From San Francisco Business Times

by Chris Rauber

The former administrator of Kaiser Permanente’s troubled Northern California kidney transplant unit has filed a wrongful termination lawsuit against the health-care giant, seeking at least $5 million in damages.

The suit, filed Friday in San Francisco Superior Court by the former administrative head of the unit, David Merlin, alleges he was terminated by Oakland-based Kaiser after two months on the job for raising concerns early this year about patient care and related issues in the transplant program, including violations of state and federal guidelines.

Those problems occurred after Kaiser brought kidney transplant services in-house in late 2004. Previously, Kaiser farmed kidney transplants out to non-Kaiser medical centers. Within a few weeks of starting his job in mid-December, the suit states, Merlin “discovered that the program was so poorly organized and unprofessionally managed that it failed to comply with state and federal requirements and was compromising patient care, leading to unnecessary suffering and possibly deaths.”

The unit served 19 Northern California medical centers, according to the suit, and received patients referred by 48 Kaiser nephrologists or kidney specialists throughout the region.

Along with wrongful termination, the suit — filed by Sacramento attorney Brian Taugher — alleges that Kaiser violated public policy and engaged in breach of contract, among other charges.

A Kaiser spokeswoman said the organization wouldn’t comment because it hasn’t seen the complaint.

Merlin is a former hospital executive at Brigham and Women’s Hospital in Boston, which is affiliated with Harvard University, Saint Francis Memorial Hospital in San Francisco and Saint Luke’s Hospital, also in San Francisco. His salary at Kaiser as the non-medical head of the transplant department was $128,000 annually, and he was charged with “responsibility for patient safety and risk management,” the lawsuit said.

Among its specific allegations about patient care and management of the transplant unit, the suit states that:

Three months after Merlin’s termination, in early May, federal and state regulators put pressure on Kaiser to close the unit and transfer about 2,000 kidney transplant patients to University of California, San Francisco, and UC Davis medical centers. Investigations into the operation and management of the unit continue.

Merlin’s suit says he tried to inform several top officers of the Permanente Medical Group, the for-profit Kaiser doctors’ group that ran the program, about his concerns but was rebuffed and told to “let it go.”

That process included Jan. 24 meetings with Nancy Langholff, assistant medical group administrator at Kaiser’s San Francisco medical center, and Diane DeCorso, Langholff’s boss, and a Feb. 6 meeting with Dr. Nora Burgess, who held the dual titles of chief of cardiothoracic surgery and chief financial officer, according to the complaint. The suit said Merlin’s attempt to take his concerns to Bruce Blumberg, M.D. — then the hospital’s physician in chief — were “refused.”

Instead, the complaint contends, Merlin was told Feb. 10 that he would be fired Feb. 14, reportedly for violating the organization’s alcohol and drug policy, leaving “inappropriate voicemail messages,” and refusing to meet with the hospital’s human resources director. The suit said Merlin took a few sips of beer after hours in his office during a meeting with Dr. Sharon Inokuchi, then the unit’s medical director, left voicemails regarding his quality and patient-care concerns, and rescheduled a meeting with the HR director.

The suit describes the reasons given for termination as pretexts, and says Merlin “was really being terminated because he had raised questions about the kidney transplant program’s poor management and the risk that the program posed to patients.”