[kaiserthrive.org editor's note: This is far from an isolated incident. We hear from people on a regular basis who have been referred to Kaiser Behavioral Health because their doctor can't figure out what is wrong with them. It is ingrained in the Kaiser culture to blame the patient rather than question the competence of the diagnostician, as evidenced by Kaiser's clinical practice guidelines, which instruct Kaiser physicians to label anyone with an undiagnosed illness as a mental health problem.]

From The Columbian:

Late artist’s family wins $4.5 million malpractice case

By STEPHANIE RICE, Columbian Staff Writer

A Clark County Superior Court jury has ordered Kaiser Permanente to pay $4.5 million to a Vancouver woman whose late husband’s brain tumor went misdiagnosed for several years.

Craig Pozzi, an artist who taught photography at Clark College, died Nov. 12, 2004. He was 61.

Doctors testified during the two-week trial that if Pozzi’s tumor had been diagnosed in 1994, when he first sought treatment, he could have lived 15 to 25 years.

Instead, he was told by doctors he was experiencing panic attacks and given a prescription for Paxil, which is often used to treat anxiety and depression.

The tumor was diagnosed in December 2001, when it was the size of a racquetball.

Pozzi’s wife of 25 years, artist Angela Haseltine Pozzi, said Wednesday she was exhausted from the trial.

Having jurors conclude that Kaiser’s negligence led to her husband’s death was a painful reminder he should still be alive.

“I’m in shock,” she said. “It’s not like you can celebrate.”

The verdict was returned late Tuesday evening after the 12 jurors deliberated more than 16 hours over three days.

Mary Sawyers, a spokeswoman for Kaiser, said the company has not decided whether to appeal.

“We extend our condolences to Mr. Pozzi’s family,” she said. “We respectfully disagree with the jury verdict, and we are considering our options.”

Kaiser was represented by attorneys from the Portland firm Hoffman, Hart and Wagner.

Attorneys Paul Henderson of Vancouver and Connie Taylor of Lewiston, Idaho, represented Pozzi’s family, which includes a daughter, Nicola, of Olympia.

Henderson said Wednesday that the ‘panic attacks’ Craig Pozzi was told he was having were really mild seizures. During the seizures he wouldn’t lose consciousness. Instead, he would have a feeling of fear that would last as long as a minute, a feeling that began in his abdomen and rushed to his head.

Two doctors diagnosed the episodes as panic attacks. In 1999, a doctor looked at the 1994 diagnosis and concluded Pozzi needed to increase his dosage of Paxil, Henderson said.

“Of the three physicians who looked at him, not a single one considered seizures,” Henderson said. Henderson told jurors that an $800 brain scan could have caught the tumor in 1994.

Part of the tumor was removed in a January 2002 surgery. Afterward, Pozzi remarked to his neurosurgeon that he was no longer experiencing panic attacks, and the doctor explained that what he had been told were panic attacks had really been seizures.

The tumor grew back. Pozzi, who suffered a stroke during post-surgery radiation treatment, died at the Ray Hickey Hospice House.

Full Story

The Kaiser Papers has just posted a detailed declaration by whistleblower Dr. William Moores, in the case of past Kaiser San Francisco Medical Center Chief of Cardiovascular Surgery, Dr. Terry McEnany. This guy was so incompetent and dangerous he makes Jayant Patel look like Marcus Welby, MD.

This is one of the most egregious cover ups by Kaiser and The Permanente Medical Group (TPMG — the Kaiser Northern California physician’s group) that we have had the displeasure to read, ever. And that’s really saying something, considering the horrifying stories people send us about Kaiser Permanente every single day.

How would you like this butcher performing your heart surgery:

The “index case” that the Chief of Surgery, Dr. Douglas Grey cited as compelling the formal review was a case where Dr. McEnany forcefully removed a catheter entrapped in a patients heart, with the immediate result of the patient bleeding to death in the post operative intensive care unit.

Yeah, we’d say a review was in order all right. Too bad it came ten years too late:

The TPMG administration knew that they had to initiate a formal evaluation of Dr. McEnany’s practice, but wanted to do it in the quietest manner possible, reflecting perhaps the fact that by now they had tolerated the consequences of Dr. McEnany’s incompetence for a decade.

Everyone who worked with Dr. McEnany knew he was killing people, and many of the doctors refused to refer their patients to him. Still it took a decade for anyone to act on that knowledge, and when a formal review was finally initiated, it was later dropped in favor of allowing McEnany to “quietly resign.” No report was filed with the medical board of California, and a secret deal was negotiated by McEnany’s attorney for “a laudatory letter of recommendation” to be sent to his new employer — Luther Hospital in Eau Claire, Wisconsin — where many more of McEnany’s patients were harmed and killed.

For his part in exposing the cover up, whistleblower Dr. William Moores was retaliated against.

The Kaiser Papers has the whole sordid story here.

[kaiserthrive.org editor's note: Kaiser often defends repeat malpractice offenders -- such as Dr. Death Jayant Patel -- for years, resulting in many unnecessary patient deaths. Unlike medical care, where every penny is pinched, Kaiser spares no expense defending its negligence. The running joke is that Kaiser will spend $1,000,000 to defend a $1,000 claim, and to say that Kaiser lawyers play dirty to win is unfortunately a gross understatement. Never forget who is footing the bill: that's right, YOU.]

From the Bakersfield Californian:

Negligence claims go to medical board

Doctor’s license on the line amid allegations of endangering patient

BY EMILY HAGEDORN, Californian staff writer

The state medical board is seeking to revoke or suspend a local physician’s license after her patient was not admitted to the hospital promptly and developed blood poisoning.

The state attorney general, on behalf of the medical board, says Dr. Degrasia Anne Howard committed multiple acts of gross negligence, in a report filed June 15.

Howard could not be reached for comment.

“We will be cooperating fully with the medical board, but we are defending Dr. Howard in this case,” said Cristy Cortez-Sackrider, spokeswoman for Bakersfield’s Kaiser Permanente, for which Howard works. Cortez-Sackrider wouldn’t comment on the specifics of the case.

On April 9, 2005, Howard saw the female patient, identified as “K.Z.,” in the medical board filing, and noted the patient had abdominal pain, bloating, loose stools and bleeding for five weeks.

After looking at stool samples, a colonoscopy and biopsies, Howard determined the patient was probably suffering from ulcerative colitis, a type of inflammatory bowel disease that affects the large intestine and rectum, the medical board’s report says.

The patient did not respond to medication and during the next three to four weeks continued to have bloody stools and as many as 30 bowel movements a day. She continued to see Howard, who tried different medicines, but to no avail, the filing says.

On May 7, 2005, the patient was admitted to the hospital for diarrhea, acute respiratory distress syndrome, pneumonia with respiratory failure, anemia and septic shock, which is a serious condition that occurs when an overwhelming infection leads to low blood pressure and blood flow and may cause the brain, heart, kidneys and liver to fail, the filing says.

She was in the hospital through May 19, 2005, and made a gradual and slow recovery.

“The accusation alleges negligent care of a patient with a history of bloating and bloody diarrhea and for not admitting the patient directly to the hospital,” said Candis Cohen, spokeswoman for the medical board.

Anytime there’s an adverse outcome with a case, it is reviewed internally, Cortez-Sackrider said.

Howard does not have any other public disciplinary actions against her license, according to the medical board’s Web site.

She is still practicing medicine, Cortez-Sackrider said.

Howard graduated from Howard University’s College of Medicine in 1978 and has had her California license since December 1982.

The medical board is seeking a hearing in which the board is advocating that Howard’s license be revoked or suspended, her authority to supervise physician assistants be revoked or suspended or that if placed on probation, she is made to pay the costs of probation monitoring.

According to the Office of Administrative Hearings Web site, a hearing date has not been set.

From the L.A. Daily News:

New homeless dumping allegation probed

BY KERRY CAVANAUGH, Staff Writer

The City Attorney’s Office is investigating whether Kaiser Permanente dumped a homeless patient on Skid Row, in violation of a settlement reached in a previous case.

The latest inquiry began after officials learned that workers from Kaiser’s Baldwin Hills hospital took a 26-year-old man with severe back pain to homeless shelters downtown against his will, officials said.

Kaiser spokesman Jim Anderson said the man agreed in writing to be dropped off at a facility near downtown and Kaiser hired a third party to drop the man off there. It was unclear how he wound up at a homeless shelter, Anderson said.

City Attorney Rocky Delgadillo is investigating the incident, which took place last month. His office said the hospital is cooperating.

As part of a settlement with Delgadillo’s office reached earlier this year, Kaiser agreed to adopt a protocol for releasing homeless patients.

In June, however, Kaiser employees allegedly tried to take Jose Gonzalez, 26, to the New Images shelter on Skid Row, although he was suffering severe back pain and using a walker.

New Images would not accept him because it cannot accommodate people with walkers, according to the American Civil Liberties Union, which is representing Gonzalez.

The Kaiser workers then took Gonzalez to the Union Rescue Mission, the City Attorney’s Office said.

But Anderson said Kaiser informed New Images it would be dropping off Gonzalez and that New Images was aware that he had a walker. He was to stay at New Images for a day and a half before being transferred to Project Achieve, which provides the social services Gonzalez needs, Anderson said.

ACLU Legal Director Mark Rosenbaum said Kaiser needs to do more than just adopt a protocol.

“It’s clear that there is a very ingrained culture at Kaiser that equates being homeless with the idea that you can be dumped in Skid Row,” he said. “Here needs to be serious discussion on what can be done to change that.”

The impending release of Michael Moore’s scathing indictment of the US Health Care industry, ‘SiCKO’ — which features one Kaiser Permanente scandal after another — has the Kaiser PR goons working overtime. With their usual intent to baffle, befuddle and bamboozle, they would like to convince you to disbelieve what you see and hear with your own eyes and ears.

According to Raw Story:

The film’s most interesting scene is an archived White House conversation between then-President Richard Nixon and his aide John Ehrlichman that Moore argues is the starting point of the modern healthcare complex. In the Feb. 7, 1971 recording — part of the hundreds of hours of Nixon’s secret White House tapes — Ehrlichman explains “health maintenance organizations like Edward Kaiser’s Permanente thing.” Kaiser Permanente is now the nation’s largest HMO.

“Edgar Kaiser is running his Permanente deal for profit. … All the incentives are toward less medical care,” Ehrlichman says to Nixon, according to a transcript. “The less care they give them, the more money they make.”

But…but…but… Ehrlichman got it all wrong, Kaiser says in its official response:

John Ehrlichman, in a 1971 conversation with President Richard Nixon that’s used in the film, crudely and inaccurately paraphrases a conversation he had with Edgar Kaiser. Ehrlichman’s distorted paraphrase badly misrepresents Kaiser Permanente, its goals, its strategy, and its not-for-profit model. A Kaiser Permanente “Health Care Memorandum to John Ehrlichman,” stored in the National Archives, clearly supports this, as does this National Archives White House briefing document.

Using a secondhand, inarticulate paraphrase to represent KP’s role in the health care reform thinking of an era is a sad distortion of the truth.

Welcome to Kaiser PRBS Tactico Numero Uno: Scapegoating the Messenger. The message itself is indefensible, so Kaiser blames everything on "crude and inarticulate" Ehrlichman, and pretends to be every bit as shocked and disgusted by his conversation with Nixon as the rest of us. The links to the National Archives are also a nice touch, because as everyone knows, when corrupt politicians and businessmen are hatching their evil plots to defraud the American public, they are meticulous about including evidence of their illegal actions in the official Memoranda. [@@<---rolls eyes]

The less care they give them the more money they make.

Hmm. Not too much to misunderstand about that, and of course we know that contrary to the PRBS, Kaiser does indeed withhold necessary medical care to increase its profits ($698 million in the first quarter of 2007 alone).

Conversely, money appears to be no object when it comes to really important things, like Kaiser’s advertising budget, or the enormous legal fees it routinely shells out to defend its despicable actions.

Michael Moore also tells the story of Mychelle Williams, an eighteen month old child who died of a treatable infection because her Kaiser doctor refused to authorize emergency treatment at a non-Kaiser hospital. On his blog, Justen Deal (another Kaiser scapegoat) directs us to The Foundation for Taxpayer and Consumer Rights for the rest of the story:

The facts in Mychelle’s case are harrowing: An ambulance picked the little girl up from her grandmother’s Compton home in May 1993 and took her to Martin Luther King Jr./Drew Medical Center, the nearest hospital.

Dr. Trach Phoung Dang then gave Mychelle medication for her fever and other ailments and intravenous liquids for dehydration. He wanted to run blood tests to determine why the feverish, limp girl, who her mother said had been fine just hours earlier, was now so desperately ill. But the girl’s family belonged to the Kaiser health maintenance organization, and Kaiser’s Dr. Brian Thompson repeatedly told King/Drew that the tests should be done at Kaiser.

The telephone conversations between the doctors were tape-recorded by Kaiser, and according to a petition filed with the high court, Dang suggested three times that King do the tests before a transfer.

As the little girl’s condition deteriorated, her mother, Dawnelle Keys, now 37, pleaded with doctors for more aggressive treatment. But the child could not be given antibiotics until after a blood test, and wasn’t given the blood test because Kaiser wanted to do the tests

By the time the toddler reached Kaiser — four hours after she arrived at King — she was near death. Her heart stopped about 20 minutes later, and she could not be revived.

Justen then goes on to describe Kaiser’s response, which brings us to their 2nd Favorite PRBS Trick: Lie, Distort & Deny (and why not try to sell a few books while they’re at it…):

Kaiser Permanente’s defense? Mychelle died "14 years ago. [Her death] was not [as a result of] the denial of coverage for necessary medical care, as the movie claims."

The jury said the evidence showed otherwise, and found Kaiser Permanente liable for $338,250.

You can’t help but feel heartbroken for this poor little girl’s family. Well, unless you’re [Kaiser Permanente CEO] George Halvorson. You can’t help but feel disgusted that Mr. Halvorson would try to use (a fabrication) of this little girl’s story to sell his book. What a truly respectable "thought leader" Kaiser Permanente has in George Halvorson

NOT.

SiCKO opens Friday, June 29th, and we hope everyone will go see it. Then you can decide for yourselves whether Kaiser Permanente can be trusted to tell the truth about anything.

[By now everyone has heard that Kaiser Permanente has a starring role in Michael Moore's 'Sicko', from the infamous Nixon Tapes ("...the less care they give them, the more money they make"), to denial of care and patient dumping...it's all there.]

Michael Moore’s ‘SiCKO’ Trailer To Be Projected on Buildings Across the Country on Monday, June 25th

Continue Reading »

[kaiserthrive.org editor's note: Probably the biggest misconception about Kaiser critics in general, and this web site in particular, is the belief that we have the unrealistic goal to "bring Kaiser down" (typical accusation from the occasional hate mail we receive). That couldn't be further from the truth. Our only purpose is, and always has been, to shine a spotlight on the numerous internal problems at Kaiser so that positive changes would occur, and we believe that has indeed been happening.

Before reading the full article, we recommend that you check out Justen Deal's blog for some interesting analysis of these latest revelations about HealthConnect by new Kaiser CIO Phil Fasano.]

From East Bay Business Times:

New exec to solve IT woes at Kaiser

by Marie-Anne Hogarth

Kaiser Permanente, reeling from a succession of computer system troubles, is betting its third information executive in six months, a former banker, can set things right.

Philip Fasano, former CEO of Capital Sourcing Group Inc., takes the helm as vice president and chief information officer from Bruce Turkstra, who served in an interim capacity for only a few months after the sudden resignation of Cliff Dodd last November.

Fasano is promising to make Kaiser’s computers and call centers, which more than 12,000 physicians and 8.7 million members rely on to access sometimes life-altering data, work reliably and full time.

Dodd’s departure came days after an e-mail from a now-former employee calling attention to cost overruns and problems with Kaiser’s 3.2 billion electronic health records program, KP HealthConnect. Kaiser, which has declined to state why Dodd left, said it was unrelated to the e-mail.

Availability of IT systems will be a top priority especially as Kaiser proceeds with a number of related strategic initiatives.

The HMO giant looks to technology to capture lost revenue from problems with billing, develop new insurance products for the world of consumer-driven health care and execute on its mission of preventive medicine.

Fasano worked a succession of executive jobs over two decades with Capital One Financial Group, JPMorgan Chase, Deutsche Financial Services Corp. and others.

He says he’s well positioned for this role coming from an industry that more than two decades ago stopped treating IT as a back-office function. Financial services quickly evolved into one where being “real time” was a competitive advantage, a transition that the health care industry is only making now.

“What I would love to deliver is ‘always available,’ ‘always on’ and ‘regardless of your setting,’ ‘24-by-7,’ ‘365,’” Fasano told the East Bay Business Times in one of his first interviews in the new job. “That is the industry I came from. We spent the last 20 years in that industry developing the capabilities to allow us to deliver on that promise, particularly in our critical areas, like global trading.”

In particular, Fasano said that in the next 12, 24 or 36 months, Kaiser will be coming out with a suite of products allowing doctors to follow patients more closely. Patients in their homes could step on a scale - for instance - and their weight would be automatically uploaded electronically onto their electronic charts for doctor to see.

“Every bit of information that we expect to gather, we expect members to have access to what is appropriate for them,” Fasano said. “And do that in any format that they will like.”

The first goal, Fasano says, is to get KP HealthConnect up and running at least “five nines” - 99.999 percent of the time.

“(Kaiser CEO) George Halvorson and I have come together on that and believe very, very passionately that has got to be our goal,” Fasano said.

That’s a different message from what Turkstra related to East Bay Business Times in an interview in December, when he said the goal was an up-time of 99.7 percent. That would mean the system would be down about four minutes a day.

In the first quarter of 2007 - according to Fasano - the system has been up 99.57 percent of the time.

“If we are delivering real time health care, you have to be available all of the time,” he said. “Our clinicians require it. Our members require it and so do our customers.”
Continue Reading »

Our server was down most of the day Friday, June 22nd, and as a result some of our incoming email bounced back.

We’re requesting that anyone who attempted to send us an email on Friday please try again.

Sorry for the inconvenience.

Admin

[kaiserthrive.org editor's note: Hallelujah, regulators have finally seen the light! Too bad Kaiser will respond with another useless 'plan of correction', with no real intentions of actually following through with it.]

From San Francisco Business Times:

DMHC probe of Kaiser delayed, fines expected

by Chris Rauber

An investigation of Kaiser Permanente by the state Department of Managed Health Care, originally expected to conclude last October but later expanded, is taking far longer than expected to complete.

The department oversees HMOs and other managed-care plans. At stake is whether Kaiser is in compliance with California’s Knox-Keene Act, which regulates the state’s managed-care plans.

The probe, originally part of investigations into Kaiser’s now-defunct Northern California kidney transplant program, was later expanded to cover how the Oakland-based health-care giant handles consumer complaints and a wide spectrum of quality of care and oversight issues.

“It’s a really complicated report, and we’re working (on) some corrective actions,” DMHC spokeswoman Lynne Randolph told the San Francisco Business Times this week. In addition, Randolph said, the department would be “penalizing” Kaiser with monetary fines, but she said details aren’t clear yet.

Ultimately, however, some combination of required corrective actions and financial penalties is expected, Randolph said.

At this point, a final report is expected by mid-July, roughly eight and a half months after the original deadline. Since then, state officials have said at various times that the expanded investigation would be completed in the first quarter, by late April and by late May.

In November, state health regulators widened a probe of Kaiser’s process for handling complaints beyond its ill-fated San Francisco-based kidney transplant unit and into other operations at the health-care behemoth. The investigation grew to include Kaiser’s entire California system and a broad spectrum of quality-of-care and oversight issues, regulators said in November. It involves the Kaiser Foundation Health Plan’s responsibility for overseeing the quality of care at its medical centers and medical groups, including the Permanente Medical Group in Northern California, state officials said at the time.

Back in November, Denise Schmidt, another DMHC spokeswoman, said the investigation expanded when regulators realized problems at the troubled kidney unit may have been a small piece of a larger puzzle. “In this case, the kidney program (is being) closed down,” Schmidt said at the time, “so if they correct the way that particular program handles grievances, that’s not going to solve the problem.”

Cindy Ehnes, the department’s director, initially thought the investigation would be finished last October, but that was before its scope expanded.

Previously:

State regulators widen probe into Kaiser?s ills

From KGO TV:

Federal Report On Kaiser Infant Death

By Karina Rusk

Jun. 8 - KGO - ABC7 News has obtained the federal report on a tragic infant death at Kaiser Santa Clara. We were the first to report on the tragic death earlier this year.

The 19-page report focuses on an infant death in February caused by medical mistakes at Kaiser Santa Clara. ABC7 obtained the investigation into the deadly medication error and Kaiser’s response through the Freedom of Information Act.

Kaiser previously told ABC7 News the seven-week-old boy died as a result of human error that originated in the pharmacy and resulted in an overdose of medication.

State Department of Health and Human Services investigator, Glenn Koike, along with two independent consultants were in charge a of a federal investigation that put the hospital on notice . It could lose its Medicare and Medicaid funding.

Their investigation outlines numerous failures in the pharmacy from policies and procedures to responsibility and oversight.

The federal investigation concludes, “the hospital must develop, implement and maintain an effective ongoing, hospital-wide, data driven quality assessment and performance improvement program.”

Kaiser is required to submit a plan of correction showing it has or is in the process of taking action to reduce medical errors. While the HMO cites some changes in auditing and training, Kaiser’s repeated response in the document is this, “the hospital’s further review of its policies and procedures indicated no systematic pharmacy problems and the hospital is providing quality care in a safe environment.”

The information in this report is so new, federal investigators say they need time to review it before commenting on weather Kaiser’s plan of correction adequately addresses their concerns.

If federal and state agencies are not satisfied with Kaiser’s response and actions, the federal government could suspend Medicare and Medicaid funding to the facility — the harshest of sanctions. Kaiser Santa Clara could also become the first hospital under a new state law to face a penalty of up to $25,000 dollars.

Late this afternoon, Kaiser Santa Clara made its chief operating officer available to us. Susan Murphy again stressed the numerous quality control measures in place at the hospital and did say that one specific modification was made in the way the pharmacy handles the weighing of dry medication which ultimately lead to the newborn’s death.

Susan Murphy, Kaiser Santa Clara COO: “We now have a pharmacist only who will have the responsibility for weighing and we will have double checks conducted so that we can be certain that even though it’s a pharmacist doing it, that is is being done correctly.”

Federal investigators in San Francisco indicate they may have some reaction to Kaiser’s plan of correction as early as next week.

Previously:

• Medication error kills infant at Kaiser Santa Clara
• Kaiser may face fine over infant’s death