The alarming message came at 10 a.m. on a busy day in the operating room.
The majority of the 70 scheduled surgeries at Cooperman Barnabas Medical Center would have to be canceled, Jennifer O’Neill, its chief operating officer, learned one winter morning earlier this year.
There weren’t enough anesthesiologists to perform the procedures.
Officials scrambled, pulling residents trained in anesthesiology out of classes to cover the surgeries while under supervision, the hospital says.
It was not the first time the Livingston medical center found itself without enough anesthesiologists — often with little notice, according to officials. The understaffing of the anesthesiology department by its contracted service provider reached “the point where CBMC had to cut its operating room usage in half,” the hospital says.
Cooperman Barnabas Medical Center filed a lawsuit late last month in Essex County Superior Court claiming the New Jersey subsidiary of North American Partners in Anesthesia violated its contract by chronically understaffing the department, disrupting scheduled and emergency surgeries and other services.
The 25-page suit accuses NAPA, the private equity-funded company that had been Cooperman Barnabas’ sole provider of anesthesia services for years, of prioritizing profits over patient care and imperiling the hospital’s reputation. It also claims NAPA took on more anesthesia contracts than it could honor and would redeploy anesthesiologists from Cooperman Barnabas to other locations.
“NAPA’s understaffing is not an innocent mistake, but rather is the result of a callous business decision aimed at maximizing profits at the extreme cost of patient care and safety,” the suit says.
The competing interest of the hospital’s “public health mission versus NAPA’s profiteering — are at the heart of this dispute,” the suit says.
American Anesthesiology of New Jersey refuted Cooperman Barnabas’ claim that it and NAPA, its parent company, traded profits at the expense of patient care.
“Throughout its relationship with CBMC, AANJ has staffed operating rooms at CBMC and ensured that patients received the highest level of care,” spokesman Bob Knight said in a statement to NJ Advance Media.
But that is not the only point of contention between the hospital and the staffing provider.
After negotiations for a new contract broke down in June, “NAPA threatened to create a public health crisis if the Hospital did not agree to an unconscionable contract that would allow NAPA to continue its inadequate and unsafe staffing levels,” Cooperman Barnabas claims in its lawsuit.
So the hospital and Newark Beth Israel Medical Center in Newark — both part of the RWJBarnabas Health system — formed their own anesthesia departments with directly employed clinicians. The staff, however, included anesthesiologists as well as certified registered nurse anesthetists who had been NAPA employees.
That prompted American Anesthesiology to file its own suit late last month in Essex County Superior Court against Cooperman Barnabas as well as the employees who left to work for the hospitals. The AANJ suit says Cooperman Barnabas “pirated AANJ’s Clinicians by intimidating them into breaching their narrow and enforceable non-compete covenants with AANJ and becoming employees of CBMC.”
Cooperman Barnabas maintains it had little choice but to form its own internal anesthesiology team, although it remains understaffed.
The hospital alleges NAPA failed to provide sufficient anesthesiologists “nearly every single day” between September 2021 and June 2022, according to the suit. Cooperman Barnabas says in the lawsuit that it unsuccessfully appealed to NAPA to hire additional clinicians.
“NAPA consistently failed to provide sufficient anesthesia clinicians to cover the emergency room, labor and delivery rooms and all scheduled surgical procedures,” the lawsuit said.
The impact, Cooperman Barnabas said, “has been severe.” The suit claims the hospital tracked 286 “adverse events” from January through June stemming from understaffing, with at least 12 creating “a patient care issue.”
“These delays and cancellations harm the health and wellbeing of patients, not to mention the Hospital’s reputation ... Indeed, surgeons have selected to care for their patients at other hospitals as a direct consequence of the delays caused by NAPA’s understaffing.”
NAPA’s proposed contract during negotiations precluded the hospital from hiring per diem anesthesiologists, the lawsuit said. It would have violated the exclusive provider requirement, the hospital said.
“The health, safety and welfare of our patients is our highest priority at RWJBarnabas Health,” the health system said a statement to NJ Advance Media. “As a statewide leader in adult and pediatric surgery, the volume of patients we see daily necessitates the immediate availability of skilled anesthesiologists and certified registered nurse anesthetists (CRNAs) to provide care.
“Unfortunately, the company contracted to provide these services has been unable to consistently meet the needs of our system and patients in a timely manner. This is why we are pleased that these caregivers are now being directly employed by the system, which will ensure no disruption services to our community.”
Knight, the AANJ spokesman, said Cooperman Barnabas’ “unlawful behavior” forced the provider to take the fight to court.
“For years American Anesthesiology of New Jersey, P.C., (AANJ) has provided high-quality care to patients of Cooperman Barnabas Medical Center (CBMC) in Livingston, NJ, while attempting to negotiate in good faith an anesthesia services agreement with hospital management for over 18 months,” he said.
“CBMC engaged in an unlawful take-over of AANJ’s clinical workforce, which was action on CBMC’s part that places profits over patient care ... AANJ remains committed to providing the highest level of anesthesia care to the thousands of patients at medical facilities in communities throughout New Jersey.”
Our journalism needs your support. Please subscribe today to NJ.com.
Elizabeth Llorente may be reached at ELlorente@njadvancemedia.com. Follow her on Twitter @Liz_Llorente.
Ad Choices