Abortion Ban Deaths; Trans Paper Retraction Fallout; The Payout That Drained Steward

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Georgia Abortion Ban Linked to Two Deaths

Georgia’s maternal mortality committee concluded that the deaths of two women who didn’t receive adequate care for complications of medication abortion were preventable, according to ProPublica investigations.

Amber Thurman, 28, and Candi Miller, 41, both died in 2022, not long after the state’s abortion ban went into effect.

The committee found that Thurman did not receive necessary medical care after she didn’t expel all of the fetal tissue from her body during a medication abortion. Staff at Piedmont Henry Hospital in Stockbridge, Georgia, treated Thurman’s sepsis, but waited to perform a dilation and curettage (D&C) for nearly 20 hours. By then, Thurman’s condition had declined so severely that her surgeons determined they needed to remove her bowel and conduct a hysterectomy instead. She died during the operation, ProPublica reported.

Miller took her abortion into her own hands because of the ban, buying abortion pills online. She, too, did not expel all fetal tissue and thus would need a D&C — but she didn’t seek medical treatment out of concern about the ban, her family told ProPublica.

Every state has a maternal mortality committee charged with reviewing maternal deaths, ProPublica reported. Georgia’s is comprised of 32 members from a range of backgrounds, including ob/gyns, cardiologists, mental health care providers, health policy experts, and others. However, they often operate with a 2-year lag time, “meaning that experts are only now beginning to delve into deaths that took place after the Supreme Court overturned the federal right to abortion.”

Fallout From Retracted Trans Youth Paper

The ongoing fallout from the retraction of a Springer Nature journal study on gender dysphoria has led to internal turmoil among academic editors and journal staff, including the resignation of one editor, according to STAT News.

The study, which surveyed 1,700 parents of adolescents and young adults, was retracted a few months after publication because there was no formal process for parents to consent to the study.

After the retraction, Chris Ferguson, PhD, an editor at Current Psychology — another Springer Nature journal — accepted a manuscript by Michael Bailey, PhD, a co-author of the retracted study. In that manuscript, Bailey reportedly argued that retractions are being used to censor scientific research.

Ferguson told STAT that he hoped Bailey’s article would share insights into dealing with retractions, but the leadership of Current Psychology decided to rescind acceptance of the article. Following that decision, Ferguson resigned.

The controversy has revealed a shift in thinking on how research on trans people and other marginalized groups should be conducted. Advocates and scientists from those minority groups have been working to ensure that study subjects are allowed to play a role in shaping that research.

Alex Keuroghlian, MD, MPH, of Harvard University, told STAT that “any research about a community should be led by that community, or at least robustly include community voice.”

The Payout That Drained Steward

Steward Health Care System, which filed for bankruptcy in May, paid out $790 million in dividends to investors in 2016, according to the Wall Street Journal.

Cerberus Capital Management, the health system’s private equity owner, received the largest proportion of that payout ($719 million) — and similar shareholder payouts, paired with recurring losses, ultimately drained the company’s coffers, WSJ reported.

The $790 million would have come in handy during the pandemic in 2020, when Steward had a $408 million net loss, according to WSJ.

The 2016 payout came from a complex deal with Medical Properties Trust (MPT), an Alabama-based real-estate company, and not Steward’s earnings. MPT bought and leased back five of Steward’s Massachusetts hospitals, and provided mortgage loans for four others, which it later bought and leased back to Steward, WSJ reported.