Shamefully, the California Medical Association, California Hospital Association and California Dental Association supported Kaiser's denial of care to this patient. The Court of Appeal ruled on behalf of the patient.
Filed 2/15/12 CERTIFIED FOR PUBLICATION
IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA. SECOND APPELLATE DISTRICT
KAISER FOUNDATION HEALTH
PLAN, INC., et al.,
THE SUPERIOR COURT OF LOS
ANNA RAHM et al., Real Parties in
...Anna Rahm is a member of the Kaiser Permanente Traditional Plan (the plan),
which provides its members medically necessary health care in exchange for monthly
premiums. In August of 2008, Anna began experiencing back pain. Anna‟s parents,
Lynnette and James Rahm, took Anna to a chiropractor. After the treatments failed to
alleviate Anna‟s pain, the chiropractor recommended that Anna “consult with a medical
doctor because she was in need of an MRI.”
In March of 2009, Anna met with Charlene Huang, a primary care physician at
Kaiser. Lynnette accompanied Anna to the appointment and requested that her daughter
receive an MRI. Although Huang acknowledged that Anna‟s chiropractor had
determined that her back pain was “„severe,‟” Huang refused to order an MRI. Huang
referred Anna “to the physical medicine department at [Kaiser] and also prescribed pain medications and steroids, a much less expensive treatment than an MRI. . . .” Anna took the prescribed medications but her pain persisted.
Two weeks later, on March 24, 2009, Anna met with Ngan Vuong, a physical
medicine doctor at Kaiser. Lynnette accompanied Anna to the appointment and again
requested that Anna receive an MRI. Vuong, however, recommended that Anna receive
an epidural and suggested that her pain could be remedied through changes to her
nutrition and exercise habits. Lynnette told Vuong she did not want her daughter to
receive an epidural and renewed her request for an MRI. Voung refused to authorize an
This factual summary is based on allegations in plaintiffs‟ complaint, which we
assume to be true for the purposes of reviewing the trial court‟s order denying
defendants‟ motion to strike. (See Turman v. Turning Point of Central California, Inc. (2010) 191 Cal.App.4th 53, 63 (Turman) [“„In passing on the correctness of a ruling on a motion to strike [punitive damages allegations], judges read allegations of a pleading subject to a motion to strike as a whole, all parts in their context, and assume their truth.‟
In April of 2009, Anna sought acupuncture treatment for her pain. The treatments
were unsuccessful annd the acupuncturist recommended that Anna request an MRI from
her doctor. Lynnette called Vuong and informed her that Anna‟s acupuncturist had
recommended an MRI. Vuong again declined an MRI and referred Anna to Kaiser‟s
physical therapy department.
In May and June of 2009, Anna continued her acupuncture treatments. Two
different acupuncturists concluded that Anna was in need of an MRI. Anna also attended several physical therapy sessions at Kaiser, but was forced to discontinue the treatments because they were too painful. Kaiser‟s physical therapy department “recommended that [Anna] receive an MRI.”
Lynette called Vuong again and explained that a chiropractor, two acupuncturists
and Kaiser‟s physical therapy department had all recommended an MRI. Vuong rejected
these recommendations because they were not made by medical doctors, but invited the
Rahms to seek a second opinion.
Lynnette elected to schedule a meeting with another doctor. Prior to the
appointment, Lynnette contacted Huang, Anna‟s primary care physician, “as a last ditch effort” to get an MRI. Lynnette summarized the treatments Anna had undergone since her initial visit with Huang. Huang finally agreed to authorize an MRI, which was performed on July 2, 2009.
Anna‟s MRI indicated that she had an “aggressive mass” in her pelvis. A biopsy
revealed that Anna was suffering from a “high grade” osteosarcoma, which is “one of the fastest growing types of osteosarcoma, meaning that [Kaiser‟s] three month delay in ordering [Anna‟s] MRI allowed the cancer to spread and ultimately substantially
contributed to [Anna‟s ] poor prognosis.” Anna underwent chemotherapy and had
numerous surgeries that resulted in the loss of her right leg and portions of her pelvis and spine...