Clinic Friedrichshafen: Patient welfare at Lake Constance at risk?

DThe investigation into the scandal at the Friedrichshafen clinic, part of the Medical Campus Bodensee (MCB), could take years. On the night of December 1, 2023, former senior emergency physician Elke K. committed suicide at the age of 47, because her criticism about the poor quality of treatment at the clinic had not been listened to by the hospital management for many years. According to the doctor’s records, the patient’s well-being has been at risk on multiple occasions since 2021.

At the center of the allegations is cardiologist and clinic director Professor Jochen Werle, who is currently suspending his position as medical director. Following his appointment in 2019, Werle followed the wishes of the clinic management and expanded interventional cardiology in Friedrichshafen. Expanding the range of services should significantly increase revenues as the treatment of complex diseases changes the “case mix” (MC) and clinics are reimbursed for higher treatment costs.

The clinic is 95 percent owned by the city of Friedrichshafen, and the chairman of the supervisory board is the non-partisan mayor Andreas Brand. In 2023, the annual loss of the MCB clinic network amounted to approximately 16 million euros. Income from the legally dependent Zeppelin fund makes it a little easier for the city to offset high losses.

Have emergency patients been neglected?

According to the newspaper, the late doctor’s accusations essentially consist of three complexes: The medical staff allegedly does not have sufficient experience to carry out complex procedures in interventional cardiology. It is alleged that the care of emergency patients is being neglected in favor of cardiac patients. For complex cardiac catheter procedures – such as the installation of the Mitraclips or Impella heart pumps from Abiomed – Friedrichshafen did not have the necessary medical ecosystem in case of complications.

In fact, there is no cardiac surgery and there is no way to provide patients with ECMO, a heart-lung machine. This medical environment is not required by law. In such cases, patients will have to be transferred, for example, to the heart centers of the university hospitals Ulm or Freiburg.

The clinic denies the accusations. Law firm Feigen Graf has been tasked with clarifying the matter and is expected to review the developments by the end of March. To clarify possible treatment errors, a report from a cardiologist from Leipzig is available. At the same time, the Friedrichshafen police have created an investigation team, and the Ravensburg prosecutor’s office is conducting a preliminary investigation.

There were several deaths

Detlef Kröger, the lawyer for the deceased doctor, expects the investigation process to be lengthy and does not rule out consequences for those responsible: “If the public in Germany is informed about serious cases, nothing can be hidden in Friedrichshafen.” . Then a picture of horror will emerge,” Kröger told FAZ.

Then we will have to discuss several deaths that may be related to mismanagement at the clinic. These cases could be reconstructed. “There are several cases that can be examined through medical evidence and for which medical accountability must be brought.”

Behind similar problems in many hospitals there is also a political structural problem, which Federal Minister of Health Karl Lauterbach (SPD) is trying to solve with his reform. Hospitals providing basic, routine, or centralized care often cannot adequately fund themselves with flat rates per case. Under pressure from providers, they then try to find additional sources of income through specialty services typically provided in intensive care centers or university hospitals. For this purpose, renowned university doctors are often appointed to senior medical positions.

As a result, incomes are growing rapidly, but nursing staff and physician assistants are often undertrained and technology is lacking. Small hospitals do not have internal error correction processes for such complex procedures. There are not enough specialized departments that provide quality treatment. And for political reasons, such clinics do not enter into cooperation with other clinics.

Source: Frantfurter Allgemeine

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