Children's Hospital of Philadelphia (CHOP) pioneered a life-saving lymphatic procedure that has resulted in the deaths of some children and others suffering strokes. Risks associated with the procedure were reportedly downplayed. The case of Michael Sylvestre, who died at age 5, and his father's emotional journey illustrate the severe consequences faced by families.
CHOP pioneered a lifesaving lymphatic procedure , but some kids died or suffered strokes. Risks were downplayed.
An exclusive look into problems that were never publicly disclosed has emerged from The Inquirer’s reporting, including interviews with nine families whose children underwent lymphatic procedures at CHOP and a review of thousands of pages of court filings, including depositions, expert opinions, and medical records.CHOP’s program leaders learned from errors as they went.
CHOP did not answer detailed questions from The Inquirer, nor grant repeated requests to interview its doctors. Instead, the hospital provided“We take these risks seriously, providing counsel to families, including a review of potential risks and complications,” the statement said. “These therapies are novel and as we learn more, we update our consenting process as well.”
Working with adults, Itkin had already figured out how to use tiny needles to inject dye into a lymph node in the groin, which let him use X-ray imaging equipment to track the path of lymphatic leaks. Itkin had first plugged a leak in a child with a The procedure worked. Jameson, now 17, did not cough up any worrisome casts for a decade; he’s now awaiting a heart transplant, his family said.
Small changes to procedures, Dori said, didn’t go through the oversight committee. He would just do them. A 15-year-old boy with plastic bronchitis suffered a stroke after an oil-based dye traveled to his brain. “CHOP saved his life,” Katye Gorman said. “But I think these guys are cowboys, and they’re willing to take risks.”
Dori and Itkin were now competitors, vying to lead the nation’s first lymphatic center. No longer trying to complement each other’s expertise, they cited their differences as liabilities.He described one procedure in which Dori had drained fluid around a child’s heart without consulting the cardiology team or telling the parents and getting their consent.
“The man who invented these procedures was going to be doing it on my daughter, like what more could I ask for?” Leach said.Two months after hospital leaders received Itkin’s memo warning of problems, a 3-year-old boy from Delaware with plastic bronchitis suffered a devastating stroke at CHOP. During the March 2017 procedure, Dori failed to control the glue and it traveled to the boy’s brain.
“Had Dr. Dori simply asked for help from a trained interventional radiologist who is trained to use microcatheters in tiny vessels, many of the issues that arose in this case would have been avoided,” Srinivasa wrote. CHOP has data on patient outcomes from its lymphatic procedures registry, but it does not publish any on its webpage.who underwent lymphatic procedures at the hospital from August 2013 through March 2017. Six of the children suffered strokes. The deaths and strokes occurred post-procedure at the hospital or within two weeks of discharge.
“The documentation about the conversation with the parents about risks of the procedure is the consent form. That’s where the risks are,” Dori said. Dori wanted other doctors to avoid his missteps, said Sinha, who helped launch the lymphatic program at UCLA Mattel Children’s Hospital.She said she knew the risks going in, but there was no other choice. She believes Dori and other doctors learned from her daughter’s death.
“This was a nothing burger, as he put it, and he’s the best at doing it — him and the guy who taught him,” Lovato recalled, meaning Dori.. At the word “death,” he paused, pen aloft: “But nobody’s ever died from it,” Hollie Sylvestre recalled Smith telling her offhandedly. By 10 p.m., Hollie Sylvestre was desperate to see her son. “I’m done waiting,” she told her father, crying.
CHOP Lymphatic Procedure Child Deaths Strokes Michael Sylvestre
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