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
Kaiser Thrive Exposed would like to personally thank Dr. Geoff Galbraith - Kaiser Permanente Care Management Institute board member; and Vice President, Hawaii Permanente Medical Group, Quality Improvement Management - for inspiring us to create this website. Did we make it into the top 5?
Absolutely devastating. This story proves so many of the evils of Kaiser and why they need to be put out of business. This clearly illustrates the high cost of bad care and why Kaisers business model cannot work and should not work.
I am speechless.
Just this morning as I was having my morning coffee, another touchy-feely kaiser commercial came on TV. It talks of how they are saving lives and saving trees with their electronic medical records. We see what a jewel those are.
The reality of the situation, as demonstrated by this heart-wrenching story, makes me want to vomit.
Congratulations Mr. and Mrs. Howard on your very rare win but I am sure you would rather have your life as you knew it back. What is money when the quality of your life has been stripped away. Bless You for all the pain and sheer hell Kaiser has put you through.
Congratulations to Tim and Mary I am so sorry for all the pain that kaiser has put you through.May the Lord bless you and your family as you try to start over.There are no words to express how sad this story is and what hell the family has gone through.I want to say congratulations to Robert Vaage a job well done he put his heart in this case.I hope Kaiser can learn from this case so no one else is hurt.Mrs Cheryl Pyle November 30th 2009
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Congratulations to Esquire Vaage for the free advertising supplied at the bottom of this vigniatte.
You and this site are truly are making our health care system better with these anecdotal tales of terror. Of course the above outcome is horrible and devastating, but it is important to remember that this is an exeption, not a rule. There is no such thing as perfection in medicine.
Rest assured, that if the above named patient went into renal failure from the contrast dye used during a CAT scan, Mr. Vaage would have been the first in line to sue for damages.
This is what is ruining our health care system, not a system like Kaiser.
When you wake up to the fear tactics put forward by special interest groups, maybe we can begin reform.
Who could have guessed that the only thing holding up health care reform would be little ol’ me?
As for providing Mr. Vaage’s contact information to the people who read this blog? What you call free advertising, we call a public service. Tomato-tomahto.
And speaking of special interest groups, Simon, you do know I can tell that you posted this comment from a Kaiser facility, right?
Wow! Admin, you have got the power. The power to hold up health care reform!
Here’s a thought for real healthcare reform, how about Kaiser stop trying to pull the wool over everyones eyes with their faux healthcare?
Exception? My butt Simon. You know as well as every Kaiser victim/member knows what the true underlying motivation is at kaiser…profit, profit, profit…withold, withold, withold.
Until Kaiser revamps their style there will be no health care reform.
Simon, maybe you aren’t aware of this?
http://www.whitehousetapes.net/clips/1971_0217_hmos/
I AM A STROKE SURVIVOR, ON MAY 18TH OF 2009 I WENT TO THE E.R. AT KAISER IN RIVERSIDE COUNTY, CA WITH A MAJOR INFECTION. MY BLOOD PRESSURE WAS OUT OF CONTROOL. KNOWING THAT I HAD A YEAR EARLIER ALMOST TO THE DAY OPEN HEART SURGERY FOR A VALVE REPLACEMENT, THE E.R. DOCTORS SENT ME TO STANDARD INPATIENT CARE INSTEAD OF I.C.U WHERE THEY COULD OF WATCHED ME BETTER. AFTER ABOUT 8 HOURS IN THE KAISER HOSPITAL I WAS SHOWING SIGNS OF NUROLOGICAL PROBLEMS, I.E THROWING UP, LOSS OF FEELING ON MY LEFT SIDE, SLURRED SPEECH. MY WIFE AMD FRIENDS NOTICED THIS AND WERE CONCERNED. A FEW HOURS LATTER I WAS HAVING MAJOR PROBLEMS MOVING THE LEFT SIDE OF MY BODY, ALL THAT I REMEMBER IS THE NURSE RIPING OFF MY CLOTHES AND SAYING ” WE THINK YOU ARE HAVING A STROKE” THEY THEN HAD ME GO TO HAVE A CT SCAN AND NOTICED A BIG BLEED AREA ABOUT THE SIZE OF A SMALL BALL ON THE RIGHT SIDE OG MY FRONTAL LOBE. THE THEN CALLED THE KAISER HOSPITAL IN FONTANA TO SPEAK TO A NUREO DOCTOR. THE DOCTOR IN RIVERSIDE HAD TO BEGG THE DOCTOR IN FONTANA TO TAKE ME. WITH ALOT OF POSTURING THE FONTANA DOCTOR AGREED TO TAKE ME IN. I WAS STABLE AT THAT POINT, THEN THINGS GOT WORSE, ABOUT 2/3 THE WAY TO KAISER FONTANA I STARTED GOING DOWN HILL. THE PAIN STARTED GETTING MORE INTENSE, MY BLOOD PRESSURE WAS DROPING FAST, I WAS LOSING THE FIGHT TO LIVE.AFTER ARRIVING AT KAISER FONTANA MY WIFE WAS CALLED, THE DOCTOR THERE TOLD HER THAT I WAS STABLE AND RESTING AND DONT BOTHER COMING DOWN TONIGHT. ABOUT AN HOUR LATTER SHE RECIEVED ANOTHER CALL, SAYING” YOUR HUSBAND IS CRASHING WE NEED THE AUTHORIZATION TO OPPERATE ON HIM AND YOU NEED TO GET DOWN HERE”. MY WIFE WAS IN A PANIC! ONE MINUTE HER HUSBAND WAS FINE, ONE MINUTE I WAS LOOSING MY BATTLE. I AWOKE FROM MY COMA ABOUT 3 WEEKS LATTER WITHOUT THE ABILITY TO MOVE THE LEFT SIDE OF MY BODY.
BEING AN ACTIVE 40 YEAR OLD MAN WITH YOUNG KIDS I COULD NOT GRASP THE NOTION THAT I WOULD NOT BE ABLE TO USE MY LEG OR HAND/ ARM AGAIN OR WALK WITH MY WIFE AND KIDS ON THE BEACH, PLAY CATCH OR THROW A FRISBY. IT TURNS OUT THAT KAISER DOCTORS HAD NOT PUT ME INTO I.C.U. BECAUSE IT WAS TOO EXPENSIVE, BUT THE INCREASED ATTENTION COULD HAVE PREVENTED MY STROKE BY MONITORING MY BLOOD PRESSURE CLOSER…. I AM ONE OF THE LUCKY ONES… I STILL HAVE MY LIFE BUT I CANT USE 1/2 OF MY BODY WHICH WAS TAKEN FROM ME BY A FAILED H.M.O. IF YOU LOVE YOURSELF AND YOUR FAMILY DO NOT CHOOSE KAISER EVEN IF THEY ATR CHEEPER INSURANCE. KAISER-WE LOVE YOU WHEN YOU ARE HEALTHY BUT WHEN YOU ARE SICK WE WILL KILL YOU!