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Deadly collapse of Miami building shines light on Florida’s condo politics

The line of condominiums and hotels along Collins Avenue that offer residents sweeping views of the Atlantic Ocean is now broken up by a haunting pile of rubble.

A fortnight after Champlain Towers South, a 12-storey apartment building with 136 units, collapsed in the Miami suburb of Surfside, officials in south Florida this week called off the search for survivors.

Emergency crews switched their focus to recovering the bodies of victims of the collapse, which, as of Friday evening, had killed at least 79 people with a further 61 “potentially unaccounted for”.

The search for the cause of the collapse has also begun, although investigators say it is too soon to know how long it will take — let alone what the final answer will be.

Yet what is clear is that Champlain Towers South needed to undergo millions of dollars worth of repairs as part of a 40-year “recertification”, a process established in Miami-Dade and Broward counties to ensure that buildings remain safe in the face of decades of abuse from Florida’s sun, sea and salt.

Organising those repairs fell to the board of the condominium association, a legal entity staffed by volunteer owners elected by other residents, which maintains the structure and common areas of a building comprising individually owned apartments.

The repairs were delayed because of disputes over the cost. This had ballooned from $ 9m to $ 15m before the board voted in April to fund them via a “special assessment”, a charge levied for a specific project and a dreaded prospect for many condo owners who must stump up their share.

There are parallels to the crippling bills that some apartment owners are being forced to pay as landlords upgrade the cladding on their buildings in response to the deadly Grenfell fire in London four years ago.

A woman adds flowers to a memorial featuring photos of some of those lost in the Champlain Towers South collapse © Giorgia Viera/AFP via Getty Images

Fewer than a third of condo associations in the US have sufficient funds saved up for big-ticket repairs such as structural work or replacing a roof, and experts say delays and disagreements are common not just in Florida but across the US.

“Every condominium is like a little micro-society,” said Carolina Sznajderman Sheir, a partner at Eisinger Law that specialises in condominium law.

Sheir said that, while the 40-year recertification might sound like a “very matter-of fact” process, it often results in infighting among residents. “Here’s why it’s difficult: we’re talking about monumental projects, we’re talking about millions of dollars in restoration.”

“Boards that levy assessments are not popular boards,” she added. “People don’t want to pay huge assessments . . . And politics are politics, whether they’re national or on a tiny little board.”

Annotated photograph explaining the collapse of The Champlain Towers in Miami

Marta Reeves knows only too well how the process can descend into acrimony. Her family has lived for more than three decades at the Imperial at Brickell, a 161-unit building located about 12 miles south-west of Champlain Towers South. Built in 1983 along Biscayne Bay, its distinctive “red wall” can be seen in the opening credits of the 1980s television show “Miami Vice”.

The situation at the Imperial underscores how debates over how to pay for repairs can lead to hostility: owners with varying incomes and differing philosophies over how much maintenance is necessary snipe at one another, sometimes over Facebook or email.

Reeves won a seat on the Imperial condo board in 2010, and was part of a co-ordinated slate of officers elected in March 2018. The five new board members passed a $ 1m special assessment to repair the roof, cooling tower and elevators because the building lacked enough reserves to pay for the work.

The board subsequently decided to replace the 944 windows along the famous red wall; an engineer’s report from more than a decade ago had said they were reaching the end of their useful life. The building’s 40-year certification, coming due in 2023, called for a waterproof “envelope”, while new building codes specified the glass should be able to resist the impact of hurricanes that batter Florida’s coastline.

So the board passed a $ 9m assessment, which would have cost homeowners between $ 45,000 and $ 62,000 per unit. Despite securing financing to help homeowners bear the cost, Reeves and her fellow four board members then lost their bid for re-election in February 2020.

The current and former boards of the Imperial condo disagree on maintenance for the 944 windows along its ‘red wall,’ which can be seen in the opening credits of the 1980s television show ‘Miami Vice’ © Claire Bushey

“It’s not a popular job when, after years of not fixing things in a timely manner, the piper is going to come,” said Reeves. “That’s what got us voted out.”

Reeves looked on in frustration as the new board tried to tackle the repairs with what she perceived as less organisational acumen than before. “I’m not saying that they’re not fixing it,” she said. “They’re putting Band-aids on it.”

Rissig Licha, a member of the Imperial’s current board, dismissed such suggestions. In an emailed statement, she said the board had “made compliance with the 40-year recertification its primary objective since assuming office”.

The board also said it had “actively communicated” with owners during the process and had sought out “the best structural and construction experts and specialists at considerable expense”.

Florida has 1.5m condos, more than any other state. State law requires associations to have a schedule to pay for big repairs, but there is a loophole: homeowners can vote to waive paying into a reserve fund. Only six states require condos to maintain “adequate” reserves without giving homeowners the option to waive the requirement.

Sheir, the attorney, noted that many of Florida’s condo owners are retirees and are therefore less concerned with the long-term upkeep of their property. They would prefer to keep the monthly association dues as low as possible, she added.

“People just don’t want to pay higher assessments,” she said. “They’d rather have the money in their pocket than in someone else’s.”

Failing to keep money aside for capital improvements is a problem across the US, but it is particularly acute in Florida, where the climate exacts a harsher toll on buildings. Constructors use concrete because the weight of the material protects against hurricanes, but over time Ultraviolet rays and salty air end up corroding the material, according to Sinisa Kolar, vice-president of the engineering and architectural consulting firm Falcon Group.

The rest of the condo was demolished on July 4 © Giorgio Viera/AFP via Getty Images

Some local politicians have suggested that Florida should cut the recertification process from 40 years to 20, which Kolar said would “make everybody aware of the work that they absolutely need”.

But Robert Nordlund, chief executive of Association Reserves, is sceptical of whether legislation can force condo owners to budget for future repairs.

What might make more of a difference, he said, is if insurers and mortgage lenders considered the state of a condo association’s finances when setting premiums or making a loan. Lenders generally only require that a condo association’s reserve fund be 10 per cent funded before they are willing to give a mortgage to a buyer.

“The risk factors are there, and they’re so obvious,” he said. “I don’t know why they’re missing those clues . . . I wonder if this is a time that they will start to learn and refine their underwriting standards.”

The Surfside disaster has gripped the residents at Imperial, just as it has at condo buildings throughout Miami.

Emergency support columns were placed in the building’s parking garage last week, but Licha said the structural engineers hired by the condo association “have not identified repairs or conditions not ordinary and consistent with similarly situated buildings of the same age group”. Reeves agrees with the current board that the apartment block is structurally sound.

Still, at least one resident seemed unnerved this week. He stopped his car in the garage to tell Reeves that he had written to the board to express his worries. She told him to keep writing: tragedies sometimes bring change.

“It is a very high cost,” he replied.

PASCAL Mitral Valve Repair Shines at 2 Years in CLASP

Transcatheter mitral valve repair with the PASCAL device showed high rates of survival and freedom from heart failure rehospitalization at 2 years in the single-arm, safety and efficacy CLASP study.

The early reductions in mitral regurgitation (MR) were sustained with 97% of patients having MR grades of 2+ or less and 78% having MR grades of 1+ or less at 2 years.

There was also evidence of left ventricular (LV) reverse remodeling and significant improvements in functional status, Molly Szerlip, MD, Baylor Scott & White Health, Plano, Texas, reported as lead author. The results were published online May 18 in JACC: Cardiovascular Interventions.

“The PASCAL transcatheter valve repair system is a favorable option for treating patients with MR,” she said in a simultaneous virtual presentation at the 2021 Congress of European Association of Percutaneous Cardiovascular Interventions (EuroPCR 2021).

The PASCAL system is not approved in the United States, but Szerlip observed that the investigators are eagerly awaiting results from the ongoing, pivotal CLASP IID/IIF trial comparing the edge-to-edge repair system with another such device, MitraClip, in 1275 patients with functional or degenerative MR. The primary completion date is set for December 2023.

Abbott’s MitraClip has been available in the US since 2013 and in Europe since 2008; Edwards Lifesciences received a CE mark for the PASCAL system in 2019.

“The results of the CLASP study are remarkable and indicate an additional differentiated tool ready for clinical routine,” Georg Goliasch, MD, PhD, and Philipp Bartko, MD, both from the Medical University of Vienna in Vienna, Austria, write in an accompanying editorial.

As both systems target similar lesions, there might be “significant overlap in this particular patient population,” Goliasch told theheart.org | Medscape Cardiology. From a technical perspective, the separate leaflet grasping was initially one of the advantages of the PASCAL, but this has also been recently introduced for the MitraClip.

That said, the “PASCAL device may offer a leaflet repair with decreased mechanical leaflet traction — specifically appealing to treat ventricular secondary MR — because mechanical forces applied to leaflets remain low, and the [central] spacer augments the leaflet surface in a way that reduces restrictive diastolic opening,” he added. “However, this remains highly speculative.”

The CLASP study enrolled 124 patients (56% male) with symptomatic MR grade of at least 3+ who were receiving optimal medical therapy at 14 sites in five countries. Their mean age was 75 years, 69% had functional MR (FMR), 31% had degenerative MR (DMR), and 60% were NYHA functional class III to IVa.

The primary endpoints of procedural and clinical success and adverse events at 30 days and 1-year outcomes were published last year. Echocardiographic data were available for 36 patients at 2 years with follow-up ongoing.

Composite major adverse event rates were 8.1% at 30 days, 18.5% at 1 year, and 16.9% at 2 years, driven mostly by severe bleeding at 7.3%, 11.3%, and 7.3%, respectively, Szerlip said.

Kaplan-Meier estimates showed 80.3% survival at 2 years (72.3% FMR, 94.3% DMR) and 84.3% freedom from heart failure rehospitalization (77.5% FMR, 97.3% DMR). The annualized HF rehospitalization rate fell to 85% at 2 years.

These results, the authors noted, hinged on minimizing residual MR. In the FMR group, 100% and 95% of patients achieved MR ≤2+ at 1 year and 2 years, respectively, compared with 95% and 99% treated with the MitraClip in the COAPT study.

In the DMR group, 100% of patients achieved MR ≤2+ at both 1 and 2 years, which “compares favorably to 94% from the EXPAND study at 1 year” with the MitraClip NTR and XTR systems, they write.

In CLASP, the LV end-diastolic volume decreased by 11 mL at 30 days and continued to decrease at 1 year (25 mL) and 2 years (33 mL; P < .001).

LV end-diastolic diameter (LVEDD) fell by 2.7 mm at 30 days, 3.9 mm at 1 year, and by 2.7 mm at 2 years (P = .002). At 2 years, 93% of patients were in NYHA class I or II (P < .001).

“The authors of the trial observed significant LV reverse remodeling with a decrease in LVEDD. These findings are indeed of particular interest and warrant further investigation by future studies as this has not been shown to such an extent in previous E2E [edge-to-edge] repair studies,” Goliasch told Medscape.

He raised an eyebrow, however, at the cross-trial comparisons, adding, “We should be very careful to draw any hasty conclusions considering the high proportion of missing echocardiographic data. Nevertheless, all these aspects might make the design of future studies for direct comparisons between E2E devices in the various structural aspects of mitral valve disease attractive to tailor treatment and optimize patient care.”

Szerlip and colleagues cited several study limitations including the absence of a control arm that may have contributed to a Hawthorne effect; not all patients had reached 2-year follow-up at the time of the analysis; and adjudication of events and assessment of the 6-minute walk test and quality-of-life measures were limited to 1 year based on the protocol.

The study was sponsored by Edwards Lifesciences. Szerlip reported serving as a proctor/speaker for Edwards; a national principal investigator for EFS; a speaker for Boston Scientific, and serving on steering committees for Medtronic and Abbott. Goliasch and Bartko have disclosed no relevant financial relationships.

J Am Coll Cardiol Intv. Published online May 18, 2021. Abstract, Editorial

Follow Patrice Wendling on Twitter: @pwendl. For more from theheart.org | Medscape Cardiology, join us on Twitter and Facebook.

This post originally appeared on Medscape Medical News Headlines

The Beatles: John and Paul's love for their mothers shines on heartbreaking tracks

Those lyrics go: “When I find myself in times of trouble, Mother Mary comes to me, Speaking words of wisdom, let it be.

“And in my hour of darkness she is standing right in front of me, Speaking words of wisdom, let it be.”

Many have seen the opening of Let It Be as referring to Jesus’ mother but Paul himself once spoke about how it was inspired by the loss of his own mother Mary to breast cancer.

Paul said: “I had a dream in the Sixties where my mum who died came to me in a dream and was reassuring me, saying: ‘It’s gonna be OK. Just let it be…”

However one of the Beatles’ inner circle, Malcolm ‘Mal’ Evans, long claimed that he had been the inspiration for the song but Paul had been forced to change the lyrics in case people took it the wrong way.