Trinity had been performing therapeutic cardiac catheterizations, where a long thin tube is threaded through a blood vessel into the heart to treat problems such as blocked arteries, since April 2010.
Cardiac catheterizations are the most commonly performed heart procedures in the U.S. and were done over 1 million times in 2010, according to the National Hospital Discharge Survey,
Prior to 2008, the state would only allow hospitals that did open heart surgery perform therapeutic catheterizations but a state law passed that year allowed an exemption for others to apply if they met certain criteria.
Part of that criteria was performing at least 200 such procedures, including 36 “primary” cardiac interventions or catheterizations by its third year, according to the record of a Georgia Department of Community Health administrative hearing where Trinity was appealing the loss of its designation, which has to be reviewed and renewed annually.
“Primary” is not actually defined in the regulations but a Trinity expert at the hearing defined it as an emergency catheterization where the patient is unstable because of a heart attack from a blockage.
In 2013, when Trinity was applying to renew its permission to continue therapeutic catheterizations, it reported doing four primary procedures for the previous year.
A state expert said that low number was the reason for the denial. Doing the primary procedures are important because that demonstrates the ability to do “emergency non-elective services requiring rapid response from the staff,” according to the hearing record.
Among those applying for exemptions, Trinity’s numbers were “the lowest each year of their submission, the absolute lowest,” according to an unnamed state senior analyst testifying at the hearing. “No one was close.”
Trinity asked for the ability to recalculate the way it counts what is a primary procedure but was denied. The hearing officer upheld the denial and last month the department confirmed that decision.
The hospital did not respond to calls for comment.