<figure>
 <img src="https://media.eaglewebservices.com/public/2020/2/1581619424617.jpeg" alt=" Pinnacle Regional Hospital, at 128th Street and Metcalf Avenue in Overland Park, was previously known as Blue Valley Hospital. Dan Margolies / KCUR 89.3" />
 <figcaption> Pinnacle Regional Hospital, at 128th Street and Metcalf Avenue in Overland Park, was previously known as Blue Valley Hospital. Dan Margolies / KCUR 89.3</figcaption>
 </figure>By DAN MARGOLIES <a href="https://www.kcur.org/post/two-patients-died-after-surgery-overland-park-hospital-their-families-want-answers#stream/0">Kansas News Service</a>On Feb. 6, 2018, Travis Claussen had his right hip replaced at Blue Valley Hospital in Overland Park.The
 40-year-old resident of Lawson, Missouri, had been experiencing severe 
back pain for years. Before then, he’d been a physical fitness buff who 
was into off-road motorcycle racing.His back pain got so bad 
that, other than helping out his mother with her small T-shirt and sign 
business, he’d been unable to work for the previous five years.Claussen
 was considered a poor candidate for back surgery because, at 
six-feet-one-inches tall and 240 pounds, he was considered obese. But 
one of the doctors at Blue Valley thought he was sufficiently young and 
healthy to undergo hip replacement surgery.Claussen went ahead 
with the procedure, but following his discharge from the hospital he 
developed a surgical site infection. He returned to the hospital 13 days
 after his discharge and was treated with pain medications, intravenous 
antibiotics and a wound dressing to promote healing.He was 
discharged again a week later but readmitted several more times over the
 following weeks when it became clear the infection wasn’t clearing up. 
On April 9, 2018, the surgeon removed Claussen’s hip implants. During 
the procedure, Claussen’s right femur fractured.<figure>
 <img src="https://media.eaglewebservices.com/public/2020/2/1581619478474.jpeg" alt=" Travis Claussen was 40 years old when he died. Credit Claussen family" />
 <figcaption> Travis Claussen was 40 years old when he died. Credit Claussen family</figcaption>
 </figure>Medical records show that over the next 24 or so hours, he was given 
large quantities of narcotics, including fentanyl and oxycodone, and 
sedatives, including Valium and Ativan. At 3:50 a.m. on April 11, a 
nurse found him unresponsive. He was transported about 50 minutes later 
just down the road to Saint Luke’s South Hospital but it was too late. 
Claussen was dead.He wasn’t the first patient at privately owned
 Blue Valley Hospital, which was renamed Pinnacle Regional Hospital in 
2018 and on Wednesday filed for Chapter 11 bankruptcy, to die following 
surgery there.Joseph Metz, who had endured back pain for years, 
underwent spinal fusion surgery at Blue Valley on Dec. 22, 2017. He was 
discharged four days later, although his temperature was elevated and an
 autopsy subsequently showed he had pneumonia. The following day he was 
discovered unresponsive in bed at home. He was pronounced dead at 4:43 
that morning. Metz was 36 years old.The two men’s deaths came 
during a time when the hospital was in peril of losing its Medicare 
certification because it didn’t have a sufficient number of inpatients. 
In fact, a hospital staffer told CMS inspectors in 2017 that it was 
performing “a lot of extra surgeries to get the numbers we needed.”&nbsp;Andrea
 Carabetta, the pharmacy director at Blue Valley Hospital for nearly 
three years before she left in the fall of 2018, told KCUR that Claussen
 should have been transferred to another hospital with a higher level of
 care.“I feel like they killed him,” she said.<h2>Families sue</h2>In
 October, Metz’s two minor children and the personal representative of 
his estate sued the hospital and two of its physicians for medical 
malpractice, alleging they were negligent in their treatment of Metz. 
The defendants have denied the allegations, claiming the plaintiffs’ 
injuries “were the direct and unavoidable consequence of Joseph Metz’s 
pre-existing condition.”<figure>
 <img src="https://media.eaglewebservices.com/public/2020/2/1581619507576.jpeg" alt=" Travis Claussen's parents, Debra and Herm Claussen, say they never got a word of apology from the hospital. Credit Dan Margolies / KCUR 89.3" />
 <figcaption> Travis Claussen's parents, Debra and Herm Claussen, say they never got a word of apology from the hospital. Credit Dan Margolies / KCUR 89.3</figcaption>
 </figure>Claussen’s family filed their own lawsuit against the hospital, two 
of its physicians and a nurse practitioner on Thursday. Like the Metz 
family's lawsuit, it alleges the defendants were negligent in their 
treatment of their son and seeks unspecified damages.<h2>A ‘more intimate hospital experience’</h2>The
 hospital, which is located at 128th Street and Metcalf Avenue, is owned
 by businessman Douglas Palzer, who opened it in 2010 as a seven-bed 
facility with two operating rooms. Palzer, who lives part of the time in
 Las Vegas and could not be reached for comment, had previously owned a 
nearby ambulatory surgical center specializing in weight loss surgery.A
 news release announcing the hospital’s opening said that while it was 
designed with weight-loss surgery in mind, “it is expanding its range of
 specialties and procedures.”“We offer a more intimate hospital 
experience than what many people expect,” Palzer was quoted in the 
release as saying. “With only three outpatient and four inpatient beds, 
our patients get a lot of personal attention.”Federal records 
obtained by KCUR, however, show they may not have gotten enough. In June
 2018, regulators issued a statement of deficiencies report about the 
hospital containing an “immediate jeopardy” finding – or a situation 
where patients could be at risk of injury or even death.<h2>‘Screamed of overdose’ </h2>The
 report by inspectors for the Centers for Medicare and Medicaid Services
 (CMS) found that both Claussen’s and Metz’s deaths resulted from 
multiple failures by hospital staff to comply with conditions for 
getting Medicare and Medicaid funding.As part of their 
investigation, the inspectors interviewed members of the hospital’s 
staff, including physicians and nurses. The report, as is customary with
 statements of deficiencies, does not identify the staff members by 
name, but some of their statements are damning.One said that 
after Claussen (who is identified in the report as Patient 10) was found
 unresponsive, they reviewed the crash cart and discovered that no 
Narcan, epinephrine or any emergency drugs were used.“We gave 
Patient 10 a lot of narcotics and I believe anyone with experience would
 have recognized a potential for narcotic overdose and would have tried 
at least one dose of Narcan,” the staff member said, referring to a drug
 used to treat narcotic overdoses.Another staff member said that
 Claussen’s symptoms “screamed of overdose to me. Patient 10 should have
 gotten Narcan. We do stock Narcan here, so it was available.”The
 CMS report said Claussen’s autopsy report indicated the cause of death 
as coronary artery disease with fentanyl intoxication as a contributing 
factor.The report said that “oxycodone intoxication,” along with
 underlying medical conditions, likewise contributed to Metz’s death. 
Citing the autopsy report, it said the concentration of oxycodone found 
in Metz, who is identified as Patient 3, was “above the expected 
therapeutic range and within the potentially fatal range.”<h2>‘Blame game’</h2>A
 hospital staff member told the CMS inspectors that following Metz’s 
death, hospital staff fought over having the reason for his death 
changed. The staff member said “there is a lot of the blame game going 
on …”At the time, Blue Valley was trying to boost the number of surgeries it performed.CMS
 had concluded the hospital did not “primarily engage” in providing 
services to inpatients – a requirement for participation in Medicare – 
and said it was going to end Blue Valley’s eligibility for Medicare 
reimbursements. Hospitals that don’t average at least two inpatients per
 day and at least two night average length of stay are considered 
same-day surgical centers, which are reimbursed differently.Carabetta,
 the pharmacy director who left in the fall of 2018, told KCUR she 
believed Claussen had been kept at the hospital instead of being 
transferred “to keep the patient census up to meet CMS requirements.”“I took my oath to provide good quality care and I didn’t feel I was living that oath,” she said.A spokeswoman for the hospital did not return phone calls seeking comment.<h2>‘No one expressed any sympathy’</h2>Still
 grieving over their loss, the Claussens are angry and upset over what 
they describe as the hospital’s cavalier response to their son’s death.“The
 doctor never acted like he was sorry this happened. He sure never said 
he was sorry this happened. The hospitalist never said he was sorry. The
 director of nursing never said she was sorry this happened,” says Debra
 Claussen, Travis’ mother.“Even after he died, nobody in 
management expressed any sympathy or regret. And I know that’s because 
they’re expecting a lawsuit and they’ve got to be careful what they 
say.”Money was clearly on the minds of the hospital’s administrators over the last few years.Before
 it lost its Medicare certification, Blue Valley claimed to perform 35% 
of all Missouri Medicaid bariatric surgeries, a procedure performed on 
obese patients. Seeking to restore its Medicare funding, Blue Valley 
filed a <a href="https://www.kcur.org/post/overland-park-weight-loss-hospital-sues-after-government-cuts-medicare-funding#stream/0">lawsuit in which it claimed that its</a>
 termination from the program would likely result in the loss of 
Medicaid and commercial coverage as well, which would financially 
cripple it.<h2>‘Extra surgeries’</h2>In
 an April 2018 statement of deficiencies finding Blue Valley did not 
qualify for participation in Medicare, CMS inspectors said a hospital 
staff member – from the context, it appears to be one of the hospital’s 
executives – told them the hospital performed “a lot of extra surgeries 
to get the numbers we needed.”“So, I offered a new benefit to 
all employees and their families,” the staff member told the inspectors,
 according to the report. “I told them for those that medically qualify 
for a gastric sleeve, we would pay what insurance didn’t. Our staff has 
requested it for years because the insurance we have won’t cover the 
costs for the surgery here. Unfortunately, I have a lot of obese 
employees and they wanted this surgery. So it was something that could 
help us both. We have done about 50-60 employee/family surgeries to date
 with about 70 more that want it.”Although <a href="https://www.kcur.org/post/overland-park-weight-loss-hospital-loses-bid-regain-its-medicare-funding#stream/0">a federal judge dismissed Blue Valley’s lawsuit</a> on procedural grounds – <a href="https://www.kcur.org/post/overland-park-weight-loss-hospital-struggles-regain-its-medicare-certification#stream/0">a decision upheld by a federal appeals court</a>
 – Palzer, the hospital’s owner, managed to get around CMS’ termination 
of its participation in Medicare by buying Cooper County Memorial 
Hospital in Boonville, Missouri, in 2018.After the purchase, he renamed the Boonville and Overland Park facilities Pinnacle Regional Hospital.<figure>
 <img src="https://media.eaglewebservices.com/public/2020/2/1581619542408.jpeg" alt=" Pinnacle Regional Hospital in Boonville, Missouri, closed its doors last month, although its CEO says it plans to reopen as part of a bankruptcy reorganization. Credit Sebastian Martinez Valdivia / Side Effects Public Media" />
 <figcaption> Pinnacle Regional Hospital in Boonville, Missouri, closed its doors last month, although its CEO says it plans to reopen as part of a bankruptcy reorganization. Credit Sebastian Martinez Valdivia / Side Effects Public Media</figcaption>
 </figure>But last month, about two years after he purchased it, <a href="https://www.kcur.org/post/pinnacle-regional-hospital-boonville-missouri-shuts-down-operations#stream/0">Palzer closed down the Boonville hospital</a>. In a statement, Pinnacle CEO Joseph Conigliaro said that Missouri regulators’ <a href="https://www.kcur.org/post/boonville-missouri-hospital-ordered-stop-performing-surgery#stream/0">demand that the hospital upgrade its sterile processing procedures</a> would have proved too costly.By then Pinnacle was already <a href="https://www.kcur.org/post/shuttered-boonville-hospital-s-financial-woes-had-been-piling-year#stream/0">in serious financial trouble</a>.
 Vendors were suing for nonpayment and Pinnacle’s lender, Great Western 
Bank, claimed it was owed more than $24 million in unpaid loans, 
interest, late fees and other charges.In a lawsuit filed last 
month, Great Western said that both the Boonville and Overland Park 
businesses were “collapsing” and asked the court to appoint a receiver 
to oversee them and assess whether a sale would maximize their value.Seeking
 to restructure their debts, Pinnacle and its parent company, Pinnacle 
Healthcare System Inc., filed for Chapter 11 bankruptcy reorganization 
on Wednesday. The companies said they hope to emerge from the proceeding
 as more stable, viable businesses.In astatement Thursday 
announcing the filing, Pinnacle CEO Joe Conigliaro said the Overland 
Park hospital would remain open and the Boonville hospital would be 
reopened.The Chapter 11 filing, Conigliaro said, will allow the 
companies “to restructure our debts and ensure stable, stronger, and 
viable business operations now and when we emerge from Chapter 11”“The
 reorganization proceedings will enable our companies to continue our 
mission of providing high quality and cost effective medical and 
surgical services in our communities,” Conigliaro said.Dan Margolies is a senior reporter and editor at KCUR. You can reach him on Twitter <a href="https://twitter.com/DanMargolies">@DanMargolies</a>.

Families want answers after patient deaths at Kan. hospital