This isn’t the first time Kaiser Permanente has interfered with a union vote, which is why its Labor-Management Partnership is such a huge farce. We have been receiving complaints from Kaiser employees for years about the leaders of the SEIU working against labor for the benefit of management and their own wallets. Of course it was all over the news when NUHW lost to SEIU, but barely a whimper now that it has been brought to light that KP illegally helped them to win.

BeyondChron has the full story:

NLRB Judge Finds Kaiser Permanente Guilty of Violating the Law
by Leighton Woodhouse, NUHW
Dec. 15‚ 2010

LOS ANGELES – Yesterday, National Labor Relations Board (NLRB) Judge William Schmidt announced that Kaiser Permanente brazenly violated federal labor law by withholding scheduled raises and tuition reimbursements from workers who voted to leave the Service Employees International Union (SEIU) and join the National Union of Healthcare Workers (NUHW) earlier this year, and ordered immediate remedial action.

In the plainest of rebukes, Judge Schmidt referred to the “massive damage done” to workers’ rights by Kaiser, characterized the company’s justification for its actions as “lack(ing) merit” and “without legal foundation,” and called its cited legal precedents “misplaced.” Judge Schmidt ordered Kaiser to “immediately restore and apply” the scheduled wage increases plus interest, tuition reimbursement benefit, and steward training benefit provided under the workers’ prior union contract.

Read the rest

This is an interesting find. Seems that Kaiser Permanente was fined an administrative penalty of $75,000 by the California Department of Managed Health Care (DMHC) back in June 2010, for unnecessarily delaying Andrew Arce’s autism treatment. The Letter of Agreement doesn’t have the patient’s name on it, but a little birdy inside Kaiser assures us that Andrew is indeed the member in question, and all of the facts fit. It’s a long letter that interested parties can read here, but we have pulled out the highlights from the DMHC’s conclusions below:

• Concerns initially raised by Andrew’s father about his son’s developmental delays, which should have raised red flags with the Kaiser pediatrician, were basically ignored, therefore closing the window when experts agree that autism screening and evaluation can result in an early diagnosis and critical early intervention.
• After several more months passed and Andrew’s father raised concerns about his son’s issues for the second time, the pediatrician referred Andrew for evaluation by speech and occupational therapists instead of a formal autism evaluation.
• When the speech and occupational therapists both noted significant developmental delays and referred Andrew to the team of specialists that conducts formal autism assessments, a series of bumbling administrative and communication errors led to another 4 month delay before he was able to get an appointment for the evaluation.
• In February of 2008, when Andrew was finally evaluated by the team of autism specialists, Andrew’s father was forced to file a grievance with Kaiser because the treatment plan was deficient. Kaiser then denied that grievance on medical necessity grounds.
• 13 long months after Andrew’s father first expressed concerns about his son’s developmental delays, an Independent Medical Review (IMR) overturned Kaiser’s denial, allowing Andrew to get the treatment he needed — AFTER THE DAMAGE FROM DELAYS BY KAISER WAS DONE.
• The DMHC found that the conduct of Kaiser Foundation Health Plan and the Southern California Permanente Medical Group resulted in an unreasonable delay of the formal autism evaluation, as well as the IMR process. It was concluded that Kaiser was out of compliance with several provisions of the Health and Safety Code and the California Code of Regulations, and that there was sufficient evidence to proceed with an official Accusation asserting that violations of the Knox-Keene Act had occurred, and a penalty of $75,000 was warranted.

Meanwhile, Kaiser’s Ministry of Truth PR goons continue to characterize KP as “leaders” in the field of autism treatment, despite all evidence to the contrary. Ever wonder how they can do that and keep a straight face?

See our prior posts for more information on the Arce v. Kaiser Autism Class Action Lawsuit.

Received the following press release from attorney Charles T. Mathews‘ office today. This is going to be a big one, folks, and it has been a long time coming. Read the Summons and Complaint.

Kaiser hit with lawsuit for denying legally mandated health care to 57,000 of its most vulnerable patients, the chronically disabled and other “special needs patients” because it just didn’t want to spend the money!

When: October 7,2010
Where: LA County Court House (Front Steps)
111 N. Hill St., Los Angeles, California
Time: 9:30 a.m.
Contact: Charles T. Mathews, Esq., Counsel for Plaintiffs (626) 683-8291

Dr. Richard Della Penna M.D., a former Kaiser physician and one of America’s leading medical experts in Elder Care and the treatment of Special Needs Patients (”SNP’s) will file a lawsuit against Kaiser Permanente including The Permanente Federation, LLC, Kaiser Foundation Health Plan, Inc., and Kaiser Foundation hospitals as a result of Kaiser’s calculated plan to deny legally mandated proper treatment to approximately 57,000 seriously disabled and chronically ill patients in California, Colorado and Georgia because it just didn’t want to spend the money.

Dr. Della Penna’s lawsuit charges that despite receiving $13 BILLION dollars in Medicare money, Kaiser intentionally violated and continues to violate federal laws (the Medicare Modernization Act of 2003 and the Medicare Improvements for Patients and Providers Act of 2008) by denying these vulnerable patients crucial annual physical, functional and psychosocial assessments and a proper plan for the care and treatment of these Kaiser members.

Dr. Della Penna charges that despite his efforts to have Kaiser comply with these laws, Kaiser made the conscious decision to provide these required services to only 5% of these vulnerable patents so that they could showcase them to regulators when and if they were questioned.

He further alleges that when he complained to Kaiser about its failure to take proper care of these Special Needs Patients and complained about Kaiser’s failure to provide properly trained and credentialed staff to provide palliative care to patients with advanced illnesses, those near death and their families, he was rebuffed, isolated, marginalized and ultimately forced to resign.

Dr. Della Penna’s lawsuit seeks to force Kaiser to deliver to these disabled patients and their families the kind and quality of care that it promises when it lures people to join and claims that it wants them to “Thrive.”

Dr. Della Penna’s attorney, Charles T. Mathews, Esq. will be available to discuss the case immediately after it is filed. He will also ask any Special Needs Patients and/or the families of patients requiring Palliative Care (those near death or afflicted with terminal disease) to contact his office so that efforts can be made to compel Kaiser to get them the required care.

FOR FURTHER INFORMATION CALL: Charles T. Mathews & Associates (626) 683-8291

From the comments:

We are lawyers who regularly take on Kaiser and hold them accountable. We are investigating Kaiser’s failure to properly care for SPECIAL NEEDS Patients, those requiring PALLIATIVE CARE, and INFANT Deaths at Kaiser facilities. If you or someone close to you is a kaiser special needs patient or someone needing palliative care please contact us. Also, if you or anyone you know has sustained the death of an infant at Kaiser contact me.

We usually represent doctors, nurses and administrators who stand up to Kaiser for what is right and best for patients.

Charles T. Mathews

Contact information can be found on Mr. Mathews’ website: ctmesq.com

This story speaks for itself:

Kaiser Permanente Pulled Plug On Woman’s Insurance While She Was In A Coma

Great news! The California Court of Appeals has reversed a prior ruling (pdf) by the Superior Court of Los Angeles County, and has sustained Andrew Arce’s right to a class action lawsuit against Kaiser Permanente. The case is scheduled for a jury trial on March 22, 2010 absent any delays.

Yes, you read that right: a JURY TRIAL, thanks to a prior ruling (pdf) by the lower court denying Kaiser’s Motion to Compel Arbitration.

This decision of the Court of Appeals is precedent setting and has been certified for publication. It is a big win against Kaiser. Although we are not yet sure of the impact this case will have on the future rights of other Kaiser victims to have their day in court, it sure can’t hurt!

The Arces’ attorney, Scott Glovsky, is looking for more parents with letters from Kaiser denying treatment for their children’s autism. The more denial letters Mr. Glovsky can collect to present in court, the more likely he will be to prove that Kaiser is refusing to provide necessary services to an entire class of individuals with autism.

The letters can be scanned and emailed, faxed, or mailed the old fashioned way to:

Law Offices of Scott C. Glovsky
225 S. Lake Avenue, Suite 1000
Pasadena, CA 91101
Phone: (626) 243-5598
Fax: (866) 243-2243
Email: sglovsky@scottglovskylaw.com

For background on the case, see our prior posts on the matter.

A complete list of documents related to the Arce v. Kaiser autism class action lawsuit can be found here.

Courtesy of Vickie Travis of the Kaiser Papers:

Valencia Assistant Principal Timothy Howard and his wife Mary Howard were awarded $5 million in a binding arbitration against Kaiser Healthcare. A panel of three arbitrators found that Kaiser physicians were negligent for failing to timely work up Mr. Howard’s transient ischemic attacks (TIA) of the retina which resulted in a devastating stroke and complications that included bilateral amputations of the patient’s legs. “This is a flaw in the Kaiser system that I’ve seen over and over again. Being in a hurry; not listening to the patient; not ordering tests,” said the Howards’ San Diego attorney, Robert Vaage, who has never lost an arbitration against Kaiser. “How does Kaiser expect you to ‘thrive’ if its doctors won’t follow common sense medicine?”

In October of 2007, Mr. Howard was a healthy 46-year-old, working at a middle school in Valencia. He was married and had two twin daughters. He began having symptoms of intermittent “gray-out” or blindness in his right eye. He saw his Kaiser primary care doctor, who referred him to an ophthalmologist, who found no structural abnormalities of the eye. Mr. Howard continued to have vision symptoms, with new complaints of headaches, neck pain, and tingling in his left pinky. At the insistence of his wife, Mr. Howard was seen by Kaiser Neurologist Marika Issakhanian, M.D. It was alleged that Dr. Issakhanian was in a hurry and not interested in hearing the concerns of Mr. Howard and his wife. She diagnosed Mr. Howard with an ocular migraine headache, completely ignoring the signs and symptoms of TIA of the retina. To placate the Howards, she ordered an MRI and MRA (magnetic resonance angiography) of the head and neck, but not until December.

On Thanksgiving evening, Mr. Howard experienced complete vision loss in his right eye. He went to Kaiser Woodland Hills Urgent Care. The doctor there told him he was experiencing an ocular migraine, but agreed to run a CT scan in order to placate Mrs. Howard, who was insisting something was wrong. While waiting for the scan results, Mr. Howard suffered a devastating stroke. Kaiser emergency room doctors diagnosed a carotid dissection as causing the stroke.

Mr. Howard has not been able to return to work since the stroke. He has no use of his left arm and has left-sided weakness. He is wheelchair-bound and needs assistance with all aspects of his life. He also has cognitive and mental deficits from his stroke. He requires assistance 24 hours a day, 7 days a week. His future care needs are estimated in the millions of dollars.

TIA of the retina is caused by intermittent disruption of blood flow to the eye, which causes the gray-outs or visual disturbances. In men under the age of 60, the most likely cause is a carotid dissection. It is diagnosed by MRI/MRA of the head and neck. Treatment for a carotid dissection usually involves taking anticoagulation medication to prevent blood clots. The dissection or tear usually repairs itself within 3-6 months, and the patient can return to a normal life. Left undiagnosed and untreated, a carotid dissection can lead to a devastating stroke.

Kaiser’s electronic records also may have played a role in preventing Mr. Howard from obtaining urgent scans. “Once he was diagnosed incorrectly, that diagnosis followed him from doctor to doctor,” explained Vaage. “When he arrived at Urgent Care, the doctor looked at the E-record, saw Dr. Issakhanian’s diagnosis, and accepted the diagnosis without further testing. That’s all fine and good if you’ve got a good diagnosis.”

“I don’t get it,” added Vaage. “What happened to ruling out the worst potential cause first? Dr. Issakhanian testified that she considered TIA of the retina, knew it could lead to a stroke, but did nothing to rule it out at the time. All it took was one set of scans done within 24-48 hours, and Mr. Howard would have been back to work as an assistant principal. Instead, the Howards’ lives are forever changed.”

Because of the Medical Injury Compensation Reform Act (MICRA), the Howards’ general damages (non-economic damages) are capped at $250,000 apiece. “The Howards’ lives have been destroyed,” said Vaage. “Put in the context of healthcare reform, look at the cost to the public: We’ve lost a hard-working member of society; we have to spend millions of dollars to care for Mr. Howard; the state of California is ending up spending hundreds of thousands of dollars in disability payments; and our health insurance premiums keep going up. The real cost of healthcare is the cost related to the care of patients like Mr. Howard, not tort reform. Kaiser completely failed him.”

For further information please contact:
Robert F. Vaage, Esq.
The Law Offices of Robert Vaage
110 West C St., Suite 2105
San Diego, CA 92101
(619) 338-0505
(619) 338-0588 - fax

Thank you to Paul Payne of the The Press Democrat, for his report today on the ratings of seven Sonoma County Hospitals, by the non-profit Niagara Health Quality Coalition. The report cards were based on California Department of Health records for 2007, and covered 36 different procedures and conditions, as well as hospital errors and mortality rates.

A one-star rating indicates worse than average outcomes, two stars for average, and three stars were given for better than average. There was no overall grade.

Kaiser Permanente Santa Rosa was the only hospital in Sonoma County to receive three one-star below average ratings, for acute stroke mortality, birth trauma for infants, and post-operative hip fractures.

Cue KP’s PRBS response:

“To get the full picture of Kaiser Permanente’s superior quality, it’s important to review and balance both inpatient and outpatient ratings, and health plan services,” spokesman Carl Campbell said in a statement.

Right, because as long as they don’t harm every patient every day, then quality is “superior.” Superior to what, we ask? Of the seven hospitals rated, KP Santa Rosa had the highest number of below average ratings. Way to spin it, spokesliars, but somehow we doubt that statement will be a big comfort to pregnant mothers due to give birth at the Santa Rosa facility in the near future.

The complete Niagara Health Quality Coalition report card is available on the myHealthFinder.com website.

We received an interesting comment today, left by a Kaiser Permanente physician on Donna and Jack Berlin’s post about their son Sean’s death at Kaiser Walnut Creek.

We’ve said it before and we’ll say it again: It is not impossible to get good medical care at Kaiser Permanente. What IS impossible is getting them to take responsibility and make restitution when something does go wrong. And THAT in a nutshell is what makes Kaiser Permanente’s health plan and health care provider in one model more harmful than most other insurance companies. Our reply is below.

First, Robert’s comment:

I am a non Kaiser physician from Massachusetts potentially joining this organization, and objectively it seems that these problems are more with the medical system itself, rather than with Kaiser. Kaiser is an easier target because it is so big. If you think the problems mentioned above are scary, you should see what I see as a medical insider. Believe me when I say Kaiser does not hold the corner on the market of negligence. It is universal. Kaiser unlike other private practices does not provide incentives for their physicians to do more procedures. Whether you know it or not, this is a large source of complications and bad outcomes. As a for instance - a cardiologist saw a patient that came in for a slow heart beat. This physician stands to make money when he/she puts in the pacemaker. He/she ignores the fact that this particular patient’s heart rate is slow because of medications she is on. The pacemaker gets put in anyway. This patient then develops an allergic reaction to the tape on the dressing. The pacemaker wound then gets infected, and eventually the pacemaker itself. Within days, the infection is now in the heart forming an abcess. That is where we stand now.

I only point this out to show that there are far reaching problems that extend to all of medical practice. And while there still will always be bad outcomes, because nothing is perfect, I think at least some organizations make an effort to prevent that which is preventable.

Insurance companies do not want Obama’s reforms to go through because they are making tons of money with the current awful broken system. So fear tactics are employed. A website like this contributes to the fear tactics.

I am sorry for your loss, and if this was indeed preventable, we need to change our medical system so that this sort of thing doesn’t happen again.

And here is our reply:

Repost of a comment I wrote for the front page USA Today article about missing medical records in Beth Stover’s case:

Kaiser is different from traditional insurance in that the doctors essentially ARE the health plan (they would tell you differently) due to a deliberately deceptive organizational structure and physician profit-sharing. Most of the denials we hear about are from doctors ignoring patient complaints, or failure to treat or order necessary tests. Because of peer pressure and identical training a patient can seek a 2nd, 3rd or 4th opinion inside Kaiser and always get the same answer.

This creates a barrier between the patient and the health plan (Kaiser is all about barriers), prevents more complaints from making it to official grievance status, and allows Kaiser to claim health care decisions are only made by doctors. It’s not technically a lie, except that they have so thoroughly dumbed down the standard of care, and because they’re all in on it, the end result is the same as an insurance denial.

We’ve heard from lots of people who end up paying out of pocket to see a non-Kaiser doctor, who will order up the tests just like that and diagnose a problem that Kaiser may have missed for literally months or years. They miss it because they automatically treat every symptom as if it comes from the simplest, least expensive cause (chest infection vs. lung cancer for example). You could say the odds are on Kaiser’s side because most medical problems aren’t life threatening, and will clear up on their own without any intervention from a doctor at all. With the mandatory binding arbitration requirement, and Kaiser’s unlimited legal budget, they can easily slap down most cases that do make it to a lawsuit (they control ALL of the evidence and alter it at will), and even with an occasional big loss they will always be way ahead financially over treating the patients fully in the first place.

Robert stated that “Kaiser unlike other private practices does not provide incentives for their physicians to do more procedures.” Well no kidding, I think the taped conversation that John D. Ehrlichman had with Richard Nixon about KP’s business model made that fact crystal clear:

Ehrlichman: “Edgar Kaiser is running his Permanente deal for profit. And the reason that he can … the reason he can do it … I had Edgar Kaiser come in … talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because …”

President Nixon: [Unclear.]

Ehrlichman: “… the less care they give them, the more money they make.”

President Nixon: “Fine.” [Unclear.]

Ehrlichman: [Unclear] “… and the incentives run the right way.”

President Nixon: “Not bad.”

Kaiser would like the public to believe there is no incentive for its physicians to deny medical care. But what Robert failed to mention is that the Permanente Medical Groups, which employ the doctors, are the FOR PROFIT third arm of the Kaiser Permanente triad (the not for profit health plan and hospitals being the other two).

The for profit Permanente Medical Groups receive payment from the health plan, and the percentage of those payments that makes it into the doctors’ pockets just happens to have an inverse relationship to how much care is provided. So no, there’s no memo line on the check that reads “For Medical Care Denied”, but the incentive is implied in the math. So let me repeat: the doctors essentially ARE Kaiser Permanente, and they are FOR PROFIT. See how Robert’s intentions for posting here suddenly seem so much more clear?

So there you have it. Makes you want to run right out and sign up for Kaiser!

This heartbreaking story arrived in our in box a few days ago. There is only one thing we can think of that is more tragic than a mother having to bury her child, and that is having to live with the knowledge that the death occurred unnecessarily at the hands of the doctors entrusted to save him. Justice rarely prevails in these situations, because the system has long been stacked against patients and in favor of corporate abuse of money and power. We ask our readers to keep Sean Berlin in heart and mind as they witness KP CEO George Halvorson making his rounds, touting Kaiser-style health care “reform” for all… because your child could be next.

I’m writing to tell the story of our 32 year old son, Sean Berlin, who expired at Kaiser Permanente, Walnut Creek on 2/22/07 needlessly & wrongfully. Throughout his short stay — first at Kaiser Redwood City for sinus abscess surgery, and then a needless transfer to Walnut Creek on a holiday weekend to save money — Kaiser negligently failed to diagnose, treat, care for and manage him in connection with his medical condition. They also failed to recognize & timely treat him; failed to provide appropriate follow up procedures, medicines, testing, and screening; and he was allowed to deteriorate while unchecked & improperly monitored as his condition rapidly declined, resulting in his untimely death. He died from severe sepsis, which is a hospital acquired condition that can be treated if detected early enough and with the proper treatments. At all times, we feel Kaiser neglected to abide by the laws & rules of the proper standards of patient care.

We spoke with numerous attorneys who felt we had a case but were unwilling to take it because of the MICRA law in California limiting judgments. The three attorneys who did agree to take the case had to drop it for being unable to find a medical expert willing to testify in Kaiser’s rigged arbitration system. The last attorney extorted thousands of dollars from us before he forced us to drop the arbitration for the same reason — no medical expert willing to go through Kaiser’s binding arbitration. By this time the one year limit for filing arbitration had passed. We also filed grievances with JCAHO and the State Medical Board of California, and once again we were passed off and given the run around.

Losing a child is the most difficult thing anyone can ever go through. I hope that when people read this story they can make a judgment on whether this is the way they would like their loved one to be treated. I hope not because everyone deserves to be treated with the highest degree of care available. The Kaiser system is negligent in so many ways & needs to be accountable for its negligence.

Jack & Donna Berlin