A year later, Santillán mishap still unresolved

While tomorrow marks the one-year anniversary of Jésica Santillán's botched heart-lung transplant at Duke University Hospital, little has been resolved in her case despite extended discussion between both sides.    

The Santillán family has yet to file a lawsuit against the hospital but a resolution does not look likely in the near future, in spite of constant communication between administrators and the family, said John Burness, the University's senior vice president of public affairs and government relations.    

"In circumstances such as this, there's an inevitable strain [of finding a resolution]," Burness said. "I think we are trying to act in the best possible faith and have been in our dealings with the family." Santillán, a type-O seventeen-year-old who suffered from restrictive cardiopathy, died two weeks after she mistakenly received a type A heart-lung transplant. When the Santillán family spokesperson, Mack Mahoney, appealed to the media for support following the mix-up, a matching set of type O organs were located, but the second transplant failed to restore Santillán's health. She died amid a media circus that attracted national attention to Duke's mistakes and renewed the focus on patient safety and, specifically, organ donation procedures. Although Mahoney blames DUH for poorly managed procedures and for trying to "cover up" the ordeal, Dr. Bill Fulkerson, chief executive officer of DUH, says the events elicited very personal reactions.    

"I think the response from me and from others on behalf of the institution, I hope, was realized as being honest and from the heart," Fulkerson said.    

Still grieving the loss of her daughter, Magdalena Santillán has refocused her efforts on a public campaign to garner support for organ donation and a charity originally established for her daughter, Jésica's Hope Chest. She currently stars in a commercial, broadcast in both the United States and Mexico, advocating organ donation on behalf of several organizations.    

However, Santillán is not pleased by the efforts Duke has undertaken to commemorate her daughter's death and retracted her support for the Santillán fund, which was to provide for services in the hospital to Spanish speakers, two months after it was originally announced by Duke.    

Questions remain as to whether the blundered transplant was ultimately responsible for Santillán's death, and concerns linger over the possible effects the media's portrayal of the incident has had on DUH's reputation.    

Dr. Duane Davis, associate professor of thoracic surgery and medical director of Carolina Donor Services--one of the organ procurement organization involved in Santillán's transplant--disagreed with blaming a single entity within the process of organ transplantation for a patient's death.    

"Certainly multiple things could have been done differently at the time," Davis said. "There was a series of errors at multiple levels including the Hospital, Carolina Donor Services, UNOS... that could have all prevented this from happening."    

He added there was no clear evidence of antibody-mediated rejection being the cause of Santillán's body failing following the initial transplant. Davis explained that there are many issues that can cause a heart-lung transplant not to work properly, only one of which is antibody-mediated rejection.    

"It is completely unclear whether ABO [blood type] incompatibility was truly the cause of her death," Davis said. Davis also disagrees with Burness and Fulkerson as to the potential effects that the Santillán case has had on the hospital's image.    

"There's no way you can say that Duke's reputation wasn't affected by that type of media coverage," Davis said. "It was unprecedented. I don't think you can quantitate the effect well."    

While Duke and the Santillán family have not yet reached a settlement, Duke remains hopeful the family will find tranquility.    

"Like everyone we grieve for the loss of the Santillán family," Burness said. "We hope that, whatever the resolution, they can find some peace."