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Kaiser Kidney Transplant Program Gets Reprieve From Medicare Officials

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Nearly 2 years after Kaiser's new program began, in May 2006, the LA Times reported that hundreds of patients were stuck in "transplant limbo" because of improper handling of paperwork, and that because of the delays, many patients missed opportunities for a transplant and that the Kaiser waiting list had grown to more than 2,000 patients.

Most of the patients on the list were waiting for kidneys from strangers, which can normally take over 5 years. But some patients had offers of kidney donations from relatives, which if well-matched, usually means a transplant right away.

Thirty-one-year-old, Jessica Parker told CBS News that she had two people who were willing to donate a kidney to her for over a year, but says appointments were delayed and calls to Kaiser's transplant program often went unreturned.

Ms Parker spends most weekdays hooked to a dialysis machine and says she is angered by Kaiser's incompetence and mismanagement. "Kaiser needs to come out and publicly say, 'these are the changes we are going to make' and possibly issue an apology to the families and people on the wait list that have been waiting in vain through mismanagement and incompetence," Ms Parker told CBS.

The Times reported that doctors attempting to build a record of success avoided the riskier organs and patients, which slowed the rate of transplants, and that doctors at UC San Francisco revealed that in 25 cases where kidneys were a perfect match for Kaiser patients, the HMO refused to authorize the hospital to perform the transplants.

On May 3, 2006, the Times quoted current and former Kaiser employees who said that problems at Kaiser went beyond mere growing pains. "Surgeons and kidney specialists battled over who should receive transplants," the newspaper wrote. "Desperate patients complained of inexplicable delays," it noted.

And since the transplant program began, the Times discovered that 10 permanent Kaiser employees had either quit or been fired out of a staff of 22. In less than a year, the first administrator of the program left, and a little over a year later, her replacement was terminated.

In January, 2006, kidney specialist, Dr James Chon, sent a 12-page letter to Kaiser's physician-in-chief describing problems he saw in the transplant program, including "numerous resignations" and other internal issues.

"On the outside, the program seems to have settled into a reasonably functioning unit," he wrote. "However, a closer look at the program will show that it is suffering from very serious and potentially explosive problems," he said.

In his letter, Dr Chon detailed battles between staff members over which patients could receive transplants. One 73-year-old woman, he wrote, had been waiting, initially at UC San Francisco, since 1999.

Dr Chon stated that he and his colleagues felt that although the woman was a high-risk patient, she was a viable candidate but that Dr Sharon Inokuchi, the program's medical director, refused to sign off until she saw additional medical records, which Dr Chon said were irrelevant.

"I truly believe that decision to overrule four other transplant physicians was unjust and unethical," he wrote in the letter.

Dr Chon was also put on leave in February 2006, after the dispute with Dr Inokuchi.

In February 2006, kidney specialist, Dr Eric Savransky, walked off the job and cleared out his office and never returned, but Kaiser officials told the Times that he was technically on leave.

According to the May 3, 2006 LA Times, in the end, Dr Inokuchi was "relieved" of her administrative duties to focus on patient care and with all the departures, she was the only kidney specialist left to manage patients' care after their transplants, see them for checkups, handle calls for medical advice, review lab results and evaluate patients.

Transplant surgeons at other hospitals told the Times that programs of Kaiser's size would have trouble functioning without at least four or five transplant nephrologists.

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Evelyn Pringle is a columnist for OpEd News and investigative journalist focused on exposing corruption in government and corporate America.
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