My guess is that administrators pressured doctors to sign the second letter. Why? Because Kaiser could be held liable for patient deaths if one of their doctors was found to be unprofessional. Kaiser seems to have a knee-jerk response to criticism of Kaiser doctors: deny any problem, cover it up, and don't let reason or ethics interfere with decisions.
More about this letter can be found at The Kaiser Papers.
Hamid Safari: Kaiser tried to bribe baby-killing doctor
Kaiser Permanente Thrive Exposed
March 8th, 2008
[How do you like that? Only at Kaiser can you kill two babies and endanger countless others, only to be handed $2 million of member money to quietly resign. The pattern should be glaringly obvious by now. Kaiser always tries to lie and buy its way out of a scandal, and only does the right thing when its malfeasance becomes a media event. Note that even after Safari turned down the settlement, Kaiser still would have declined to suspend him if only CMS hadn't rejected the first plan of correction (pdf).]
From the Fresno Bee:
Kaiser doctor rejected a deal
Hospital offered beleaguered Safari $2 million to resign.
By Tracy Correa
Three months before Kaiser Permanente suspended a Fresno physician at the center of a state investigation into the deaths of two babies, the hospital offered him $2 million to resign.
Dr. Hamid Safari, who treated high-risk pregnancies, said he refused the Nov. 28 offer because he wanted to continue working and believes he has done nothing wrong.
“I have spent my life to be a perinatologist and help patients, mothers and babies. The money was not my intention or my goal in life,” Safari said.
Kaiser officials acknowledged that they have discussed a settlement with Safari, but would not confirm the $2 million figure. The hospital suspended the doctor last week.
“We have considered many alternatives over time regarding Dr. Safari leaving the organization, including settlement, because we believed it was in everyone’s best interest,” Linda Monte, interim senior vice president and area manager for Kaiser’s Fresno hospital, said in a written statement.
The doctor and his lawyer, Stephen Schear, said Kaiser buckled under the pressure of bad publicity. They also criticized Kaiser for telling reporters about the suspension.
Schear said Safari was not interested in taking any amount of money in exchange for his career.
“Our counteroffer was to sit down and work things out so he could continue to treat patients at Kaiser Fresno,” he said.
Safari said a Kaiser representative showed up at his home about 5 p.m. on Feb. 29 and handed over a letter stating that he was suspended, effective immediately. He had been off that day for his deposition in a lawsuit filed by two Kaiser doctors who said they were retaliated against by hospital administration for questioning Safari’s competence.
The suspension followed months of criticism and public pressure on the doctor and Kaiser Permanente since details of the deaths — in 2004 and 2005 — became public late last year.
In September, the California Medical Board accused Safari of gross negligence — charges that could lead to loss of his California medical license. A hearing is pending.
In 2004, Safari waited more than three hours before performing a Caesarean section on a patient even though the baby was in distress, according to the accusation. The baby girl, who was deprived of oxygen, died 10 months later.
The other case occurred in 2005, when Safari allegedly severed the spinal cord of a baby boy, a twin, in what has been described by investigators in documents as a brutal delivery.
Medical staff and nurses have said they had raised questions about Safari’s competence but hospital administration failed to act.
Drs. Gilbert Moran and Robert Rusche are now suing Kaiser for retaliating against them after they complained about Safari.
Safari, in turn, accuses Moran — the former head of the OB/GYN department — and Rusche of complaining to the state medical board as part of a vendetta against him. He said they did so after he complained to superiors that one of the doctors was abusing his power on a quality review committee to go after doctors he didn’t like.
In January, federal health officials issued a critical 68-page report following an investigation into the situation. The report suggested that if Safari had been monitored more closely, the deaths might have been prevented.
Days later, Susan Ryan, the hospital’s then-top administrator, stepped down.
Schear said the bad publicity had become too much and Kaiser was determined to get rid of Safari. He also said that even though the doctor is suspended, he is collecting his Kaiser paycheck and is still entitled to due process, involving hearings and appeals, that can take months or years.
Schear said the $2 million settlement offer was an attempt to quickly disassociate the hospital from Safari and shortcut that process.
Schear provided The Bee a copy of a Nov. 28 letter from a Los Angeles law firm he said represented Kaiser. He blanked out all but one passage in the letter, which reads, “Kaiser will pay Dr. Safari $2 million, provided Dr. Safari complies with all conditions set forth herein.”
Schear said the letter also set forth conditions, including a confidentiality agreement and a pledge that Safari wouldn’t sue Kaiser.
“The essence was, you leave and we give you the money,” Schear said.
He said $2 million was a starting point and that the offer came “with indications they would pay him significantly more than that if he immediately resigned.”
Schear said he believes Kaiser moved to suspend Safari because it doesn’t think the medical board will end up revoking his license when all the facts come out.
“They just decided to throw him overboard,” Schear said.
Safari said he has performed well in recent months and that there have been no reports of any problems since 2005. He said his patient satisfaction rates are the highest they have ever been and only eight Kaiser patients have asked to be reassigned to another doctor.
“I think the action [suspension] was taken because he’s performing too well and building up a track record,” Schear said. “The longer he goes without problems, the harder it is to get rid of him.”
Safari now serves primarily as a consultant in high-risk births. Kaiser restricted Safari in July 2005 from performing vaginal deliveries and made the restrictions permanent in April 2007.
Doc’s credentials terminated due to negligence
21 October, 2010
fresnobee.com on October 18, 2010 reported that Kaiser Permanente in Fresno has terminated the hospital privileges and credentials of Dr. Hamid Safari after a nearly three-year fight by the beleaguered perinatologist to keep his job following allegations of negligence. Kaiser’s action comes despite the California Medical Board’s decision last year to clear Safari of negligence related to the deaths of two babies in 2004 and 2007.
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