$2 Million Fine Small Potatoes For Kaiser Transplant Disaster

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By Evelyn Pringle (about the author) Page 2 of 5 page(s)

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A former transplant unit administrator told the Business Times that Kaiser planned to use the San Francisco program as a template for a series of other transplant centers nationwide that would save the HMO huge amounts of money by not having to send patients to outside hospitals for transplants.

Critics told Business Times that the powerful influence of Kaiser's doctors within the organization is little known to the public or to regulators, and that financial incentives sometimes result in clinical decisions that can put patients in jeopardy.

That certainly turned out to be the case with the transplant program. According to a CBS channel 5 news analysis of the national transplant data for 2005, Kaiser performed only 56 kidney transplants that year, but 116 patients, or more than twice as many transplant patients, died while on the waiting list.

Overall, the exact opposite occurred with transplant patients statewide in California. CBS found that more than 1,800 patients received successful transplants, while only 866 died.

And the number of transplants completed at Kaiser was less than 3% of the people on the waiting list compared to an average 12% on other waiting lists statewide.

Looking back, during the two years before Kaiser began its program, UC San Francisco and UC Davis combined, performed at least 168 transplants on Kaiser patients, three times as many as Kaiser performed in its first year of operation.

While it may be difficult to come up with the exact number of patients who died as a direct result of Kaiser's failed transplant program, critics say, its clear that many patients were needlessly forced to endure grueling sessions of prolonged dialysis which lessens the chances for a successful transplant.

Ruben Porras had already been waiting for a kidney at UC Davis for 3 years when Kaiser cancelled the program. As a result, Mr Porras was put on inactive status in November 2004, meaning he could not receive a kidney.

In the end, his transfer to Kaiser's program was not completed until September 2005, and because kidneys are more difficult to obtain in the heavily populated San Francisco area than in Sacramento, the waiting period for Mr Porras was expected to be 3 more years.

Several of his relatives were being assessed as potential donors at UC Davis, but when Kaiser ended the contract, the assessments were also cancelled. When the relatives called Kaiser to try and continue the assessments no one returned their calls.

Less than one month after his transfer to Kaiser's list was completed, Mr Porrass died at 47, as a result of an infection caused by extended dialysis treatment.

As it turns out, Mr Porras wasted what little time he had left on dialysis hoping for a transplant. "There's no other life out there for you other than being treated," his wife told the LA Times. "He had no energy to do anything, go anywhere or do things for himself."

In another similar case, 63-year-old James Klinkner sent in his forms when he was told that he would be transferred to Kaiser's list but they too apparently got lost because Kaiser sent him another form to fill out. When he called to find out what happened, his call was not returned. In the meantime, Mr Klinkner also died from complications of prolonged dialysis.

In fact, an investigation by the LA Times found hundreds of other patients at UC Davis and UC San Francisco stranded between programs because of Kaiser's delays and errors in processing paperwork

And if all this wasn't bad enough, on May 4, 2006, the Times reported that 25 Kaiser patients "were denied the chance for new kidneys that were nearly perfectly matched to them last year during the troubled start-up of the giant HMO's kidney transplant program in San Francisco."

The 25 kidneys were offered between January and December 2005, the California Transplant Donor Network told the Times.

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