Wednesday, January 30, 2013

Patient who commented on Internet wins in Minnesota Supreme Court against doctor who sued him for defamation

Mr. Laurion wins, Dr. McKee loses.

The Minnesota Supreme Court agrees with Mr. Laurion that patients have a right to report on the Internet their observations regarding the behavior of doctors. Patients also have the right to report their opinions to medical groups. I don't know what country Dr. McKee thought he was living in. I believe Dr. McKee proved that he has a bad attitude by hounding Mr. Laurion.

See post: Can you tag your doctor a 'tool' online?

See Doctors Silencing Patients on Thank Heaven for Insurance Companies blog.

Read the decision HERE.

Saturday, January 26, 2013

Kaiser Bungles X-Ray, Girl Suffers, Dad Says

The handling of this X-ray was accidentally bungled; Kaiser also intentionally mishandles X-rays to save money.

January 22, 2013
Kaiser Bungles X-Ray, Girl Suffers, Dad Says
By PHILIP A. JANQUART
Courthouse News

IRVINE, Calif. (CN) - Kaiser's delivery of an X-ray to the wrong doctor resulted in major surgery and a permanent scar for a 14-year-old girl, her father claims in Orange County Court.

Nicole Ley, now 16, had taken two bites of a barbecued hamburger during a family dinner on Jan. 10, 2010, when she felt something lodge in her throat. Attempts were made to clear the unknown object out, but parents Marc and Tina could not see anything. Nicole then began having a hard time breathing and complained of persistent pain. Marc and Tina are insured by Anthem Blue Cross, but rushed their daughter to a Kaiser Permanente hospital because it was the closest to their home.

An x-ray was taken of her throat, but Dr. Nak B. Chhiv said he did not see any foreign objects and that Nicole probably scratched her esophagus while eating the hamburger. He added she would need to "tough it out."

Nicole was cleared to go home and Chhiv told the family the radiologist would look at the x-ray to confirm his findings. They were told the radiologist would call the next day if there were any unforeseen problems.

Four days later, Nicole was still experiencing significant pain. On Jan. 15, 2010, she woke up with a 101.6 degree fever, prompting her mother to take her to the pediatrician. Dr. Michael B. Nestor, a Kaiser emergency room doctor on duty the night Nicole showed up, called while they were en route, explaining that the x-ray was mistakenly put in his in-box. He said he had passed Nicole off to Dr. Chhiv during a shift change and that the x-ray should not have been put in his in-box since he was leaving for vacation. He did not see it until four days later, when he returned.

He then informed Tina he had discovered a foreign object in her daughter's throat and she needed to get her to a hospital. Tina and Nicole raced to Hoag Hospital in Newport Beach, where a CT scan revealed the foreign body was lodged dangerously close to her carotid artery. Nicole was transported to Childrens Hospital of Orange County where she stayed for seven days. On Jan. 19, 2010, cardiothoracic surgeon, Dr. Brian Palafox, performed surgery to remove a metallic bristle that had migrated, penetrated through the esophagus and abutted against the carotid artery.

"If proper interpretation of abnormal x-ray findings had been communicated at an earlier date, the metallic foreign body would not have moved/migrated approximately 1 cm abutting carotid artery," the complaint states. "Nicole Ley has suffered very significant physical and emotional injuries. She has suffered with significant depression, nightmares, difficulty concentrating and became withdrawn and introverted."

She was consequently diagnosed with Post Traumatic Stress Disorder and has been receiving treatment from a psychotherapist, according to the complaint.

"Her school work suffered and she later switched schools," the complaint states. "She has felt very self-conscious about the scar on her neck and consulted with a plastic surgeon about scar revision."

Plaintiff is suing for negligence and is seeking general, incidental and consequential damages, in addition to medical and related expenses, and loss of earnings and earning capacity.

Ronald E. Harrington of Irvine represents Ley.

Friday, January 25, 2013

Kaiser Mistakes Blamed for Woman's Death from Cancer

Most Kaiser doctors are very careful not to spend too much money on finding and treating cancer patients. They are rewarded financially for keeping costs down. My childhood friend had bleeding for a year-and-a-half before Kaiser did a biopsy, then got very poor care after her cancer was diagnosed. Her first appointment with an oncologist was scheduled two weeks later than her death.



Kaiser Mistakes Blamed for Woman's Death
By PHILIP A. JANQUART
Courthouse News
January 24, 2013

CLEVELAND, Ohio (CN) - A woman who died of lung cancer may have had a shot at life had Kaiser Permanente radiologists not misinterpreted her CT scans, the woman's husband claims in Cuyahoga County Court.

In 2006, Deborah Lee Jones was under "radiological surveillance" for development of tumors in her lungs, according to the complaint. A chest X-ray taken Nov. 23, 2009 at Cleveland Heights Medical Center revealed a "questionable" new nodule in her left lung, the complaint said. A CT scan was consequently performed, revealing the new mass, which went unnoticed by Kaiser Permanente Radiologist and co-defendant David Acquah, the complaint said.

Another CT scan was performed March 9, 2010, but Kaiser radiologist David Radebaugh interpreted it as showing no change from the Nov. 23, 2009 scan, the complaint said.

Jones underwent yet another CT scan Oct. 25, 2010, which revealed a 3.3 x 2.1cm mass, and was diagnosed Nov. 11, 2010 with non-small cell lung adenocarcinoma, or lung cancer. Jones passed away Jan. 22, 2011 from bacterial sepsis due to metastatic lung cancer, according to the complaint.

Jones had been a Kaiser Permanente member since 1987.

Husband Gerald filed a wrongful death complaint in the Cuyahoga County Court of Common Pleas, naming Acquah, Radebaugh, Kaiser Foundation Health Plan of Ohio and Ohio Permanente Medical Group as defendants.v The defendants, he said, "rendered substandard care and were otherwise negligent and departed from the applicable standard of care by failing to properly interpret radiographic studies and treat Deborah Lee Jones for signs and symptoms of lung cancer."

Jones said his wife could have been saved if the tumor had been properly detected early on in its development.

"As a direct and proximate result of the aforementioned negligence, plaintiff's decedent condition was allowed to change from being curative to non-curative and untreatable," the complaint states.

Jones is seeking in excess of $25,000 including funeral costs.

Thomas H. Terry of Madison, Ohio represents the plaintiff.

Big Pharma consists of very rich "takers" who succeed through fraud, and then get congress to reward them half a billion dollars

Republican Minority Leader Mitch McConnell isn't the only one in the pocket of Big Pharma

Big Pharma buys off the Senate An eleventh hour loophole in the "fiscal cliff" deal confirms our worst suspicions about how Congress operates
BY BILL MOYERS AND MICHAEL WINSHIP
BILLMOYERS.COM
JAN 25, 2013

The inauguration of a president is one of those spectacles of democracy that can make us remember we’re part of something big and enduring. So for a few hours this past Monday the pomp and circumstance inspired us to think that government of, by, and for the people really is just that, despite the predatory threats that stalk it.

But the mood didn’t last. Every now and then, as the cameras panned upward, the Capitol dome towering over the ceremony was a reminder of something the good feeling of the moment couldn’t erase. It’s the journalist’s curse to have a good time spoiled by the reality beyond the pageantry. Just a couple of days before the inaugural festivities, The New York Times published some superb investigative reporting by the team of Eric Lipton and Kevin Sack, and their revelations were hard to forget, even at a time of celebration.

The story told us of a pharmaceutical giant called Amgen and three senators so close to it they might be entries on its balance sheet: Republican Minority Leader Mitch McConnell, Democratic Senator Max Baucus, chair of the Senate Finance Committee, and that powerful committee’s ranking Republican, Orrin Hatch. A trio of perpetrators who treat the United States treasury as if it were a cash-and-carry annex of corporate America.

The Times story described how Amgen got a huge hidden gift from unnamed members of Congress and their staffers. They slipped an eleventh hour loophole into the New Year’s Eve deal that kept the government from going over the fiscal cliff. When the sun rose in the morning, there it was, a richly embroidered loophole for Amgen that will cost taxpayers a cool half a billion dollars.

Amgen is the world’s largest biotechnology firm, a drug maker that sells a variety of medications. The little clause secretly sneaked into the fiscal cliff bill gives the company two more years of relief from Medicare cost controls for certain drugs used by patients who are on kidney dialysis, including a pill called Sensipar, manufactured by Amgen.

The provision didn’t mention Amgen by name, but according to reporters Lipton and Sack, the news that it had been tucked into the fiscal cliff deal “was so welcome, that the company’s chief executive quickly relayed it to investment analysts.” Tipping them off, it would seem, to a jackpot in the making.

Amgen has 74 lobbyists on its team in Washington and lobbied hard for that loophole, currying favor with friends at the White House and on Capitol Hill. The Times reporters traced its “deep financial and political ties” to Baucus, McConnell and Hatch, “who hold heavy sway over Medicare payment policy.”

All three have received hefty campaign donations from the company whose bottom line mysteriously just got padded at taxpayer expense. Since 2007, Amgen employees and its political action committee have contributed nearly $68,000 to Senator Baucus, $73,000 to Senator McConnell’s campaigns, and $59,000 to Senator Hatch.

And lo and behold, among those 74 Amgen lobbyists are the former chief of staff to Senator Baucus and the former chief of staff to Senator McConnell. You get the picture: Two guys nurtured at public expense, paid as public servants, disappear through the gold-plated revolving door of Congress and presto, return as money changers in the temple of crony capitalism.

Inside to welcome them is a current top aide to Senator Hatch, one who helped weave this lucrative loophole. He used to work as a health policy analyst for — you guessed it — Amgen.

So the trail winds deeper into the sordid swamp beneath that great Capitol dome, a sinkhole where shame has all but disappeared. As reporters Lipton and Sack remind us, just weeks before this backroom betrayal of the public interest by elected officials and the mercenaries they have mentored, Amgen pleaded guilty to fraud. Look it up: fraud means trickery, cheating and duplicity. Amgen agreed to pay $762 million in criminal and civil penalties; the company had been caught illegally marketing another one of its drugs.

The fact that their puppet master had been the subject of fines and a massive federal investigation mattered not to its servile pawns in the Senate, where pomp and circumstance are but masks for the brute power of money.

Peter Welch, Vermont’s Democratic congressman, has just introduced bipartisan legislation to repeal the half billion-dollar giveaway to Amgen. Its co-sponsors include Republican Richard Hanna of New York and Democrats Jim Cooper of Tennessee and Bruce Braley of Iowa.

The Amgen deal “confirms the American public’s worst suspicions of how Congress operates,” Representative Welch told us this week. “As the nation’s economy teetered on the edge of a Congressional-created fiscal cliff, lobbyists for a private, for-profit company seized an opportunity to feed at the public trough. It’s no wonder cockroaches and root canals are more popular than Congress.”

In his inaugural address, Barack Obama said the commitments we make to each other through Medicare, Medicaid, and Social Security don’t make us a nation of takers. But the actions of Amgen and its cronies under the dome on Capitol Hill show who the real takers are — not those who look to government for support in old age and hard times but the ones at the top whose avarice and lust for profit compel them to take as much as they can from that government at the expense of everyone else.

Bill Moyers is managing editor of the new weekly public affairs program, "Moyers & Company," airing on public television. Check local airtimes or comment

Tuesday, January 15, 2013

Kaiser demands cuts in nursing staff and wages--despite $5.7 BILLION profit since 2009 (and so does Sutter Health San Francisco with $200,000,000 profit in 2012)

What's more important than consumer health? A 20% profit rate by a "non-profit".

Who helped punish nurses for forming a new union? Lawyer Emma Leheny, who is now head counsel of CTA, California Teachers Association (see below).

"The state’s huge hospital chains and health corporations are demanding concessions on very front: staffing levels, health and welfare, pensions, even wages, and this at a time when these corporations (all ‘non-profits’) have rarely been more profitable."
--Cal Winslow


An Alliance in Healthcare
By Cal Winslow
Zcommunications.org
January 05, 2013
Cal Winslow's ZSpace Page

In a giant step forward for California healthcare workers, two of the nation’s most militant unions have joined forces in the battle against Kaiser Permanente, the giant California based healthcare corporation. It is a battle of enormous proportion, one with implications for the entire industry, almost certainly beyond.

The alliance joins the California Nurses Association (CNA) with the new National Union of Healthcare Workers (NUHW); it was formally announced January 3, at CNA headquarters in Oakland, CA. It comes in the face of a set of interrelated challenges, each crucial, first of all of healthcare workers of course, but equally important for patients, for workers nationwide, for us all.

“This is an affiliation whose time has come,” NUHW president Sal Rosselli told the assembly of healthcare workers, union staff and members of the press. “Employer attacks are on the rise, nowhere more so than at Kaiser Permanente. NUHW members at Kaiser, with RN co-workers from CNA have already engaged in repeated statewide strikes to stand their ground against threatened reductions to wages, benefits and job protections that other unions at Kaiser have already agreed to in spite of four years of record profits for Kaiser.”

Other unions? Here, already, the plot thickens, for this alliance is not just to battle Kaiser; it is also to fight Kaiser’s incumbent union, the Service Employees International Union’s (SEIU) California affiliate, United Healthcare Worker West (UHW). Zenei Cortez, RN, who chairs CNA’s Kaiser bargaining team, also CNA co-president, explained, “Uniting together, CNA and NUHW are taking a huge step forward in achieving our joint goal of upholding standards for workers and patients.” She made it quite clear, however, that the fight was also with SEIU’s UHW. “We will have to fight Dave Regan /UHW’s imported, thug extraordinaire president/ as well. We will fight Reagan and his cronies, it is disheartening to say that he has undermined our fight, but we will fight him every step of the way.”

It will be an uphill fight. California healthcare workers face an employer’s assault unprecedented in recent history. The state’s huge hospital chains and health corporations are demanding concessions on very front: staffing levels, health and welfare, pensions, even wages, and this at a time when these corporations (all ‘non-profits’) have rarely been more profitable. Kaiser, the country’s largest healthcare corporation, has made $5.7 billion since 2009; it pays its CEO George Halvorson $8 million a year (along with a dozen pensions). Kaiser has twenty top executives who receive annually more than $1 million each.

Sutter Health, another huge Northern California hospital chain, last year alone made 200 million dollars at its San Francisco complex, an astounding feat – as Bay Area labor writer Carl Finamore points out, it presents a profit rate of 20%, far above industry averages. In the past year Sutter RNs have repeatedly struck, defying demand’s for concessions, most recently December 24. Sutter, like Kaiser, sits on huge reserves...


California’s Health Care Wars
Counterpunch
by CAL WINSLOW
June 19, 2012

California’s healthcare workers’ wars continue, in the streets, in collective bargaining and in the courts, at a level of conflict not often matched in the US today. More, in these California conflicts, healthcare workers and their unions are as often as not on the offensive.

The new National Union of Healthcare Workers (NUHW) has struck the huge healthcare chain Kaiser Permanente four times now in the past year, twice with support from California Nurses Association (CNA-NNU) RNs. These two walk-outs (in September 2011 and January 2012), involving 20,000 strikers plus each, rank as the largest but one (the Verizon strike) on the table of recent strikes. At the same time, this spring, the NUHW has won first contracts – with wage increases and no concessions – at hospitals including Keck Medical Center, University of Southern California; Sutter Health’s California Pacific Medical Center in San Francisco; Santa Rosa Memorial Hospital; the Salinas Valley Memorial Hospital; and Doctors Medical Center in San Pablo.

At Kaiser, NUHW members are refusing to accept demands in deliberately stalled negotiations for concessions by a (non-profit?) corporation that “profited” $2.1 billion last year and pays its CEO George Halvorson $9 million annually (eight pension plans thrown in). And they are doing this while the rival Service Employees International Union (SEIU) has caved in to Kaiser yet again, this time signing a backroom deal that includes concessions demanded by Kaiser in particular in healthcare benefits. The union has agreed to a “Wellness Program” that commits members to (among other things) “holding down the costs of care at KP” and “enhancing the effectiveness and productivity of the organization” –an agreement that sets a very dangerous precedent for unions in California and a primary reason the Kaiser nurses have already been out – in solidarity strikes, supporting NUHW – twice. All this comes as NUHW members prepare for the upcoming rerun of the big Kaiser election (43,000 service and technical workers) of 2010 – the results of that election, won by SEIU in collusion with Kaiser, having been thrown out by an NLRB judge, based on evidence of widespread misconduct by SEIU.

At the same time, NUHW’s fight with SEIU has gone through another round in the courts. On Wednesday, June 13, in a San Francisco courtroom packed with NUHW members and supporters, NUHW lawyers presented oral arguments in the appeal of sixteen former United Healthcare Workers West (UHW) elected officers and leaders and the NUHW. They appealed damages awarded in the 2010 civil suit brought by the SEIU.

The 2010 San Francisco civil case was a sordid episode, another low in SEIU’s most recent low road adventures. SEIU, to the surprise of few, had trusteed its militant, progressive, 150,000 member California local, UHW.

SEIU seized the assets of UHW, fired its officers, removed its elected executive board and purged its stewards. Not content with trusteeship, SEIU was determined, in the words of its then vice president, “Wall Street” Dave Regan, now UHW president, “to drive a stake through the heart” of the new union, and, more, to see that the former, elected, UHW leaders and staff would “never again work in the labor movement.”

SEIU’s goal, then, was not just to wreck UHW (which it now has done), but to punish its leaders and staff. In the extraordinary trial in Federal Court, 28 NUHW leaders were sued for “damages” – SEIU, in a civil lawsuit, demanded of the defendants $25 million. It was astonishing, an assault on a group of working class organizers, all the more vicious given lifestyles of SEIU’s top leaders (Regan: salary $300,000 plus), not to mention their millionaire lawyers. It charged that these people, all union men and women, had “conspired” (for “personal power and profit”) – for years and all on “company” time – to leave SEIU and found a new union. It claimed they were responsible for an array of alleged offences including alleged illegal actions. They were charged with “theft, violence, and sabotage;” they “left contacts open,” “neglected grievances,” were guilty of “fiduciary malfeasance.”

But all these were dropped, and the pursuit of damages was reduced to $4 million. The case essentially came down to the charge that the UHW leaders were working – for two or three weeks in January, 2009 – against SEIU while still on the payroll. The judge, William Alsup, clearly agreed and the he instructed the jury to fix awards accordingly.

The jury – which included not a single union member – found against sixteen of the defendants, all former UHW leaders and held them liable for $725,000. NUHW was also found liable for $725,000, though this too was extraordinary; NUHW had no “fiduciary duty” to SEIU and did not exist in the weeks at issue.

$1.5 million, nevertheless, was awarded, a far cry from the $25 million first demanded, but cruel punishment for sixteen working men and women.

The appeal was argued before a three judge panel of the US Court of Appeals, Ninth Circuit. Oakland attorney Dan Siegel contested the awards in the 2010 trial. Siegel challenged the basis for these findings, focusing on the alleged “fiduciary malfeasance.” –the charge that the UHW leaders had defied “fiduciary obligations” to SEIU leadership. In addition, he argued that the judge had erred in his instructions to the jury. In the 2010 trial, Alsup had repeatedly hectored the jurors, explaining at one point that this case – this conflict between a national union and its members in a local – was analogous to a dispute between the Bank of America and a branch office. A sort of corporate affair, an internal conflict within a corporation. He prohibited any discussion of any of the issues in the dispute within SEIU. No one on the jury was a union member.

Siegel insisted that the then elected officers and leaders of UHW had the right to contest the trusteeship, including the right to oppose the SEIU national leadership’s forced transfer of 65,000 long-term care workers from UHW to another local California, the key issue at the time, the one that ultimately was decisive in SEIU’s case for the trusteeship. The then UHW leadership had insisted that these workers had the right to decide the local of their choice – including the right to vote on the transfer.

Siegel argued that these officers’ responsibilities, then, were not simply to the SEIU‘s national leadership, led at the time by Andy Stern, but also to the members of UHW (including the 65,000), the people who had elected them, who determined the local union’s policies and paid the bills. Indeed they had an obligation to abide by the member’s decisions.

He contended that this fact invalidated the award of damages – these officers and leaders, even as SEIU members, had every right to explain to the local union’s members what rights they had in the weeks between to decision to transfer the 65,000 and, three weeks later, the imposition of the trusteeship when they were all summarily fired.

They were exercising protected speech, free speech, Siegel argued, when they organized meetings to inform UHW members of these rights and choices – including their right to dissent, to decertify, even the right to form a new union. SEIU lawyers had responded that the UHW leaders had no such rights and the case was essentially reduced to charge that the UHW leaders were working against SEIU while still on the payroll.

Siegel also argued that there were larger issues, issues just as important in the long run. What were the responsibilities of local union officers, not just to national leaders but to their members, again, the workers who elected them, set policy, etc., in particular when these members were in disagreement with national policies?

SEIU lawyer, Leon Dayan, repeated that there was a long-term conspiracy, something the jury had not found in 2010, and argued that the duties of the UHW officers and staff to the national and the local were one and the same – hence asserting that the elected local union officers and leaders were essentially no more than an administrative arm of the national union.

Speaking after the hearing, Siegel said the outcome was important for two reasons, first “to remove these entirely unfair judgments, still hanging over the heads of the sixteen defendants.” In this he said he was optimistic.

Second, on the larger issues, he said he was worried that the case raised issues that could prove “very dangerous for union activists. It took a law – Landrum Griffin Act, 1959 – in part designed to protect rank-and-file workers, and turned it on its head, using it as a vehicle for payback against dissenting local union officers and members.”

Back to the streets. At the same time these workers were in court – fighting for the right to have a union, one of their own choosing – nurses at Sutter Health were on strike at ten northern California hospitals. Their walkout, the fourth strike at Sutter since September, came as union officials and Sutter management continued to clash over sick leave, retirement benefits, health care payments, patient care conditions and other issues.

“Nurses at Sutter facilities are facing an unprecedented attack on their practice the scope of which we have not seen in over 20 years,” said Zenei Cortez, co-president of CNA/NNU. “Nurses everywhere are unifying to resist Sutter’s policies of unprecedented cuts in vital patient services for our communities and deterioration of patient care standards in our hospitals.”

The strike affected 4,400 RNs , as well as hundreds of respiratory, X-ray and other technicians at three Alta Bates Summit Medical Center facilities in Berkeley and Oakland, Mills-Peninsula Health Services hospitals in Burlingame and San Mateo, Eden Medical Center in Castro Valley, San Leandro Hospital, Sutter Delta in Antioch, Sutter Solano in Vallejo, Novato Community Hospital.

“We don’t believe that Sutter needs to be demanding these onerous and unwarranted cuts from nurses because they are an extremely profitable operation that operates as what I call J.P. Morgan West,” said a California Nurses Association spokesperson. Sutter Health has made over $4.2 billion in profits since 2005, according to CNA. “They’re making decisions on what provides the best return for their shareholders, not for patient care,” he said.

Following the San Francisco hearing, a delegation of NUHW members, clad in red tee-shirts, headed for a noon rally across the Bay at Alta-Bates Summit. June, of course, has not been a good month for labor in the US, particularly in Wisconsin where the electoral turn into a (predictable) catastrophe. It’s far from all over, however. The fight-back continues, including here, in California’s booming healthcare industry.

Cal Winslow is the author of Labor’s Civil War in California, PM Press, 2012 (second edition, revised and expanded), an editor of Rebel Rank and File: Labor Militancy and Revolt From Below during the Long Seventies (Verso, 2010), and an editor of West of Eden, Communes and Utopia in Northern California (PM Press, 2012). He is a Fellow at UC Berkeley, Director of the Mendocino Institute and associated with the Bay Area collective, Retort. He can be reached at cwinslow@berkeley.edu


TEACHERS versus NURSES???? See who was on the SEIU team!

Head Counsel Emma Leheny, the real decision-maker for California Teachers Association? CTA head counsel Emma Leheny represented the union that caved in to Kaiser, SEIU, allowing cuts for nurses, and affirming the power of union officials over their members. Leheny is exactly the type of lawyer that CTA's corrupt officials like to have.


SEIU v. NUHW

Click to see entire decision affirming lower court judgment

FOR PUBLICATION
UNITED STATES COURT OF APPEALS
FOR THE NINTH CIRCUIT
No. 09-15855
D.C. No. 3:09-cv-00404-WHA

SERVICE EMPLOYEES INTERNATIONAL
UNION;
DAVID REGAN; ELISEO
MEDINA, as Trustees for SEIU
United Healthcare Workers­ West
and fiduciaries of the SEIU United
Healthcare Workers­West and
Joint Employer Education Fund;
SEIU UNITED HEALTHCARE
WORKERS­WEST, an unincorporated
association and fiduciary of the
SEIU United Healthcare Workers­
West and Joint Employer
Education Fund; REBECCA COLLINS,
as a participant in the SEIU
United Healthcare Workers­West
and Joint Employer Education
Fund,

Plaintiffs-Appellees,

OPINION v.

NATIONAL UNION OF HEALTHCARE
WORKERS; JOHN BORSOS; AARON
BRICKMAN; GAIL BUHLER; WILL
CLAYTON; JOAN EMSLIE; GLENN
GOLDSTEIN; MARK KIPFER; GABRIEL
KRISTAL; PAUL KUMAR; BARBARA
LEWIS; FREJA NELSON; FRED
SEAVEY; IAN SELDEN; SAL ROSSELLI;
JOHN VELLARDITA; PHYLLIS
WILLETT,

Defendants-Appellants.


______________________________

SEIU v. NATIONAL UNION OF HEALTHCARE
Appeal from the United States District Court
for the Northern District of California
William H. Alsup, District Judge, Presiding

Argued and Submitted
January 14, 2010--San Francisco, California

Filed March 15, 2010

Before: Myron H. Bright,* Michael Daly Hawkins, and
Milan D. Smith, Jr., Circuit Judges.

Opinion by Judge Bright


*The Honorable Myron H. Bright, Senior United States Circuit Judge for the Eighth Circuit, sitting by designation.

______________________________
SEIU v. NATIONAL UNION OF HEALTHCARE

COUNSEL

Jeffrey B. Demain (argued), Stephen P. Berzon, Peter D.
Nussbaum, Jonathan Weissglass, San Francisco, California,
Robert M. Weinberg, Leon Dayan, Washington, DC, Glenn
Rothner, and Emma Leheny, Pasadena, California, for the
plaintiffs-appellees.

Daniel Siegel (argued), Jose Luis Fuentes, and Dean Royer,
Oakland, California, for the defendants-appellants.

Sunday, January 6, 2013

Do doctors have too much political clout? Kamala Harris protects bad doctors from public scrutiny

Doctors seem to have too much clout in government, protecting them from scrutiny. We need more oversight of doctors and less secrecy in the medical profession.

Kamala Harris has a powerful tool for identifying reckless doctors, but she doesn't use it.
By Lisa Girion and Scott Glover
LA Times
December 30, 2012

As California's attorney general, Harris controls a database that tracks prescriptions for painkillers and other commonly abused drugs from doctors' offices to pharmacy counters and into patients' hands.

The system, known as CURES, was created so physicians and pharmacists could check to see whether patients were obtaining drugs from multiple providers.

Law enforcement officials and medical regulators could mine the data for a different purpose: To draw a bead on rogue doctors.

But they don't, and that has allowed corrupt or negligent physicians to prescribe narcotics recklessly for years before authorities learned about their conduct through other means, a Times investigation found.

Prescription drug overdoses have increased sharply over the last decade, fueling a doubling of drug fatalities in the U.S. To help stem the loss of life, the federal Centers for Disease Control and Prevention recommends that states use prescription data to spot signs of irresponsible prescribing, and at least six states do.

California is not one of them.

By monitoring the flow of prescriptions, authorities can get an early jump on illegal or dangerous conduct by a doctor. Among the telltale signs: writing an inordinate number of prescriptions for addictive medications or for combinations of drugs popular among addicts.

Harris' office keeps CURES off-limits to the public and the news media. But information from a commercial database containing the same kind of data illustrates how valuable CURES could be as an investigative tool.

Private firms purchase prescription data from pharmacies and sell it to drug companies for use in marketing their products. The Times obtained a list from such a database ranking the most prolific prescribers of narcotic painkillers in the Los Angeles area for June 2008.

Of the top 10 doctors on the list, six were eventually convicted of drug dealing or similar crimes or were sanctioned by medical regulators. One of them was a cocaine addict. Some had been prescribing narcotics in high volume for years before authorities caught up with them.

At least 20 of their patients died of overdoses or related causes after taking drugs they prescribed, according to coroners' records.

Had officials been tracking the doctors' prescriptions in CURES, some of those deaths might have been prevented.

Harris, a career prosecutor who was elected attorney general in 2010, declined repeated requests to be interviewed for this article.

Nathan Barankin, her chief of staff, said Harris wants to improve CURES so more doctors can use it to identify drug-seeking patients, and to help prosecutors pursue dealers and other drug offenders.

She has not proposed using CURES to detect signs of excessive prescribing.

Barankin said financial constraints limit the attorney general's options. CURES is "on life support" because of state budget cuts and is barely able to fulfill its primary mission of helping doctors and pharmacists track patients' use of medications, he said.

Even so, the database, as is, could be used to look for signs of improper prescribing. "It certainly has that capacity, as I understand it," Barankin said.

He added, however, that if Harris did begin using CURES to monitor doctors, the state Department of Justice lacks the resources to follow up on leads.

"We don't have the horses or the ability to do that kind of work," he said.

The Medical Board of California, which licenses and oversees physicians, has appealed to the public to report instances of excessive prescribing, a step it took in response to recent Times articles on overdose deaths.

But the board does not use CURES to identify doctors whose prescribing poses a danger to patients.

"We don't have the resources," said executive director Linda K. Whitney.

Dr. Tyron Reece was one physician who would have tripped an alarm early on, if officials had been watching his prescriptions in CURES.

The Inglewood family practitioner ranked fourth among prescribers of oxycodone and hydrocodone in the Los Angeles area in June 2008, according to the commercial database. Reece's customers paid for nearly all those prescriptions in cash, the data show.

The pharmacies that filled Reece's prescriptions were required by law to report them to CURES.

But Reece was not stopped until 2011, and then only because federal authorities investigating a drug smuggling ring stumbled upon evidence that implicated him. Dozens of prescription vials bearing the doctor's name had been found in the trash at a suspect's home.

Confronted by investigators, Reece admitted that he regularly sold prescriptions for cash to patients he had never examined. He pleaded guilty to drug dealing and is awaiting sentencing.

Nathan Kuemmerle, a West Hollywood psychiatrist, was busted in 2010 after narcotics detectives arrested a suspect for selling prescription pills on Craigslist. The suspect identified Kuemmerle as the source of the drugs, court records show.

During their investigation, detectives requested a CURES report on Kuemmerle in 2009 and found that he was the No. 2 prescriber of narcotic painkillers in California and the No. 1 prescriber of the highest-dose form of the stimulant Adderall, according to court records.

Kuemmerle prescribed nearly four times as many of the Adderall pills as the next doctor on the list, the CURES report showed. A medical expert said Kuemmerle wrote an average of 15 prescriptions per day for controlled substances over a four-year period, a "remarkably high" figure, court records show.

Kuemmerle pleaded guilty in 2011 to drug dealing and was sentenced to three years' probation.

Investigators expressed amazement that Kuemmerle was able to get away with such high-volume prescribing while his prescriptions were being reported to CURES. The failure to use the database to look for signs of improper prescribing closes off a valuable source of leads, they say.

"If a doctor is prescribing in a way that could be considered unreasonable, there is nothing from CURES to say, 'This might be a problem,'" said Redondo Beach Police Det. Robert Carlborg, who worked on the case. "If there had been, Kuemmerle would have been caught way sooner."...

Debra, 54, and Jesse Barajas, 20

Amos Barajas holds his wife's driver's license and a photograph of his son Jesse as a young boy. As Jesse got older, he began abusing drugs and alcohol and stole his mother's medications, Amos said. Jesse was 20 when he died of an overdose on fentanyl, which was believed to have been his mother's. Debra died of an overdose about 16 months later at the age of 54. Amos Barajas' son, Jesse, and his wife, Debra, overdosed in their home in Goleta, where Amos still lives with the family dog. Amos Barajas lost his 20-year-old son, Jesse, then his wife, Debra, to prescription medication overdoses.

Joey Rovero, 21

Joey Rovero drove more than 350 miles from Arizona State University in Tempe to get his prescriptions from a doctor in Rowland Heights and then 33 more miles to Pacifica Pharmacy in Huntington Beach. “I thought to myself, ‘Why in the world would these kids go that much farther out of their way?’ ” said Joey’s mother, April Rovero, above, with husband Joe. The fading sun reflects off the windows of the apartment complex in Tempe, Ariz., where Joey Rovero overdosed. (Aaron Lavinsky / For the Los Angeles Times) April and Joe Rovero hold a picture of their son Joey with his birthday cupcakes. He had flown home from Arizona State University to celebrate his 20th birthday with his family and girlfriend. He was 21 when he died from a drug overdose.

Byron McKinney, 33

Byron McKinney in a family photo with his brother Clint, left. Clint McKinney's brother Byron died of prescription drug-related causes in 2008. Byron McKinney was found dead of a prescription medication overdose in this Van Nuys house.

Andrew Corless, 46

Leslie Greenberg found her boyfriend, Andrew Corless, dead in front of their Northridge home. “He was a kind and gentle soul and did not deserve this,” Leslie Greenberg said of her late boyfriend Andrew Corless. He called Dr. Carlos Estiandan’s office on Aug. 11, 2006, saying he was about to undergo drug detoxification and asking the doctor to “please not see him anymore.” Corless recanted, and Estiandan continued prescribing drugs for him. He died of an overdose months later. Greenberg said the phone call was a “cry for help.” Leslie Greenberg keeps a photo and mementos from her late boyfriend, Andrew Corless, who died at the age of 46 of acute combined medicinal drug and alcohol intoxication in December 2006.

Naythan Kenney was living in an apartment in this building in Huntington Beach when he fatally overdosed in 2008, at the age of 34. Photographs of Verlene Crawford's late son, Naythan Kenney, fill much of the space on her refrigerator. “It's sad, but I need to see his face,” Crawford said. “I don't want to forget him … or put him in a storage closet. It hurts to look at him, but I can't imagine putting everything away and not looking at him.” “A lot of people say it stems from home, drugs. No, not all of it stems from home. It takes just a prescription. Just a prescription can tear a whole family apart. And that's the God's truth,” Darlene Cronin, right, with daughter Verlene Crawford, says of her grandson Naythan Kenney.

Naythan Kenney, 34 speaking, grandmother Darlene Cronin

Kelle Stavron found her son Matthew on her bathroom floor, dead at the age of 24. OxyContin, Soma and Xanax were strewn around. Matthew Stavron was 13 when he shattered his leg in a motorcycle accident in the 1990s. He had numerous surgeries — with complications — and began abusing prescription drugs. “I mean, oh my God, how could this be? How could this be? On the street, when the kids are using...they're using, they're using. But this is a doctor. My son saw a doctor,” Kelle Stavron, with her husband, Bruce, said of their son Matthew's death.

Matthew Stavron, 24 speaking, mother Kelle Stavron

Chaz La Bry, a 26-year-old aspiring rapper from San Clemente, died of an overdose of prescription medication and methamphetamine at his parents' apartment in San Clemente. Chaz La Bry, 26, was last seen alive by his father, Randy La Bry, sleeping on the living room couch. He had recently been released from jail and had been living with his parents. Darenee La Bry comforts her mother, Robin, center, as Robin recounts the day her son died of an overdose.

Chaz La Bry, 26 speaking, mother Robin La Bry

William “Skip” Halpin was found dead in a planter outside a private business complex in the 6011 block of Ball Road in Cypress from a prescription drug overdose. “There's just something different about it. It's not heroin. It's not marijuana. It's not cocaine. It's not alcohol. They're just little pills,” Jerry Halpin, principal of Brea Olinda High School in Brea, said about his brother's abuse of prescription drugs. Jerry Halpin's older brother, William “Skip” Halpin, second from left, died of a prescription drug overdose in 2008. He was a heroin abuser who had been sober for nine days before his death and was using methadone for detoxification, according to coroner's records.

William "Skip" Halpin, 51 speaking, brother Jerry Halpin

Margaret Polizo, an occupational therapist, saw her husband Doneno “Rick” Polizo on the couch before he died in 2009. He appeared to be “sleeping and snoring.” He died of multiple drug overdose. Margaret Polizo's husband, Doneno “Rick” Polizo died of an overdose in 2009. Not only did he miss watching his son and daughter grow up, she said, but his children missed out on having him in their adult lives. Margaret Polizo holds a photograph of her and her husband, Doneno “Rick” Polizo, who had a long-term problem with heroin and other illicit drugs.

Doneno "Rick" Polizo, 58 speaking, wife Margaret Polizo

“When I look at the Medicare statements that I was given for the last three months of his life, and I look at the incredible, unbelievable number of prescriptions that were prescribed to him by five different doctors — it makes me wonder what is going on out there,” Sally Finnila-Sloane says of her brother Karl Finnila, who died of an overdose in 2007. Karl Finnila sat down on the curb and died of a prescription medication overdose on the cul-de-sac at the end of this street near a sober-living home he checked into that day. Sally Finnila-Sloane's brother Karl Finnila in a photograph taken at the sober-living home shortly before he died of an overdose.

Karl Finnila, 43 speaking, sister Sally Finnila-Sloane

Danielle Thurber keeps a photograph of her late sister, Jennifer Beth Thurber, in a wallet that once belonged to her sister, who died of a prescription medication overdose in 2007 at the age of 22. Jennifer Thurber overdosed at home in May 2007. Her father, Charles, found her in her bed, pale and motionless. Charles Thurber, an Orange County sheriff's deputy, sits with his daughter, Danielle, at a park near their home in Fountain Valley.

Jennifer Thurber, 22 speaking, father Charles Thurber

As a teenager, Alex Clyburn was an athlete and Eagle Scout. In 2006, after he suffered painful injuries in an auto accident, he became addicted to OxyContin. Alex Clyburn, 23, died of a drug overdose after being admitted to a rehab facility in 2008. "If it can happen to us, it can happen to anybody," Arline Clyburn said of her son Alex's addiction to prescription drugs.

Alex Clyburn, 23 speaking, father Ron Clyburn

Larry Carmichael filled a doctor's prescription for half a dozen pain and anxiety medications days before he fatally overdosed on March 12, 2007. He was 51. Dan Carmichael found his father, Larry, dead from an accidental overdose of morphine in this apartment complex. Larry had moved in days before his death and Dan told a coroner's investigator that he thought his father’s back might have been bothering him during the move. Larry Carmichael didn’t live to see the children of his son Dan, and daughter-in-law, Rachel.

Larry Carmichael, 51 speaking, son Dan Carmichael

“Was he a junkie? No. Was he in pain? Yes. Could he get it fixed with prescriptions? Evidently not; you have to take too many,” Ron Oshier said about his brother, Clifford Dwight Oshier, who died of a prescription medication overdose in July 2009. Clifford Dwight Oshier, who had worked as a financial planner, had lost his business and home in the months before he died, said his brother, Ron Oshier. Clifford had been involved in multiple motorcycle accidents and had developed chronic pain. Clifford Oshier died in his San Diego apartment located in this residential community atop a secluded hill overlooking Mission Valley.

Clifford Dwight Oshier, 60 speaking, brother Ron Oshier

What does non-profit Kaiser do with its billions of dollars of profit each year?

Kaiser is a non-profit with billions of dollars of profits every year(!?) Much of that money is used to buy political clout--and it is very effective. Kaiser seems to control the Department of Managed Care in California.

Also, a lot of the money is funneled into Permanente Medical Group, which aggressively strives for big profits. Permanente uses it to pay generous pensions for doctors and administrators.

Patients are not Kaiser Permanente's shareholders, the doctors are. Perhaps consumers need a health care organization with the public as the owner.


Kaiser Permanente HOSPITAL GIVE $5 million to another hospital when customers continue to pay 10% average increases every year Oakland, California
Ripoff Report
Reported By: SteveW
Livermore California USA
January 05, 2013

Kaiser Permanente has donated/given away $5 MILLION DOLLARS to another hospital, how can this medical company give away $5 million when each and every year they increase customer cost by approximately 10%. 10% increase includes co-pays for doctor visist, monthly premiums and medicine co-pays as well as hospital stays. When customer cost continue to rise and I am now paying $1,237.00 per month plus co-pays on doctors, medicine and related cost. Something is wrong when my cost go up every year and this KAISER CAN donate money to some other hospital. Customer service and call backs are also problem and when you complain nobody ever calls you to explain why things are happening.

Saturday, January 5, 2013

Kaiser Safety Worries Led to Firing, Nurse Says

Kaiser can't seem to figure out whether it's an organization devoted to patient care or an organization that tasks its lawyers and administrators with squeezing every dime possible out of its operations, regardless of the effect on its customers.

No, I'm wrong about that. Kaiser has definitely figured this out. Most employees understand the rules, but apparently Helen Raquipiso thought she was supposed to be concerned about patient welfare.


Kaiser Safety Worries Led to Firing, Nurse Says

By PHILIP A. JANQUART
Courthouse News Service
January 04, 2013

SAN MATEO, Calif. (CN) - A nurse was fired after blowing the whistle on unsafe patient care practiced at a San Francisco Kaiser Permanente hospital, she claims in San Mateo County Superior Court.

Helen Raquipiso began working as an assistant nurse manager for Kaiser Permanente's South San Francisco Medical Center in 2005, but alleges she was fired in 2010 for reporting unsafe "incidents" involving errors in medication distribution, patients being transferred to inappropriate care units and admissions violations.

Raquipiso worked during the evening shift and was responsible for the northwest, central east and southwest medical-surgical units, according to the complaint.

"Between mid-2009 and December 2010, she complained of various incidents that not only affected patient safety, but violated specific regulations governing patient care," the complaint states.

The incidents involved an error in dispensing "high alert medication," Kaiser employees transferring a stroke patient to Raquipiso's unit, which is not certified to care for stroke patients, and over-admitting patients, violating the hospital's 5 to 1 patient-to-nurse ratio requirements.

Raquipiso claims hospital staff retaliated against her for voicing the complaints, receiving a negative performance review, written warnings and placed on a performance improvement plan.

She says she was only given an incomplete, oral explanation of her performance evaluation, which was conducted January 2009, and that despite repeated requests, did not receive a written copy of the evaluation until a meeting held April 16, 2010.

"At this meeting, she was also given a 'notice of final warning' despite never having been given any previous warnings, written or otherwise," the complaint states. "Although this 'final' warning was ultimately withdrawn after Raquipiso complained, it was replaced with another written warning on or about Oct. 1, 2010."

She was ultimately fired for "failure to meet the required performance improvement expectations," according to the complaint.

She is suing for retaliation under California Labor Code and wrongful termination in violation of public policy. She seeks compensatory, consequential and punitive damages.

Andrew Agtagma of San Mateo, represents Raquipiso.

Vast cache of Kaiser patient details was kept in private home

Kaiser won't let me see my own X-rays, and it falsified my medical records, but I'm apparently the only person Kaiser is trying to hide the information from.

Vast cache of Kaiser patient details was kept in private home
The case of Kaiser and Sure File Filing Systems underscores how patient information remains vulnerable in the hands of healthcare providers and outside contractors.
By Chad Terhune
Los Angeles Times
January 5, 2013

Federal and state officials are investigating whether healthcare giant Kaiser Permanente violated patient privacy in its work with an Indio couple who stored nearly 300,000 confidential hospital records for the company.

The California Department of Public Health has already determined that Kaiser "failed to safeguard all patients' medical records" at one Southern California hospital by giving files to Stephan and Liza Dean for about seven months without a contract. The couple's document storage firm kept those patient records at a warehouse in Indio that they shared with another man's party rental business and his Ford Mustang until 2010.

Until this week, the Deans also had emails from Kaiser and other files listing thousands of patients' names, Social Security numbers, dates of birth and treatment information stored on their home computers.

The state agency said it was awaiting more information from Kaiser on its "plan of correction" before considering any penalties.

Officials at the U.S. Department of Health and Human Services began looking into Kaiser's conduct last year after receiving a complaint from the Deans about the healthcare provider's handling of patient data, letters from the agency show. Kaiser said it hadn't been contacted by federal regulators, and a Health and Human Services spokesman declined to comment.

Kaiser said it remained confident that this patient information was never disclosed or accessed inappropriately. It said that some employees were disciplined because company policies were not followed and that it had informed regulators of the steps it had taken to ensure this type of incident didn't happen again.

"Kaiser Permanente is committed to protecting the medical and personal privacy of its patients," spokesman John Nelson said. "In retrospect, we certainly wish we'd never done business with Mr. Dean."

Even with tougher government oversight of medical privacy in recent years, this case underscores how confidential patient information remains vulnerable in the hands of big healthcare institutions and legions of outside contractors.

"Kaiser has shown extraordinary recklessness in this situation," said Beth Givens, director of the Privacy Rights Clearinghouse in San Diego. "Healthcare companies have to make sure their contractors adhere to ironclad security practices."

Federal and state laws impose strict standards on anyone dealing with patient information. The privacy rule of the federal Health Insurance Portability and Accountability Act, known as HIPAA, bans the unauthorized disclosure of individuals' medical records and requires healthcare providers and vendors, such as billing and storage companies, to protect the information.

Despite those rules, personal medical information of 21 million people nationwide has been improperly exposed since 2009, according to federal data. Last year, Blue Cross Blue Shield of Tennessee agreed to pay $1.5 million to resolve allegations it violated federal law after 57 computer hard drives with patient information were stolen from an outside facility.

In October, Kaiser sued the Deans in Riverside County Superior Court, accusing them of violating their contract by not returning all of its patient information two years ago when Kaiser picked up the paper records.

In court filings, Kaiser said the Deans put patient data at risk by leaving two computer hard drives in their garage with the door open. In response, Stephan Dean moved them to a spare room. On a recent day they sat next to a red recliner where Ziggy, the family's black-and-white cat, curled up for a nap. Dean said those hard drives contained spreadsheets on thousands of Kaiser patients, prepared at the company's request.

At one point, Dean told Kaiser he was planning to contact patients about the whereabouts of their medical information because he felt Kaiser hadn't taken proper precautions. The company sought a temporary restraining order against Dean, barring him from disclosing any confidential information. A Superior Court judge granted Kaiser's request until Thursday, when another hearing is scheduled.

Dean, 47, got his foot in the door at Kaiser from his previous work labeling paper folders for courthouses, hospitals and doctors.

But the demand for folders was slipping as hospitals and doctors used computers more. Kaiser was at the forefront of this as it invested billions of dollars in its HealthConnect system, which it bills as the largest private-sector electronic health record in the world. Kaiser, with more than 9 million customers, is the nation's largest nonprofit insurer and hospital system.

Dean said his small business, Sure File Filing Systems, got a big break when Kaiser acquired the Moreno Valley Community Hospital in 2008. The company needed to organize and clear out thousands of old patient files and it gave the job to the Deans, Kaiser records show.

In August 2008, the Deans started packing up thousands of files from Moreno Valley and moving them to the warehouse in Indio.

Hospital clerks routinely messaged Dean asking him to pull records on specific patients, emails sent by Kaiser to Sure File show. Dean said some Kaiser employees would put the patient's full name in the subject line of the email, and other messages listed the patient's Social Security number, date of birth, doctors' names and treatment dates. One message started, "Good Morning Sure File," and requested adoption records for a child.

Dean said Kaiser showed little concern for patient privacy in handling those requests. Only one out of more than 600 emails from Kaiser was password-protected with encryption, he said. Many medical providers use such technology so information isn't visible to others.


"Every one of these records is somebody's life," Dean said recently, scrolling quickly through what he said was Kaiser information on his computer screen. "We could have sold these emails to somebody in Nigeria, but Kaiser doesn't care about its patients' information."

Kaiser said that government rules don't require encryption and that "our vendors are contractually required to maintain secure environments for all records, and this includes Sure File."

The healthcare company awarded another job to Sure File in January 2010: to "deactivate" and store about 345,000 records from its West Los Angeles Medical Center for $206,000, according to Kaiser documents.

But within a few weeks, Dean said, he stopped working because he didn't have a contract yet for the West Los Angeles work. The two sides reached an accord in March 2010, and in a letter that month a Kaiser purchasing manager apologized to Dean for the confusion.

"We should have signed a contract prior to the commencement of this project," the manager wrote.

Three months later, in June 2010, Dean said, he stopped working for Kaiser again. This time, he said, he could no longer afford the insurance on the warehouse and $1,500 a month for gas for his file deliveries to Kaiser.

By July 2010, Kaiser had terminated the Deans' contract and picked up the medical records from the Indio warehouse, court files show.


The two sides signed an agreement in March 2011 to resolve their differences and Kaiser paid $110,000 to Dean, according to court documents. In its lawsuit, Kaiser said Dean was required to return or destroy "all the protected information of Kaiser members" as part of their agreements.

Dean says those agreements covered only the return of paper records. On New Year's Eve, Dean said, he deleted the Kaiser emails and other patient information on the two hard drives.

Kaiser said "this is a positive step, although based on [Dean's] behavior we will be seeking independent verification of his promised performance." In court filings, the company said it had sought access to his computers and email account for inspection by a forensic consultant.

Dean said he offered to grant that access — if the company paid him $100,000. Kaiser said it already had fully compensated the Deans, paying them about $500,000 in all...