[It's late and I'm tired, so I'm posting this without commentary. I'll add more information as the news stories start trickling in tomorrow. But whew! 3.2 million.]

From the OC register:

Kaiser pays $3.2 million in birthing malpractice case

A now 14-year-old girl wasn’t breathing when she was born at the Anaheim hospital.

BY COURTNEY PERKES

A 14-year-old Lake Forest girl who suffered brain damage during her birth at Kaiser Permanente’s Anaheim hospital received a $3.2 million settlement this month.

Ariana Ehtemam wasn’t breathing when she was delivered by Caesarean section and now suffers from physical and behavioral problems, according to court documents.

The money from Kaiser has purchased an annuity worth $20 million over her lifetime. She will receive the first payment at 18.

Her parents, Ardie and Ela Ehtemam, declined to comment through their attorney, Frank Barbaro.

The settlement was reached after a binding arbitration decision in favor of the family.

“We were surprised by the verdict but want to extend our sympathy to the family,” Kaiser spokesman Jim Anderson said Tuesday.

According to court settlement papers filed Jan. 11, Ela Ehtemam’s C-section wasn’t performed in a timely matter. The baby had to be resuscitated and spent several weeks in the hospital. Ariana now suffers from hearing loss, poor impulse control and attention deficits.

The money will pay for future medical expenses, ongoing rehabilitation services and any residential supervision she may need.

“She is keeping up with her schooling,” Barbaro said. “She has to have a lot of accommodations. She has these wonderful parents who really do protect her and a school district responding to her need.”

In California, malpractice judgments are capped at $250,000 for pain and suffering. Additional monetary damages result from loss of wages and need for ongoing care. Some of Orange County’s largest medical malpractice judgments have exceeded $15 million.

Late last year, Kaiser paid $1.8 million to the family of a Huntington Beach man who suffered a brain aneurysm after his headache was misdiagnosed.

Contact the writer: 714-796-3686 or cperkes@ocregister.com

[Same old story: complaints were ignored, patients died, whistleblowers were retaliated against, and Kaiser denies any wrongdoing regardless of copious evidence to the contrary. It happens so often we would be bored if it wasn't so damned tragic. Scroll down to the bottom of the story for a link to the original report about this incident from last October.]

From the LA Times:

Report criticizes Kaiser for lack of action

Federal inspectors fault its Fresno hospital’s response to complaints about a doctor who allegedly fatally botched two deliveries.

By Tracy Weber and Charles Ornstein

If Kaiser Permanente’s Fresno hospital had acted on complaints and kept a closer watch over its medical staff, two babies might still be alive, federal health inspectors concluded in a report released this week.

The U.S. Centers for Medicare and Medicaid Services began investigating the hospital in October, two days after the Los Angeles Times reported that doctors and nurses had complained repeatedly to higher-ups about perinatologist Hamid Safari’s medical and interpersonal skills.

Rather than address their concerns, hospital leaders allowed Safari to continue treating high-risk pregnant women without restriction, staffers told the newspaper.

Safari allegedly botched at least two deliveries after staff members had raised concerns. One baby died in the delivery room; another, months after her birth.

In its report, the Medicare agency criticized the way Kaiser Fresno responded to those deliveries, both of which were detailed in The Times story. At least one staffer told inspectors that Kaiser had received complaints about Safari as far back as 1998.

In a written response to the report, Kaiser Fresno administrator Susan Ryan defended the hospital’s quality oversight program and said officials took appropriate action after Safari’s alleged mistakes.

In a statement to The Times on Friday, Ryan said, “These are difficult and emotional situations, and we empathize with all involved. When these events occurred, they were thoroughly investigated and corrective actions were taken. This has led to significant improvements in our perinatal safety program.”

In one of the two cases cited by inspectors, Safari waited more than three hours before he performed a caesarean section on a patient in 2004 — even though there was clear evidence that her baby was in distress, the report said. The baby was severely deprived of oxygen and died months later.

One Kaiser nurse told inspectors that she fruitlessly voiced concerns about the baby’s condition to Safari, and that after the delivery, the perinatologist “was hounding nurses” and telling them how to describe the incident in the medical records.

Another staffer told inspectors there was a “violation of common sense and standard of practice” during that delivery.

In the other case, in April 2005, Safari allegedly severed the spinal cord of a baby after repeatedly and vigorously attempting to draw him out with a vacuum extractor. When the baby finally emerged, he was “white as a sheet” and unresponsive, staffers told inspectors. He died.

A clinical summary documented that the baby “had a good fetal heart rate up to the time of delivery,” the Medicare report said.

One nurse told inspectors that after the baby was pronounced dead, Safari was “angry and yelled at everyone else saying it was their fault.” Safari then “harassed” staff members and told them what to write in the medical records, the nurse said.

In July 2005, three months after the second baby’s death, Kaiser imposed restrictions on Safari, barring him from performing vaginal deliveries and requiring him to be monitored by another physician or advanced-practice nurse. The restrictions became permanent last April, hospital officials said.

Since September, Safari has not performed any surgeries or c-sections and has served only as a consultant at the hospital, Ryan wrote Friday.

The federal report refers to additional guidelines that had been put in place for Safari, including a rule that he make his rounds with a high-risk nurse specialist. But nurses told inspectors that Safari did not follow those rules, and the hospital did nothing about it.

One perinatal nurse said Safari’s failure to comply “was a serious and significant problem with potential negative impact” on his patients. The federal report concluded that Kaiser’s failure to hold Safari accountable “placed patients at risk.”

In her statement to The Times, Ryan wrote that the hospital “will take further steps to ensure Dr. Safari is accompanied during rounds.”

The federal report is the latest in a series of critical assessments of Safari, Kaiser Fresno and the giant HMO itself, the nation’s largest, with 6.5 million members in California.

In September, the state medical board accused Safari of gross negligence, seeking to revoke or suspend his license. And Kaiser’s handling of the matter is the subject of a civil lawsuit filed by two doctors who claim they were punished for raising concerns about the April 2005 incident in which the baby died. Kaiser denies the allegations.

Safari’s lawyer, Stephen D. Schear, said he believes his client will be exonerated. He also speculated that the federal report was based on “bad information” from the same sources who talked to the medical board and perhaps The Times.

“This is all just a tragic smearing of a very excellent doctor by people who had motivation and the means to ruin his reputation without basis,” Schear said.

Previously:

Kaiser covers up for another negligent doctor, whistleblowers retaliated against — AGAIN

[One of the more disturbing patterns that has emerged over four years of tracking Kaiser's many misdeeds, is that patients with very real and serious medical problems are often misdiagnosed with mental health issues, leading to much unnecessary suffering, and sometimes death. A few recent examples are the cases of Jupirena Stein, Craig Pozzi, and a woman with West Nile Virus, who was repeatedly told her symptoms were all in her head even after a positive blood test confirmed the infection. For the reason behind this troublesome trend, one need look no further than Kaiser's clinical practice guidelines, where Kaiser doctors are instructed to label anyone with an undiagnosed illness as a psych case.

Update 12/9/07: We have added a scan of A Secret of Behavioral Health Integration: The Handoff from "The Collected Papers of Nicholas A. Cummings, Volume I: The Value of Psychological Treatment." In it he describes the process by which Kaiser members are manipulated into accepting mental health treatment for physical illnesses.

The money quote (because it's always about the money at Kaiser):

"Without this seemingly simple touch, patient compliance was not very good, but with this idea of the handoff, compliance jumped to 90 percent. And the saving in medical costs was tremendous."

Cummings developed the Kaiser Behavioral Health Division.]

From the OC Register:

Kaiser to pay $1.8 million in malpractice case

45-year-old man was not diagnosed with cerebral bleeding and later suffered permanent brain damage.

BY COURTNEY PERKES

Kaiser Permanente will pay $1.8 million to the family of a man who suffered a brain aneurysm after his headache was wrongly attributed to grief.

In 2005, 45-year-old Ted Blackwell visited a Kaiser clinic in Orange County with a headache and neck pain. According to the binding arbitration document, doctors attributed his symptoms to grief over the death of his brother eight days earlier.

He received an injection and was sent home.

Blackwell returned to the clinic two days later, still in pain. According to the document, his daughter requested a CT scan because of her father’s disorientation but doctors decided that wasn’t necessary.

Two days later, Blackwell collapsed and underwent surgery at Hoag Hospital for bleeding in his brain. He suffered permanent brain damage and is unable to work, according to his attorney James McElroy of Del Mar.

Jim Anderson, a spokesman for Kaiser, expressed sympathy to Blackwell, but added “we thought differently in this or we wouldn’t have taken it to arbitration.”

The award, decided by arbitrator Robert Devich, covers pain and suffering and lost wages, but the bulk is for around-the-clock supervision for the rest of Blackwell’s life.

In California, malpractice judgments are capped at $250,000 for pain and suffering. Additional monetary damages result from loss of wages and need for ongoing care.

Contact the writer: 714-796-3686 or cperkes@ocregister.com

[The most appalling thing about the needless death of this Kaiser member -- who suffocated and died due to a severe allergic reaction to an antibiotic -- is that the Kaiser doctor and nurses that were present didn't know what to do to save her. They called 911 instead, and the patient wasn't given what should have been a life-saving shot of epinephrine until she was in the ambulance on the way to the hospital, when it was too late. Let that sink in for a minute. She was in the doctor's office, where presumably the drug that could have saved her life was sitting in a cabinet nearby -- if only they had used it -- but they didn't and she died. With no medical training whatsoever, even we know that epinephrine should be administered for severe anaphylactic reactions, and that time is of the essence. The EMTs in the ambulance certainly knew it. Everyone knew it but the health care "professionals" at Kaiser. Be very afraid.]

From the Maryland Daily Record:

Family: Death from drug allergy was preventable

BRENDAN KEARNEY
Daily Record Legal Affairs Writer

The family of a Temple Hills woman who suffocated after receiving an antibiotic at a Kaiser Permanente facility has filed a claim against her doctor and health plan, alleging they failed to recognize and treat her allergic reaction to the drug.

According to the filing, Laverne Williams, 54, had trouble breathing immediately after receiving intravenous Rocephin at Kaiser’s Camp Springs Medical Center.

“You don’t go to Kaiser to die,” said Christian A. Lodowski, the plaintiffs’ lawyer. “Mrs. Williams relied upon the wrong people to do the right thing. Kaiser just blew it.”

Williams, a retired federal government worker, sought treatment for urinary tract problems at the center on the evening of Dec. 11, 2006.

According to the claim filed this week with the Health Care Alternative Dispute Resolution Office, Dr. Sharada Jain prescribed the intravenous Rocephin.

When Williams became unresponsive, Jain and the nurses stopped the intravenous drug and administered oxygen therapy, then cardio-pulmonary resuscitation and automated external defibrillation, according to medical records.

But they never gave her epinephrine, “the definitive treatment” for anaphylaxis, which they should have had close at hand, the claim states.

“Sadly, over the next several minutes the Health Care Providers stood by while Decedent suffocated and became brain dead right before them,” the claim says.

Lodowski said the case is the worst his medical expert has seen in 20 years.

“For that doctor to not think and do something is just so far below the standard,” Lodowski said.

Lodowski is representing Williams’ husband and two adult children in the claim against Jain, a family practitioner, and the Kaiser Foundation Health Plan of the Mid-Atlantic States Inc., the nonprofit health plan component of Kaiser Permanente.

Lodowski said he plans to waive arbitration and file the claim as a lawsuit in Prince George’s County Circuit Court next week.

Amy Goodwin, a spokeswoman for Kaiser Permanente, said the Health Insurance Portability and Accountability Act prevents her from speaking about the specifics of the incident.

“This is an unforeseeable event,” Goodwin said. “We would like to comment on the medical facts of this claim but we are prohibited by federal privacy regulations. When the truth comes out in the court of law, it will show that we delivered excellent care.”

Williams had been given Rocephin during previous visits to the facility and had no known allergies, according to the medical records. But reactions can occur on second or third exposure, Lodowski said.

“You have to take patients as they come,” he said.

Full Story

Ian Bogost of Kotaku has written a not so healthy review of Kaiser Permanente’s much hyped new health game for kids, the Incredible Adventures of the Amazing Food Detective. It’s nice to know we’re not the only ones who recognize Kaiser PRBS? when we see it:

Kaiser is a big company with a lot of money, and it’s good that they are seeing value in games and choosing to invest in them. But they are trying to buy legitimacy they have not earned. As Spider-Man would say, with great power comes great responsibility. This game is not education and it’s certainly not health advocacy. It’s unadulterated and nefarious public relations. If you use it for anything, use Amazing Food Detective to teach your kids how corporations vie to buy their attention, not to teach them to eat carrots instead of potato chips.

Well said, Ian.

If you can stand it, read the full review for more about how Kaiser’s PR pushers have been cramming the Brand Baloney — disguised as a video game — down the throats of America’s children.

Note to Kaiser: Perhaps you misunderstand what critics mean when we call for more transparency at KP? What we don’t want is another transparent attempt to manipulate public perception. What we do want is more honesty and openness, and less ulterior motive behind everything you say and do. Hope we were able to clear that up.

[We're practically speechless, so we'll just ask one question: How can a non-profit double its net income -- with zero membership growth -- and still call itself a non-profit?]

From San Francisco Business Times:

Kaiser Permanente’s 9-months’ profit more than doubles to $2.5 billion

by Chris Rauber

Kaiser Foundation Health Plan Inc., Kaiser Foundation Hospitals and their subsidiaries announced gigantic jumps in net income, operating income and investment income for the third quarter ending September and the year’s first three quarters, including startling increases sure to raise questions about the organization’s non-profit status.

Operating income more than doubled from $868 million in the first three quarters of 2006 to $1.8 billion this year, and first nine-months’ net income soared from $1.1 billion to $2.5 billion, officials said Nov. 7.

Net income in the third quarter, meanwhile, jumped 56.8 percent, from $417 million last year to $654 million for the quarter that ended Sept. 30.

In other major developments, officials at the Oakland-based health-care giant said Wednesday:

* Third-quarter operating income jumped 26.5 percent from last year’s $355 million to $449 million.
* Operating revenue for the quarter was $9.4 billion, up 8 percent from $8.7 billion a year earlier.
* Operating revenue for the first nine months jumped 9.3 percent, from $25.8 billion to $28.2 billion.

Kaiser also posted $205 million in non-operating third-quarter income, resulting in a quarterly net income of $654 million, up nearly 57 percent from $417 million in 2006’s third quarter. Kaiser attributed that explosive growth to a strong performance in finanical markets.

* Capital spending totaled $641 million for the third quarter, compared to $631 million a year earlier, while year-to-date capital spending for the nine months ended September 30 was $1.8 billion, compared with $1.9 billion during 2006’s same nine-month period.

Membership remained “relatively flat” at 8.7 million members. Officials at the Oakland-based health-care giant said “ongoing efforts to address health-care delivery costs and administrative efficiencies” contributed to the strong financial results for the quarter.

Full Story

Previously:

• Non-Profit Kaiser poster child for health insurance rate regulation
• Non-profit in name only
• Non-profit Kaiser earned more than DOUBLE the combined California proceeds of three for-profit health plans
  

[Another day, another lawsuit settled. In an unprecedented move Kaiser Permanente admitted no liability, even while handing over the check. Ha ha. That was supposed to be funny, but it's difficult to see the humor when you realize that there are real human lives that are being disrupted -- and in some cases ruined or ended -- because this organization has taken refusing to accept responsibility for its actions to the level of absurdity. It's this simple: you can't correct problems that you won't admit exist.]

From the Associated Press, via Forbes.com:

Kaiser to Pay to Settle Lawsuit

By JAYMES SONG 11.07.07, 9:48 AM ET

HONOLULU - Kaiser Foundation Health Plan Inc. will pay $180,000 to a labor and delivery nurse to settle a lawsuit that claimed the woman’s promotion was rescinded after she disclosed her pregnancy, officials said Tuesday.

Margaret McIlroy was offered a promotional transfer in 2003 from Kaiser Permanente Southern California to a clinic on Maui. Two weeks before starting the job, she disclosed her pregnancy and in less than 24 hours, she was told the offer had been withdrawn, the U.S. Equal Employment Opportunity Commission said.

“Standing up for my civil and God-given rights has come at an incalculable and a never-ending cost to my family and myself, but I felt strongly that I had to speak out,” McIlroy said in a statement.

McIlroy, who was 44 at the time, eventually lost her job. She and Kaiser also entered into a separate confidential agreement to settle her non-civil rights claims.

“Pregnancy discrimination strikes its victims at a time when they are quite vulnerable,” said Joan Ehrlich, EEOC’s San Francisco district director.

In a statement, Kaiser said it has always been an advocate for fair hiring practices and respects and adheres to all equal opportunity requirements.

“From the outset of this case, we have maintained that we followed all state and federal hiring laws; however we agreed to resolve the matter in the interest of all parties concerned,” Kaiser said.

It added that the settlement was reached with no admission of liability on Kaiser Hawaii’s part.

Besides the monetary settlement, Kaiser agreed to revamp its pregnancy policies and training programs. The company must also provide annual reports to the EEOC detailing its investigation and resolution of any internal complaints of pregnancy discrimination in Hawaii.

Kaiser, based in Oakland, Calif., serves nine states and operates 16 clinics on Oahu, Maui and the Big Island.

“We have an outstanding record of supporting and caring for staff and physicians throughout their pregnancies and as they transition back to work,” the company said. “We will augment our already extensive policies and training programs to better reflect what our actual practices have always been.”

A record 4,901 pregnancy discrimination complaints were filed with the EEOC last year.

[In early September we posted a letter written by Kaiser victim Jupirena Stein, that had been previously mailed to Kaiser CEO George Halvorson. Ms. Stein's health has literally been ruined by a botched surgery at Kaiser, and over a six year period she has collected extensive documentation supporting her claims. Halvorson's response? Zip. Zero. Zilch. Nada. The man's organization has practically ruined this poor woman's life and he couldn't even be bothered to reply. Instead, she had to call him.

Rather than a return call from the man himself, Mr. Halvorson saw fit to have his senior attorney, Mary Parks, call Ms. Stein back, and all Ms. Parks would say in response to Ms. Stein's heartfelt letter was that "Kaiser has no knowledge of any wrongdoing." Of course they don't; they never do. Except in this case it was an even more obvious lie than usual, because Ms. Stein has certainly informed Kaiser, on more than one occasion, of copious amounts of wrongdoing.

Mr. Halvorson has been sending out weekly email updates to all of his employees, and whenever the opportunity presents itself he makes a point of saying something similar to this quote from his 5-year anniversary post: "As an organization of caregivers, we all feel collective pain any time we mis-deliver care." Every chance he gets, he also likes to repeat that he sympathizes with people who have been harmed when a mistake has been made. But actions speak louder than words, and the reality of how Kaiser treats everyone who complains certainly doesn't include the kind of sympathy that involves willingly making restitution to anyone whose life has been destroyed by Kaiser; or even acknowledging any wrongdoing, as Attorney Parks made perfectly clear. We haven't been able to find one single Kaiser member who has been treated like a human being in a dispute with this "sympathetic" organization, and believe me, we have been actively trying.

Below is Ms. Stein's latest write-up, which describes in detail the hell Kaiser put her through while trying to get her issues addressed. If you think it can't happen to you, think again. You also might want to think twice before choosing to renew your Kaiser membership now that open enrollment time is approaching, or risk finding yourself among the future ranks of the harmed and ignored.]

The first year after my surgery

Please Keep in mind that I have all proper documentation to support my words. I believe (my opinion,) that KP’s doctors are treating patients to an extreme level of lacking medical knowledge, with disrespect, intolerance, and indignity.

Here’s why:

ABOVE ALL DO NO HARM

For centuries those words from the Hippocratic Oath have guided physicians in the care and treatment of their patients. This Oath became the nucleus of all medical ethics. In its most compelling portions, it emphasizes the profundity of the medical covenant, patient dignity, the confidentiality of the transaction, and the physicians responsibility to guard against abuse or corruption of his knowledge and his/her art.

American Medical Association (AMA) Principal of Medical Ethics — Rule number 1:

A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.

What I am about to write is so absurd it is hard to believe it, but this is all true.

I did not see Dr. Wolgat, Kaiser’s ENT/Professor in charge of my surgery before my surgery — at all. I did not see him during my surgery because I was obviously under general anesthetic. I have no idea if he was there or not. He said he was. He did not come to see me after I woke up, nor for those 2 days that I stayed in the hospital.

The first thing I can remember after I woke up, was that I had the most devastating type of headache one can imagine, and Dr. Timoth Wild asking me to smile. “Smile. Smile. I need you to smile for me.” Later on I came to understand, if I would be able to smile at that point in time, he would know his scalpel did not “hit” my facial nerve. He was certainly worried about it.

My family came to see me and so did Dr. Wild. On the second day before I went home, I saw Dr. Wild for the very last time. I asked him, “My head hurts badly, did everything go ok?”

He answered, “Yes, with the exception that at one point your blood was squirting out of your neck.” I was so impressed with his words, it reminded me of the movie M.A.S.H.

For the next 10 months I was in and out of Kaiser doctor’s office, at my request, being sent from one to another to another doctor. All of them told me that I was OK. That I was perhaps in need of psychiatric help because I could not accept the fact that I was diagnosed with cancer.

All of them lied to me about my injury. They “worked” carefully together, and all of them hid this devastating vascular injury from me and from my family.

NOTE: Ten days after my surgery Kaiser Permanente Pathology, come up with the diagnosis of a rare type of cancer (at that time) named Acinic Cell Carcinoma. It was found in my parotid gland, and involved 1 lymph node. KP cancer diagnosis is our next subject.
Continue Reading »

From the San Francisco Chronicle:

Doctor admits to perjury in trial of man he sponsored in drug rehab

Heather Knight, Chronicle Staff Writer

A San Francisco surgeon has pleaded guilty to perjury, admitting he lied under oath in an effort to get a man he had sponsored in a drug rehabilitation program off the hook for gun charges.

Bruce Barker, who remains a physician for Kaiser Permanente, was the key witness in the 2002 trial of Marvin Washington, a felon accused of illegally possessing a gun outside his home in San Francisco’s Holly Courts public housing project.

Prosecutors said a security officer at the housing project reported hearing gunshots at 5 p.m. on May 1, 2002, and saw Washington running with a gun. Police officers responded to the scene and found a semiautomatic pistol on the ledge outside Washington’s kitchen window and found a substance on his hands that tested positive for gunshot residue.

But Barker testified at length that he had been visiting Washington at the time and that he had been carrying a cell phone, not a gun. Barker had sponsored Washington in an organization he called Men in Motion.

“I know he’s innocent,” Barker testified. “I was there. I saw this. I know he’s innocent.”

Prosecutors said Barker’s account was impossible because the doctor had been performing surgery at the time - 4 miles away at the Kaiser Permanente Medical Center on Geary Boulevard. Hospital records showed he’d been working in the Post-Anesthesia Care Unit until 5:35 p.m. that day.

Washington’s trial ended when he pleaded guilty to being a felon in possession of a firearm and carrying a gun with an altered serial number. A judge sentenced Washington to more than eight years in prison.

The FBI began an investigation into Barker’s testimony. A federal grand jury indicted him last year on three counts of perjury and one count of making a false statement to law enforcement.

Barker pleaded guilty to one count of perjury on Wednesday, admitting he knowingly and intentionally provided false testimony in Washington’s trial.

The sentencing of Barker is scheduled for 11 a.m. Feb. 8 He faces a maximum of five years in prison and a $250,000 fine. Barker is not in custody pending sentencing.

Kaiser spokeswoman Meg Walker said, “Dr. Barker does practice here at Kaiser Permanente in San Francisco, and we are reviewing this latest development.”

Previously:

Kaiser surgeon indicted for perjury

It’s our guess that most Kaiser Permanente members aren’t aware that Kaiser was run out of Texas like a stray dog with its tail between its legs, but that is about to change, thanks to Vickie Travis and The Kaiser Papers:

In 1997 the State of Texas, Division of Insurance took formal action against Kaiser Permanente. This action and the resultant Kaiser ceasing of conduct was the start of serious financial concerns for the Permanente.

This information is just as relevant as the Nixon tapes are. Do not allow anyone to try to tell you differently.

This is one of the key actions that resulted in numerous patient deaths, for the next several years.

In this instance Kaiser had been found to be deceiving the public, harming the public and endangering the public and the people of Texas did not like it. The standard Kaiser excuse of poverty just didn’t work for them in Texas. The people of Texas also have a very long memory.

The State of Texas has provided to us the documents showing why the Insurance Commissioner took the steps that he did, what he did and what Kaiser had to do. I wish that the state of California would do something solid like this instead of being a bunch of wishy, washy fools.

The text version leads on the following page. Following the text are the actual documents. Again why can’t California be grown up enough to do the same?

http://fines.kaiserpapers.info/texasorder.html