Saturday, May 06, 2006

When your hospital tries to kill you - California Kaiser's organ transplant fiasco


Hospital horror stories are not confined to Texas. The LA Times discovered that to fill beds in it's hospital Kaiser Permanente suddenly required all kidney transplant patients to have the transplants in it's new understaffed mismanaged transplant center. The transplant center quickly developed the longest waiting list in the country. The paperwork was messed up on those awaiting transplant and the new doctors were reluctant to perform the riskiest operations. The number of transplants performed went way down while deaths went way up.
In 2005, the program's first full year, Kaiser performed only 56 transplants, while twice that many people on the waiting list died, according to a Times analysis of national transplant statistics.

At transplant centers statewide, the pattern was the reverse: More than twice as many people received kidneys than died.

Kaiser also suffered by comparison to the two outside hospitals that previously had tended to its Northern California patients. In each of the two years before Kaiser opened its program, UC San Francisco and UC Davis medical centers together performed at least 168 transplants on Kaiser patients, three times as many as Kaiser managed in its first full year.

"If they couldn't handle as many as they were doing before, they should have just transferred some" patients, said Neva Smith, whose daughter, Alison Bertino, was moved to Kaiser from UC San Francisco.

Bertino, 30, died last June while waiting for a kidney....

The problems at Kaiser went beyond mere growing pains, current and former employees said: Surgeons and kidney specialists battled over who should receive transplants. Desperate patients complained of inexplicable delays. Since the program opened, 10 permanent employees have quit or been fired out of a staff of 22.

Even today, UC San Francisco has about 220 Kaiser patients on its list whose time has not been properly transferred to Kaiser, said Dr. Stephen Tomlanovich, medical director of the university medical center's renal transplant service.
At least in California they don't have the full measure of Texas's draconian "tort reforms" protecting doctors, hospitals and HMO's. That means Kaiser Permanente should have a strong financial incentive to get its act together to counterbalance its financial incentive to let its most expensive sickest patients die.

UPDATE - Patients have lost patience, program being investigated.

I have blogged about the Andrea Clark case in Houston, Texas [last post]. Here the lawyer who helped save her life blogs about the Texas hospitals using the "futile care" law to kill patients and how that was stopped twice recently due to public outrage, not the law.



No comments: