From the Los
Transfer of Kaiser's Kidney Patients
them from the HMO transplant center to UC hospitals will take far
longer than thought.
By Tracy Weber and Charles Ornstein
Times Staff Writers
August 4, 2006
California HMO regulators said this week that it will take months
longer than expected to transfer about 2,000 patients out of Kaiser
Permanente's troubled kidney transplant center in San Francisco,
prolonging patients' dependence on a program that has been plagued by
the Kaiser program announced in May that it would shut down, the
California Department of Managed Health Care predicted that all of the
HMO's Northern California patients would be moved to new centers within
six weeks. But preparing patients and their records for transfer
has taken more time than anticipated,
pushing the target to the end of the year.
our new goal," said Lynne Randolph, a spokeswoman for the department,
who added that some patients needed updated tests and that records had
to be standardized.
Her agency also plans to announce as early
as next week that it will levy a record-breaking fine against Kaiser
for problems in the transplant program, according to a person familiar
with the matter. The largest fine previously collected by the agency
was $1 million in 2002, also against Kaiser, for lapses in the
treatment of a patient who died.
So far, only 231 Kaiser kidney
patients have been officially transferred to transplant programs at
University of California hospitals in San Francisco and Davis, Randolph
Some Kaiser patients received word of the most recent delays with
Jewell, 32, said he doesn't even know whether he has been transferred
yet. He was perplexed this week to get a letter asking his preference
between the UC hospitals, because he had already told Kaiser he wanted
UC San Francisco.
"Right now if I got a call for my kidney
transplant, I don't know who is going to be calling me," said Jewell,
who has been waiting since June 2004. "I know they're in the process of
doing something, but I don't know what…. I'm still really
the nation's largest HMO, announced the closure of its kidney
transplant program in May after reports in The Times detailed problems
arising from the center's start-up in the fall of 2004. Northern
California transplant patients, who had been treated at UC San
Francisco and UC Davis medical centers under contract with Kaiser, were
forced to transfer to the new program.
The center compiled a
dismal record: Last year at Kaiser's program in San Francisco, twice as
many people died on the waiting list as got kidneys, the newspaper
found. The statewide pattern for transplant centers was the reverse:
Twice as many patients received kidneys as died.
patients were not properly transferred from their old programs to
Kaiser's, leaving them in limbo with little hope of receiving new
Federal regulators later concluded that practically
every aspect of the Kaiser program was flawed and threatened to cut off
Medicare funding for treating all end-stage renal disease at the HMO's
San Francisco hospital. But the U.S. Centers for Medicare and Medicaid
Services late last month accepted Kaiser's plan for fixing its
problems, even though the program is closing.
patients who have been transferred said their cases have been quickly
and professionally handled by UC programs — getting them
days or weeks. Even though organs are distributed regionally, not by
individual hospitals, they said Kaiser seemed slow to act on their
behalf or found reasons not to perform their surgeries.
Goodlow, 44, said she heard next to nothing from Kaiser after being
forced into its transplant program in fall 2004. She never met the
transplant team, she said, even though she had been awaiting an organ
since June 2000 and should have been near the top of the list.
But last month, weeks after transferring to UC San Francisco's
transplant program, she got her new kidney.
was like night and day the care I got at UCSF compared to Kaiser,"
Goodlow said. "Everybody explained everything to me. Everybody was able
to answer my questions. It just all went like clockwork."
Goodlow, an administrative assistant from Vacaville, said she noticed
increased energy within a day of her July 12 transplant.
was just that instant," she said. "For the most part, I find that I
don't have to schedule my life anymore. For the last six or seven
years, I was scheduling my life around dialysis."
Beale, 57, had been waiting for a kidney for more than eight years. She
too endured grueling sessions of dialysis, a process that removes
impurities from the blood.
Beale was officially transferred to
UC San Francisco last month. Less than two weeks later, while driving
to choir practice, she got the call that a kidney had been found for
It didn't go exactly as planned. Once in surgery, doctors
were forced to use the donor's second kidney because the first one
didn't function properly. But the new kidney began working right away,
Another Kaiser patient awaiting the second kidney was forced to wait
"I just can't imagine how awful that would be," Beale said.
So far, however, Goodlow and Beale are among the lucky few.
May 12, when the closure was announced, 20 of the HMO's patients have
gotten new kidneys: 12 at Kaiser, five at UC San Francisco and three at
Kaiser spokesman Matthew Schiffgens said the closure
of the transplant program should not hurt any patient's prospects for a
kidney. Until everyone has been transferred, Kaiser will continue
performing surgeries as kidneys become available.
Northern California Kaiser kidney program by the numbers:
Patients on Kaiser Permanente's kidney transplant waiting list when the
program announced May 12
that it would close
Patients who have been contacted and given a choice of moving to
established programs at
UC San Francisco or UC Davis medical centers,
as of Thursday
Medical records transferred to the UC hospitals
Number of patients officially reassigned to the UC hospitals through
the national organ network
of transplants performed on Kaiser patients since May 12
Source: California Department of Managed Health Care