American Samoa's off-island medical referral programme has been beset with more problems.
The programme - set up for patients needing specialist care such as joint replacements and chemotherapy - was suspended a year and a half ago when the hospital ran into financial problems.
The government plans to sink 10 million US dollars into the hospital so it can pay its debts, but LBJ now faces administrative problems with healthcare providers in Hawaii and New Zealand.
The chairman of the American Samoan Medical Centre Authority, Charles Warren, says its unclear how many patients are waiting for treatment, or when the programme will resume.
"The mechanisms just aren't in place right now to get them into the hands of the providers that we need to take care of them. Unfortunately in today's world, the administrative side of healthcare sometimes seems to take priority over the patients side of healthcare. We have to have the appropriate agreements before we can send these patients off."
Mr Warren says patients needing treatment overseas will have to rely on medical insurance or pay out of their own pocket.
