refusal to help Willie and simply did not want any witnesses to be present at a meeting wherein a patient was refused care.
This brings me to my primary reason for writing this letter, Bishop Jenky. The hospital's refusal to provide care for a 16-year-old former patient is a very disturbing decision. OSF's rejection of Willie Fortune, despite being offered 100% of medical charges, appears to be patient abandonment and is not in keeping with the Sisters' mission. I am appealing to you Bishop Jenky, to provide the hospital with spiritual leadership on this matter. I am formally requesting an official Church Tribunal to look into the hospital's refusal to treat Willie. I know that in cases like this, a tribunal should be concerned with matters that affect the public good. Patient abandonment certainly fits into that category. Common sense would dictate that refusing to treat a former patient is ethically wrong. If I am mistaken and the hospital is actually morally correct in refusing to treat Willie, then please let me know that. My brother will explain your position to Willie and Willie's mother in Haiti as best he can.
At what point should a Catholic hospital's profit yield to moral considerations?
As you know, Bishop Jenky, the Catholic Diocese of Peoria has refused John's request for a tribunal regarding the hospital's ambulance business practices, instead referring him to the Holy See in Rome. I would ask that you not refer Willie Fortune's tribunal to Rome. It would be an unnecessary hardship for Willie to have to travel to Rome to pursue this matter. The time this process might take could delay Willie's medical treatment even further. I trust your moral and ethical judgment and place this situation in your hands. As you know, the withdrawal of support for Haitian Hearts by the Diocese of Peoria very nearly resulted in the death of Haitian Hearts as an organization. Likewise, the hospital's actions have very nearly resulted in the death of Willie Fortune. This is a pastoral matter that only you can effectively resolve. Please make your judgment and this time, please respond to my letter.
Sincerely,
Tom Carroll
Here is a summary of my questions:
1. Do you agree there is a conflict of interest for OSF to allow the Emergency Medical Services Project Medical Director to receive a salary from a private ambulance company when the ambulance company stands to benefit financially from decisions the director makes regarding patient transport?
2. Was it honest and accurate to tell the Dept of Public Health that there is not even a potential of a conflict of interest regarding their Project Medical Director's accepting a salary from Advanced Medical Transport? How much is this salary and was it honest and accurate to describe it as a "stipend" instead of a salary?
3. Who actually owns the private ambulance company mentioned above? Is it really the "three Peoria hospitals" or are the hospitals just "associated" with the ambulance company? If no one really owns it, who profits from the revenue associated with patient transport?
4. Is it ethically acceptable for the Diocese to threaten to end its support for a charitable organization like Haitian Hearts in order to avoid a Church tribunal? Why did Monsignor Rohlfs do this? Why did Monsignor Rohlfs tell John that if John pursued a tribunal, the Diocese would blame John in the media for the failure of Haitian Hearts? Isn't that intimidation? Does the Catholic Diocese of Peoria typically use intimidation in dealing with others?
5. Is it ethically and morally acceptable for OSF to turn down 100% of medical charges and refuse to treat 16-year-old, former patient, Willie Fortune? Will you accept my petition for a Church Tribunal to resolve this question and will you resolve it locally so that Willie does not have to travel to Rome?
6. Chris Lofgren, OSF spokesman, was quoted in the Peoria Journal Star on 07 January 2003 saying the hospital had to charge Haitian Hearts a premium to help pay for expenses and "future expansion." Does Catholic teaching on social justice imply the poor should help pay for building a larger hospital in order to receive treatment at that hospital?
7. At what point should a Catholic hospital's profit yield to moral considerations?
(My brother never did receive an answer to this letter or ANY of the 5 letters he sent to Bishop Jenky over 4 years.)
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Date: Tue May 10 15:57:552005
From: "Real name"
Subject: Case # 49022
Dear JCAHO,
You may use my original e-mail with my name for OSF-SFMC to review concerning the case in the subject box above.
The two patients names that you requested are as follows:
1. Willie Fortune--16 year old Haitian male with severe cyanotic
congential heart disease. He was operated multiple times at OSF in 1999 and 2000 with the placement of a pacemaker for complete heart block. When he returned to Haiti, I examined him there many times, and brought him medication from Peoria and watched his pacemaker activity as well.
Willie's generator started to fail at least by January, 2004. He was in congestive heart failure with a syncopal spell. His heart rate was 60 per minute and did not change with exercise. He was quite cachectic and I thought close to death. E-mails by me to OSF were not helpful getting Willie reaccepted at OSF for a pacemaker change. (I have written documentation.) Our not-for-profit organization--Haitian Hearts, with an all volunteer staff, offered OSF full charges for the surgery to change Willie's pacemaker. (The pacemaker was to be donated by Medtronic as was his first pacemaker placed at OSF with no charges by the phyisicians.)
This was denied also.
Our group stayed persistent. In May, 2004, Vanderbilt Children's accepted Willie in Nashville. I was able to get him a visa out of Haiti which is quite a cumbersome procedeure, and the physicians in Nashville placed a second pacemaker under fairly urgent conditions--they would not discharge him from the hospital until this procedeure was performed. This procedeure was done in May, 2004. Willie had survived some crucial months in Haiti. Willie's condtion much improved with the pacemaker synchronized to his needs. Wilie had been a "poster child" for OSF-CHOI in 2000 and was a "forgotten child" in 2004.
2. The second patient is a 20 year old Haitian male named Jackson Jean-Baptiste. I brought him from Haiti twice in the late 90's and 2000 for valvuloplasties on valves that had been destroyed by rheumatic fever. Jackson did well and went back to Haiti. When I examined Jackson in Haiti in January of this year, his mitral valve sounded bad and an echocardiogram in Haiti revealed severe mitral stenosis which needs surgery. As above, I e-mailed OSF Jackson's need to return and Jackson was refused by OSF's legal counsel again. Haitian Hearts has offered OSF a sizable amount of money for Jackson's surgery and a request for Haitian Heart donor lists that have been withheld from Haitian Hearts by OSF for the past two years. I have Jackson on medication from Peoria as he waits for an answer from OSF. My wife and I leave for Haiti soon and will have to give Jackson this discouraging message. The medical staff would like to see Jackson get a St. Jude's valve and his host family would love to see him again in central Illinois.
In December, 2003, I sent a letter to OSF-CHOI Community Advisory Board about a problem that I felt was severe negligence not related to the above two patients. The same OSF attorney wrote me and stated that if I continued mentioning this area that I considered to be negligence, OSF would consider litigation against me. The threat of litigation by a multibillion dollar corporation like OSF has to be taken seriously by me. I would think that this could cause some people not to report issues they have under the threat of litigation. Thus, I will not comment on this as
an official complaint at present but do submit Willie and Jackson and described above.
Thank you for your consideration of the above. My main goal would be to try and prevent other patients from being ignored like this in the future when their lives depend on OSF--an institution whose mission statements speak for health care for all.
Sincerely,
John A. Carroll, M.D.
(JCAHO responded to this e-mail and said that since Willie was a "charity case", he didn't meet the criteria for them to comment. Haitian Hearts paid thousands of dollars for his care, so he wasn't really a "charity case". And what about all the charity cases that OSF claims to do? Would JCAHO ignore those cases as well? I think not. Jackson Jean-Baptiste died.)
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Tom Carroll writes Bishop Jenky again....
24 May, 2005
Dear Bishop Jenky,
Late last year I sent you a letter that was delivered to your secretary at the Chancery building on the 22nd of December. In that letter, I formally requested a Church tribunal to investigate OSF Medical Center's refusal to treat a former patient, Willie Fortune. Willie is a 16-year-old Haitian boy who received heart surgery through the Haitian Hearts program at OSF Medical Center in 1999. Willie was brought back to the United States because he needed a new pacemaker last year, and Haitian Hearts offered to pay OSFMC 100% of the charges for this procedure. As I described in my 21st December letter, OSFMC, through its attorney, refused to accept Willie back as a patient. I have a copy of the letter in which Willie is turned down if you would like to see it.
My brother, John, brought Willie to the US for his original surgery in 1999 and back again for pacemaker surgery last spring. In the past my family and I helped take care of Willie in our home and his welfare is a very important matter to us. John picketed OSF Medical Center last summer after Willie was turned down for medical care. It is hard to believe that patient abandonment by a Catholic hospital is a morally acceptable choice. My December letter to you asked for a Church tribunal to investigate OSFMC's actions and to make a determination as to the morality of those actions. I asked you to provide OSFMC with moral guidance in a matter that literally could mean life or death to Willie Fortune.
Bishop Jenky, I have received no response from you or anyone in the Diocese regarding my written request for this tribunal. It has been more than five months now. Surely you understand that when I write about a child's health and lack of medical treatment, you have a responsibility to answer my letter. Canon law says that all petitions for a tribunal should be answered promptly. Since my petition involves medical care for a 16-year-old boy, shouldn't it be given a very high priority? Willie has still not been seen by an OSF pediatric cardiologist since he returned to the United States eleven months ago.
Perhaps some people might regard this situation as being "sad" or "tragic" but one that involves only OSF Medical Center and its administrators. OSFMC could be thought of as a separate Catholic institution that is not receptive to moral direction from the Diocese of Peoria. However, that is not the case.
The Diocese has pastoral responsibility for all Catholic entities that fall within its boundaries. Recently too, Diocesan officials and ethicists from OSFMC have worked together on moral issues. The Peoria Rape Protocol is a widely-referenced example of the cooperation between the Diocese and the hospital. There has been cooperation and, presumably, agreement between OSF and the Diocese regarding the hospital's stance on prescribing oral contraceptives and OSF HealthPlans' coverage of oral contraceptives. Thus, the Diocese has provided OSFMC with guidance on moral issues that directly affect the hospital's profit and day-to-day operation. I am requesting the same level of moral guidance from the Diocese on behalf of Willie Fortune.
Bishop Jenky, if you were to speak up for Willie, I firmly believe the administrators and the Sisters would listen. The local Catholic community would support you for taking a strong stance with regard to Catholic social teaching. Willie would be able to receive treatment at OSF - medical care that Haitian Hearts has always been willing to pay for.
I am pleading for your direct help and intervention. Will you please use the power and authority you have been given by God as our Bishop and act on Willie's behalf?
I am awaiting your answer.
Tom Carroll
(Tom received no response again from Bishop Jenky.)
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June 22, 2006
From "John Carroll, MD"
Sent Thursday, June 22, 2006 1:33 pm
To sisterjudithann@osfhealthcare.org , paul.s.kramer@osfhealthcare.org , keith.e.steffen@osfhealthcare.org , joseph.j.piccione@osfhealthcare.org , dmarshall@hinshawlaw.com
Cc pgibson@cdop.org
Subject Willie Fortune
Dear Sister Judith Ann, Keith, Paul, Gerry, Joe, and Doug Marshall,
Willie Fortune's legal custodians drove to Peoria yesterday with Willie.
He is very ill and, thanks to EMTALA (Emergency Medical Treatment and
Active Labor Act) having more power than the Sisters mission statements,
Willie was evaluated in the ER at OSF-SFMC and admitted to Medical
Intensive Care.
Willie is in severe congestive heart failure and suffering quite a bit.
His prognosis is not good.
Like I suggested with Jackson Jean-Baptiste, I would suggest that you all
visit Willie and explain why he was denied care at OSF-SFMC in the past
with full payment offered for his care. Explaining this to Willie is
important and an honest explanation to his legal custodians would be
appropriate also. They are very curious. Keith, please take the time to
explain why you were laughing at the administrative window when Willie was
standing on OSF's sidewalk asking for OSF's help two years ago. Mr.
Marshall, your e mails regarding care for Haitian Hearts patients would be
good for all to review.
Gerry and Joe, I am asking you again to present Willie's case to the
Ethics Committee to see if everyone believes Willie's case was handled
well by OSF or if changes could be made to improve the care of patients in
the future. I would be glad to be present at the meeting and present the
case as I know it. Please let me know.
Bishop Jenky, I am not sure who the Diocesan Ethics Director is at
present. Would you please have him contact me and I will present Willie's
case in detailed fashion for Diocesan review. Are you aware of a "national
Catholic ethics review board" where Willie's case could be presented so
many could learn and hopefully future patients would benefit?
I would suggest that OSF Board of Directors or Corporate or whoever makes
decisions like this do the following: Ask for the resignations of Keith
Steffen, OSF-SFMC Administrator, and Paul Kramer, Executive Director of
CHOI, from their positions at OSF. Please visit Willie, hold his hand,
talk to him, and ask yourself if the Sisters mission statements and the
Ethical and Religious Directives (regarding Catholic health care in the
United States) have been fully followed by OSF's leaders.
Sincerely,
John Carroll
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July 30, 2006: I received no answers from anyone regarding Willie.
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