The donor heart that doctors had implanted in David Kveton was “just not acting right,” Judy remembers the surgeon, Dr. Jeffrey Morgan, telling her hours before she decided to remove her husband from life support. In recent years, though, it has had some of the worst heart transplant outcomes in the country. “I feel that David was not given the opportunity he deserved after struggling with his disease for so long.” 
 
 Signed, “Concerned.” Share Your Story Help Us Investigate Care at the Texas Medical Center If you’re a patient, doctor, administrator, vendor or visitor, we’d like to hear from you about your experience at the largest medical complex in the world. Although it didn’t specify what went wrong with her husband’s transplant, it made her doubt the reasons she and her husband chose St. Luke’s more than a decade earlier, when his heart began to fail. But in recent years, the famed program has performed an outsized number of transplants resulting in deaths or unusual complications, has lost several top physicians and has scaled back its ambition for treating high-risk patients, all the while marketing itself based on its storied past, an investigation by ProPublica and the Houston Chronicle reveals. At first, his wife thought he had just been unlucky. Then she received an anonymous letter from someone at the hospital. In January, the federal Centers for Medicare and Medicaid Services cited the heart transplant program for its significantly worse-than-expected outcomes and threatened to cut off Medicare funds in August if the problems were not fixed, according to a letter obtained by ProPublica and the Chronicle. But the program has struggled in other ways. Lewis and his wife, Jennifer, drove nearly two hours from their home in rural Bay City, Texas, to Baylor St. Luke’s Medical Center in Houston, one of the nation’s most celebrated heart transplant hospitals. In another patient’s transplant a year later, Morgan stitched through the other major vein, according to the patient’s cardiologist, though Morgan said the man’s previous cancer treatments complicated the case. They explained that at a key stage of her husband’s transplant — more than two months and more than a dozen surgeries earlier — Ono tried to use a defibrillator to jolt the new heart into rhythm, a common technique in transplants. Elizabeth Conley/Houston Chronicle 
 
 In a statement, the hospital seemed to contradict Ono, saying “a backup defibrillator was nearby and readily available.” The hospital said it waited until its internal investigation was complete before explaining its findings to the family. Later, in a separate phone call, Ono told Jennifer that nearly 10 minutes passed before another defibrillator was brought into the room, but by then, the damage likely had been done. “I cannot control that part as the surgeon,” Ono said of the device failure, which he said led to an internal investigation. “I tried my best to preserve the function of the heart, but it couldn’t make it.” 
 
 The 52-year-old patient died in March after undergoing more than a dozen operations and suffering numerous complications, including strokes, serious infections and organ failure. Meanwhile, more St. Luke’s patients have lingered in the hospital for weeks or months following their transplants, a sign of slow recovery or possible complications, experts say. Some even began referring transplant patients to other programs. “Heart transplant patients often are very sick individuals who have undergone years of prior heart procedures, and sometimes even previous transplants or device implants to keep their heart beating, and often battle other illnesses and diseases — all of which can complicate a heart transplant,” the hospital said in a statement. Along the way, his wife and daughter chronicled Lee’s downward spiral in matter-of-fact Facebook posts that belied their sadness and anger but sometimes hinted at their frustration with the transplant program. Among St. Luke’s patients who received heart transplants between mid-2014 and the end of 2016, twice as many failed to survive a year as would have been expected. Luke’s and Texas Heart Institute really paved the way for complex heart surgery, particularly heart transplants, to become a routine lifesaving procedure,” said Dr. Tom MacGillivray, who took over as the lead heart transplant surgeon at Houston Methodist in 2016 after nearly two decades at Harvard University and Massachusetts General Hospital. At St. Luke’s, Patients Suffer as Renowned Heart Transplant Program Loses Its Luster The Houston hospital and its legendary surgeon Denton Cooley performed some of the world’s first heart transplants back in the 1960s. He had come to the hospital for a new heart, not another device. Then she hurried to pack for what she thought would be a two- or three-week hospital stay. As of now the highest priority for my dad is to get a hold of the infections. Ashlee Nicole Lewis and I were visiting him when he turned and looked at me. If it's in his heart , it will disperse the infection to his organs. “He came out and he was really sad, like he wanted to cry.” 
 
 More than two months would pass before she learned why. What if her husband’s brain was permanently damaged? They said that it is on the left side this time and they did say that it is smaller.  James “Lee” Lewis had waited years for a new heart, praying for the day he would be free of the mechanical pump doctors implanted in him in 2015. The family is meeting here at CHI St. Luke’s. “It was a bold move for us to offer it to him.” 
 
 Some of Morgan’s work in Detroit has been called into question. I just found this out even though he had a stroke several weeks ago. They're hoping to do the same thing today. “Was it hubris for Jeff to say, ‘I’m going to do lungs?’ “ Cohn said. “We put him in that position and said, ‘You’re the chief, man. “I can tell you I have patients who would not be alive today if not for the program at Texas Heart Institute, and I’m a better physician because of the time I spent there,” Bogaev said. “You should know that although the defibrillator didn’t function initially, the heart was still beating and circulation was maintained. Play the audio 
 
 Jennifer got her husband out of bed and told him the news. Morgan said referrals to his program were up significantly in 2017 from a year earlier and are up again this year. He has no more fungal infections in his blood but he does have the VRE in his blood which is a bad situation but he does have a fighting chance. His lungs are doing great but they can’t put the trach collar on him due to his body going through a septic shock which in short caused high lactic levels in his blood which pretty much makes his body think it isn’t getting enough oxygen. During the long car ride to St. Luke’s that morning, Lee had time to think. “I’ll let you tell him then.” 
 
 Another surgery where dr. “But I’m remaining calm.” 
 
 In a statement, Morgan said, “I recall engaging in near daily discussions with Mr. Lewis’s wife and other family members to update them on his clinical condition.” 
 
 Lee Lewis CAT scan came back from this morning. “After the surgery, I thoroughly explained to Mrs. Kveton that her husband was critically ill and was on a lot of medication to keep his blood pressure up,” he wrote in response to questions. A day later, David Kveton was taken back into surgery. Doctors connected him to a life-support machine that circulates oxygenated blood through the body, doing the work of both the heart and lungs, in an attempt to give the new heart time to strengthen. For the next three months, he remained connected to life-support machines, enduring nearly 20 follow-up surgeries and procedures, before dying on March 23. Three days later, a CT scan revealed he had likely suffered a stroke, though family members say they were not told of bleeding in his brain. Soon after, he developed an irregular heart rhythm and had to be taken back to an operating room, where Morgan reconnected him. Afterward, Morgan called Judy, who had gone home for the night to rest: “Everything went fine,” she remembers him saying. “He was afraid something was going to go wrong.” 
 
 But Lee knew he wouldn’t live long without a heart transplant, and the father of two had unfinished plans: He wanted to meet his son’s new baby, and in June, he intended to walk his daughter down the aisle at her wedding. After all her husband had been through, would they really start over? Dr. Castillo just spoke to me they want to try to close him. Early the next morning, a nurse called to tell her something had gone wrong and that she and her children should make their way to the hospital. He suffered a stroke at one point, and for days afterward, Jennifer said he seemed to stare blankly at the ceiling. During that time, the anesthesiologist told Jennifer, her husband went without normal circulation, likely starving his brain of oxygen-rich blood. (Elizabeth Conley/Houston Chronicle) 
 
 “Turn him off,” Judy remembers saying. — but now Jennifer wondered if she should have asked for his permission before allowing doctors to put the device in him. What’s the point of putting an artificial heart in him, she thought, if he never wakes up? He said it’s common to perform autopsies when patients die after receiving transplants to “learn as much as possible from our surgeries, no matter the outcome.” 
 
 Judy gave permission, then never heard back. Instead, she received a bill for more than $1 million for the transplant and her husband’s final week in the hospital. The call from the hospital finally came on the first day of 2018. The morning of the surgery, they were greeted by Ono, the surgeon who soon plans to leave St. Luke’s. Morgan connected Lee to a pair of external heart pumps — commonly referred to as an LVAD and RVAD — to keep blood pumping through the heart. “It’ll be fine, he’s alive,” her daughter, Ashlee Lewis, told her. “I was so relieved and so thankful.” 
 
 Less than an hour later, a nurse arrived in the waiting room with a much different message: Something was wrong; her husband was back in surgery and in critical condition. All she knew was that her husband’s new heart wasn’t pumping enough blood, and something had caused his head to swell grotesquely. “I can’t believe the doctor didn’t come by!” a friend and former nurse commented. Over the next several days, Lazerick underwent a series of follow-up surgeries and procedures to remove excess fluid. Dr. Chatterjee just called me and said that he has had five units of blood. He must undergo dialysis three times a week, a treatment that flushes toxins from his body — doing the work of his failed kidneys. The doctor said that the infection is in his blood stream. “He always said he never wanted to live connected to machines.” 
 
 Doctors were preparing to implant another one in his chest. Because the bypass vein is smaller, George said Lazerick is at a higher risk of developing clots and must take blood thinners daily. “I personally have not seen that happen before,” George said, explaining that it’s unusual for a major vein to be sutured closed during a transplant. Statistically, that made him one of the success stories. She has spent hours sifting through stacks of her husband’s medical records, more than 2,000 pages, searching for passages that might tell her why he died. It’s hard to make sense of any of it, she said, but there are clues. I hope that helps everyone out a bit for some information and it was a lot of information to interpret so I hope I didn’t confuse any of you😁 Our prayers for now is to let him be healed of all infections so he can begin on the road to healing from the surgeries and trauma his body has gone through! When she finally received a copy in October, it only seemed to raise more questions. The St. Luke’s physician who conducted the autopsy reported signs of a heart attack in the donor heart at the tip of the left ventricle. For many weeks, the hospital withheld key details about his care, the family said, including what went wrong in the operating room during his transplant. She wanted to know what condition it was in, how much time passed before it was stitched into her husband’s chest, how many, if any, other hospitals had rejected the organ before it reached David. Still, when she re-reads the anonymous letter — the one that suggests her husband wasn’t given a fair shot — she grows angry that someone at St. Luke’s might know what went wrong but won’t tell her: 
 
 “It just makes me as mad as hell.”
– Baylor St. Luke’s Medical Center is one of America's most storied hospitals when it comes to heart transplants. Or was. Though some of the first heart transplants took place at the Houston hospital, things have disintegrated to the point that it now "has had some of the worst heart transplant outcomes in the country." So write Mike Hixenbaugh and Charles Ornstein in a story co-published by the Houston Chronicle and ProPublica. Their joint investigation found an elevated death and complication count for heart transplant patients there, whose one-year survival rate "now ranks near the bottom nationally" at 85% for those who got a new heart between mid-2014 and 2016; the national rate was 91.4%. Hixenbaugh and Ornstein add a face to those stats via the story of James "Lee" Lewis. Word came on Jan. 1, 2018, that St. Luke's had a heart for Lewis—news that brought hope the 52-year-old would be able to walk his daughter down the aisle in June. But by March 23, he was dead, having never left the hospital. What happened in between is a series of missteps, starting with the Jan. 2 transplant. Two months after the transplant his family learned what went wrong that day: The defibrillator Dr. Masahiro Ono tried to use to "jolt the new heart into rhythm" wasn't working; he said he had to pump it by hand for 10 minutes until a working one was found. The donor heart was damaged and weakened as a result and wouldn't strengthen; it was eventually swapped for an artificial heart. Then came strokes, infection in Lewis' bloodstream, and what the family says was another equipment mishap that left him brain-dead. Read the full story here.