Kaiser's killer kidney saga

As you know, a staple feature of this column is surgical errors that kill or maim us.

Whether it's sponges, scalpels, and other hardware sewn up inside patients after operations, removal of the wrong limb, the cleansing of operating utensils with used elevator oil (Daily Dose 2/28/2005), or any number of other snafus, you've heard about it here repeatedly. That's because it happens so often.

But one species within this genus of mistake that doesn't get much mention in these pages (or anywhere else) is the simple administrative errors that result in deadly surgical cataclysms. Usually, one thinks of paperwork errors resulting in problems relating to drug administration. You know, a scribbled prescription filled for the wrong drug, a tired nurse misreading the dosage amount or interval off a medical chart, things of that nature…

This isn't the only way paperwork errors can send people to the big adios, however. Case in point:

HMO giant Kaiser Permanente has agreed to pay $2 million in fines to California regulators and donate another $3 million to an organ donor program because of their deadly mismanagement of their new kidney transplant center in 2004 and 2005. Once the center was completed in 2004, Kaiser ordered as many as 1,500 of their patients awaiting kidneys to transfer from University of California hospitals (where the transplants were originally scheduled) to the new facility.

Apparently, the center experienced some growing pains in their administration process for these poor, desperate souls. According to a recent Associated Press expose` on the matter, twice as many of these patients died waiting for viable kidneys as received transplants (which numbered only 56!) at the new center in 2005. For comparable California transplant centers, the statistics are exactly the opposite: More than twice as many people received lifesaving transplants as died waiting in line for them…

That's an increase in mortality of 200% for those unfortunate enough to be "covered" by Kaiser Permanente!

An investigation by Golden State regulators revealed that many of these deaths could have been avoided had Kaiser Permanente's handling of the transition of those in their transplant queue been more efficient. Or rather, anything LIKE efficient.

In the wake (no morbid wordplay intended) of the scandal, the California regulators cited the insurance giant for:

• Inadequate administrative oversight
• Failure to properly address patient complaints
• Insufficient personnel to manage transfer volume
• Failure to provide patients with timely access to medical specialists

Of course, Kaiser Permanente is downplaying the carnage that the obviously under-budgeted transition to their new kidney center has wrought. Quoting a source from the AP article, one of their mouthpieces said the company regrets any "problems, difficulties, or concerns" the experience may have caused their patients…

Hmmm. What about death? Does that qualify as a "problem," or "difficulty?"

rally, the regulators stopped just short of declaring Kaiser liable for any deaths, thereby likely sparing the company untold millions in court. Instead, they just rattled their saber enough to extort a few million out of the insurance firm for their own coffers - leaving the next of kin of those who perished waiting in line for Kaiser's kidneys to fend for themselves…

In other words, business as usual in the hallowed halls of government.