Tuesday, November 8, 2011

Kaiser Permanente and Sutter challenge medical peer review process

I think these are bad doctors with a good cause. Peer review usually results in doctors and nurses covering for their friends and allies who make mistakes. The only doctors who are targeted are those who are unpopular, which often has nothing to do with competence. In fact, sometimes doctors are unpopular simply because they don't go along with group goals that put the interests of doctors ahead of those of patients.

Dr. Mark Fahlen sounds like he lost the confidence of nurses, and I believe that nurses are sometimes right and doctors are sometimes wrong. I saw a nurse save a patient's life when an Emergency Room doctor ordered the patient released, and the nurse intervened and said they should wait for test results. The test results revealed that the patient had a deadly condition, malignant hyperthermia. Nerve damage had already begun. She ended up fine after about nine days in the hospital. Thank you, dear nurse!

Also, Dr. Fahlen seems to be imperious and arrogant. If he had the patients' interests at heart, he would have explained to the nurses why his orders needed to be followed.

And of course, Dr. Hamid Safari has outrageously bad judgment. Like Fahlen, he failed to communicate and lost his temper. Those two babies should not have died. He yanked a baby who was in no distress at all out of his mother's uterus, killing it. Instead, he should have patiently explained to the mother why a Caesarian section was needed.

Nov. 07, 2011
Doctor files suit against Modesto hospital
He's challenging procedures used for complaints
By Ken Carlson
Modesto Bee

A Modesto physician is one of two plaintiffs in a federal lawsuit filed Monday, which challenges a process used by California hospitals to review complaints against doctors.

Attorneys filed the lawsuit in U.S. District Court in San Francisco on behalf of Dr. Mark Fahlen, a Modesto kidney specialist who saw patients at Memorial Medical Center, and Dr. Hamid Safari, a perinatologist who worked for Kaiser Permanente's Fresno hospital.

The lawsuit charges that California's peer review process violates federal due process laws and constitutes a violation of physicians' civil rights.

Named as defendants in the lawsuit are Sutter Central Valley Hospitals, which manages Memorial, and Oakland-based Kaiser Permanente.

The lawsuit charges that Sutter terminated Fahlen's privileges in January without proper cause. The physician said he is unable to see his patients who are taken to Memorial in emergencies or because of their insurance coverage, his attorney said.

Some of those patients are in advanced stages of kidney failure, he said.

The lawsuit seeks to reinstate Fahlen at Memorial.

Stephen Schear, an attorney for the two physicians, said the state has delegated peer review authority to health care corporations, giving them power to destroy doctors' careers without due process of law.

"California's peer review system for physicians is the only legal system in the United States where a powerful corporation is permitted to target an individual's career and then pick the judge and jury who decide the matter," Schear said in a press release.

From 2003 to 2008, Fahlen brought numerous complaints to Memorial administration regarding his allegations of nursing errors and insubordination.

He alleged that nurses ignored or disobeyed his patient care orders and changed orders without his consent.

Confrontational complaints

Nurses, in turn, complained to administrators that Fahlen was confrontational with staff and that his conduct interfered with patient care.

A hospital executive committee recommended in August 2008 that Fahlen's privileges should be terminated. He exercised his right to have a hospital-appointed judicial review panel hear testimony and evidence.

Even though the review panel recommended that Fahlen keep his privileges, Sutter followed through with his termination in January, the lawsuit says. Fahlen is now chairman of the department of medicine at Doctors Medical Center in Modesto.

A spokesman for Sutter's Central Valley region said the group had not seen the lawsuit and would not comment.

The California Medical Board in 2007 accused Safari of gross negligence in the deaths of two newborns in Fresno.

But a state administrative law judge found in 2009 that Safari complied with standards of care and was not at fault.

Despite that decision, Kaiser has not allowed Safari to practice medicine at its hospitals, the lawsuit alleges.

Federal regulators also investigated complaints by Kaiser medical staff and nurses who had raised questions about the Fresno physician's competence.

Officials issued a critical report in 2008 suggesting that the deaths could have been prevented if Kaiser had more closely monitored Safari.

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