How Safe are Ambulatory / Outpatient Surgical Centers?
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The first Ambulatory Surgical Center (ASC) opened its doors in 1970. The
healthcare business magazine
Modern Healthcare reports that there are now over 5,500 such facilities that have been certified by the
Centers for Medicare and Medicaid Services as meeting the minimum standards required to receive payment directly
from Medicare. While the majority of ASCs have patient safety records
that equal or exceed those of hospitals located in the same geographic
area, some facilities have exposed patients to unnecessary risks.
On this page the medical malpractice lawyer at
The Doan Law Firm will begin a series of articles presenting an overview of why surgical
procedures performed at ASCs may pose an unnecessary risk of serious complications
or, in extreme cases, untimely deaths. In a companion article, he will
review specific circumstances that could suggest medical malpractice.
What is an “Ambulatory Surgical Center”?
Ambulatory Surgery Center Association defines an ASC, also known as an Outpatient Surgical Center (OSC), as:
"… a public or private facility, not a part of a hospital,
which provides surgical or obstetrical treatment performed under general
or regional anesthesia in an operating room environment to patients not
The majority of ASCs / OSCs are privately-owned, for-profit, corporations
that depend on referrals from the local medical community as their primary
source of income. Since the physicians who perform procedures at a given
ASC are typically shareholders in the facility, there is always concern
that a physician’s choice of surgical or related diagnostic procedures
could be influenced by his or her “return on investment.”
Collecting reliable data on the number of medical malpractice lawsuits
where an ASC / OSC is named as a defendant or co-defendant is difficult
because, until relatively recently, there was no legal requirement that
these facilities report such data to a central agency or “clearinghouse.”
In fact, as of December 2018, 17 states
do not require ASCs / OSCs to report “adverse events” such as complications
of surgery that require hospitalization or complications resulting in
a patient’s death!
Despite this lack of readily-available data, earlier this year (2018) a
study sponsored by
Kaiser Health News and
USA Today found that:
between 2013 and 2017 there were at least 260 deaths that were due to complications
of procedures that were performed in “freestanding” (not physically
connected to a hospital) ASCs / OSCs;
despite the fact that at least 14 patients had died from complications
directly caused by their surgery, in 2015 and 2017 Medicare approved payment
for many types of outpatient cervical spinal (neck) operations that had
previously required at least an overnight hospital admission;
although sound medical practice principals and regulatory agencies require
that ASCs /OSCs meet certain minimum standards regarding emergency care
of surgical complications, there were many instances where ”emergency
care” consisted of a call to 911 and transfer of a medically-unstable
patient to a nearby Emergency Room, and
physicians who had a financial interest in an ASC/OSC tended to perform
more diagnostic and/or surgical procedures than did physicians who utilized
hospital-based outpatient services.
How can I learn about an ASC’s / OSC’s patient safety record?
In all honesty, the answer to this question is either 1) “You can’t”
or 2) “Only with difficulty.” The reason for these answers
is that there is no federal law or regulation requiring ASCs / OSCs to
keep a record of surgical complications that are either treated “on
site” or require emergency admission to a hospital. Even in those
states that closely monitor the activities of ASCs / OSCs, this information
is rarely available online or by written request.
Our advice is that you should first ask the health care provider who will
be performing the procedure for information on the ASC/OSC’s safety
record. If he or she is unable or unwilling to provide a satisfactory
answer to your question, you should consider asking for a second opinion
or postponing the procedure until you are satisfied that you will not
be exposed to any additional risk of complications by having the procedure
performed outside a hospital.
Contacting a medical malpractice lawyer
We have seen that, although the majority of ASCs / OSCs are just as safe
as those operated by a hospital, there are some facilities (and physicians)
that seem to be more concerned about profit and loss than with the well-being
of their patients. Unfortunately,
proving that an injury was the result of malpractice can be difficult and will
require the services of an experienced medical malpractice lawyer.
If you suspect that you or a family member may have been a victim of medical
malpractice that involves an ASC / OSC, we invite you to contact the medical
malpractice lawyer at
The Doan Law Firm, a nationwide medical malpractice and personal injury law practice with
offices located in major cities throughout the country.
contact our firm to arrange a review of your potential medical malpractice lawsuit, your
first consultation and review of the legal options that may be available
to you is always free of charge and does not obligate you to hiring our
firm. Should you later decide to file a lawsuit and that you would like
for us represent you in court, we are willing to assume full responsibility
for all aspects of preparing your case for trial in exchange for a percentage
of the final settlement that we will win for you.