Kaiser Cost a Man His Penis, He Claims

Kaiser Cost a Man His Penis, He Claims By BARBARA WALLACE  Courthouse News Jan. 21, 2015      NAPA, Calif. (CN) - An elderly patient's penis eroded because Kaiser would not let care providers remove his catheter, he claims in Napa County Superior Court.      Rupert Collins sued Kaiser Foundation Health Plan, Inc. for elder abuse, negligence and unfair business practices.      In his lawsuit, Collins says he was a patient at nonparty Napa Valley Care Center when he developed problems with his catheterized penis.      On July 21, 2013, a nurse sent a fax to Collins' insurer, Kaiser, according to the complaint.      "The fax stated that Rupert's penis was red and swollen with what was described as a cut. Rupert had a Foley catheter inserted into his penis. Monica's fax said: 'May we have a trial of no Foley to give the area a rest.' Despite this request, Kaiser denied the request to remove the Foley. Despite the fact that Kaiser was notified that Rupert's penis was red and swollen and cut, there is no documentation to show that any physician from Kaiser ever bothered to personally examine Rupert's penis," the complaint states.      "As a direct result of this reckless neglect by Kaiser, the Foley was left in Rupert's red and swollen and cut penis, and his penis began to erode further and further each day," it continues.      Two days later, there was a care conference about Rupert Collins' care, but no Kaiser representative showed up, according to the complaint.      "As a direct result of Kaiser's failure to participate, there was no meaningful communication or ongoing assessment and the dire need to remove the catheter from Rupert's eroding penis continued to be ignored," the complaint states.      On July 30, another nurse sent another fax to Kaiser requesting permission to remove the catheter, but the request was again denied, according to the complaint.      The next day, Collins' daughter had a look, according to the complaint.      "When Diana examined Rupert's penis, she was horrified at what she saw. Rupert's penis was split completely in half from the tip of his penis all the way down to the scrotum sac," the complaint states.      Collins' daughter had a third nurse contact Kaiser, but Kaiser told the nurse, "The penis erosion is normal and will heal on its own," the complaint states.      Collins' daughter pressed the issue and got him seen by a Kaiser urologist on Aug. 2. The doctor "stated that if Rupert had been treated earlier, the penis could have been saved but that the penile erosion was now complete, Rupert's penis would never heal and that reconstructive surgery was not a viable option," the complaint states.      "Rupert's penis and urethra is permanently eroded away and Rupert has suffered permanent genital mutilation," it continues.      Collins blames Kaiser's business practices for his injuries.      "The conduct of defendants is part of a general business practice at Kaiser conceived and implemented by Kaiser and Does 1-10, inclusive. This practice exists in part because defendants unreasonably expect few adverse consequences will flow from their mistreatment of their elderly, demented, disabled and vulnerable clientele, and said defendants made a considered decision to promote profit at the expense of their moral, legal and ethical obligations to their resident-patients," the complaint states.      Rupert Collins seeks general and special damages, treble damages, attorneys' fees and costs, restitution of all funds paid to Kaiser on his behalf and injunctive relief. He is represented by Rebecca J. Freeman of Freeman & Freeman in Santa Rosa.

Kaiser takes seven months and four doctors to diagnose a broken ankle

Man claims Kaiser Permanente staff misdiagnosed his broken ankle for seven months, sues for $49,900
Aimee Green
OregonLive.com
June 16, 2014

A man who says he broke his ankle while playing soccer is suing Kaiser Permanente for nearly $50,000, claiming various medical staff repeatedly told him he only had a sprain -- and his fracture went undetected for seven painful months.
A Kaiser spokesman couldn’t offer an immediate comment Monday. But according to Andrew P. Newcomb’s lawsuit, Newcomb went to Kaiser’s Tualatin medical offices on Nov. 9, 2011, seeking treatment for an injury he suffered during an indoor soccer game. The next day, he was given an X-ray and physician assistant Jeffrey Myers told him his ankle was not broken, the suit states.
“...Myers diagnosed plaintiff Newcomb as having a ‘severe sprain,’ and recommended rest, ice, compression and elevation of the foot, and Advil, up to 500 mg twice a day with food,” states the suit, filed Friday in Multnomah County Circuit Court.
According to the suit:

• Two and a half months later, Newcomb’s ankle continued to bother him -- causing him to limp and use crutches. So he made another visit to the Tualatin medical offices. Dr. Louis H. Liu ordered an MRI and recommended physical therapy after diagnosing Newcomb with “arthralgia” -- commonly known as joint pain -- of Newcomb’s ankle or foot.

• Two months later, when his ankle had still not improved, Newcomb went in again and Dr. Christopher Jason Rae, an orthopedic specialist at Kaiser, diagnosed Newcomb with a sprain.

• More than one and a half months later, Newcomb’s ankle still ailed him. So he spoke to Rae, who ordered an MRI and again diagnosed Newcomb with joint pain.

• Less than two weeks after that, Newcomb’s ankle was still hurting so he saw Dr. Kimberly Workman, a Kaiser orthopedic specialist, who looked at Newcomb’s November 2011 x-ray and diagnosed him with a “closed fracture foot, talus." It was June 13, 2012, and more than seven months had passed since Newcomb had been injured.

Newcomb underwent surgery to repair his ankle and after some physical therapy, his ankle recovered, the suit states.
Newcomb seeks $3,500 for medical and care costs and $46,400 for months of “continuous physical pain and suffering, difficulty sleeping, anxiety, emotional distress and depression,” the suit states.
The suit was filed by Portland attorney Danna Fogarty.
-- Aimee Green

Kaiser Permanente San Diego CFO Lynnette Seid personally created a hoax CD of X-ray images

UPDATE APRIL 30, 2014:

CLICK HERE for a transcript of my bizarre adventures in the Kaiser Radiology Records Department in April 2014.

UPDATE APRIL 28, 2014:

I went to Kaiser today to get medical records that I thought might be interesting. I was not disappointed. I discovered that the last doctor I visited at Kaiser wrote this:

When asked how I could help her, [Maura Larkins] states that "really I just wanted to meet you because when I asked Dr. X for a transfer to another doctor, [Dr. X] said anyone except Dr. Z". Patient felt that...I would be honest and maybe go against what my supervisor's might want me to do. Discussed with the patient that this wasn't the case at all...

Is that cute or what? I don't think the doctor who wrote this meant to be quite so truthful about her inability to give an honest second opinion.

ORIGINAL POST ABOUT KAISER CONCEALING TEST RESULTS:


Lynette Seid, CFO and chief administrator
for San Diego Kaiser medical records

See also: Is Kaiser Permanente violating the California Business and Professions Code with false advertising about digitized x-rays?

Lynette Seid is not only Kaiser Permanente San Diego Area's Chief Financial Officer. She's also the chief administrator in charge of medical records.

I asked for a CD of my digital VUCG X-ray images to take to an out-of-plan doctor, and in response, Lynette Seid created a CD with the following X-ray images.

It pretends to be a set of 13 images, but it actually consists of only 7 distinct images.

Four of the images appear twice, labeled with different numbers, but with the exact same time stamp:
#1 is identical to #4;
#2 is identical to #3,
#7 is identical to #9, and
#8 is identical #12.

One image appears three times!
(#10, #11 and #13 are identical).

Some of the copies have labels added (“scout,” “voiding,” and “post-void”), but the time stamped on each image identifies it precisely.

Image #6 is of particular interest; it is the one new image that Kaiser was willing to produce for an out-of-plan doctor.

See the 13 images--or rather, 7 images--here.

Nice work, Lynette! A particularly nice touch was the high-tech CD Lynetter sent me. When I open up the bizarre images, which were first printed out and THEN were scanned, and therefore provide extremely little information, I get a rapid slide show just by moving my cursor across the images. Lynette is pretending that someone might actually be looking at these images for the purpose of discerning information about the X-rays. In fact, the images only provide information about how desperate Kaiser is to conceal information about the X-rays it took.

Lynette Seid (Mulan7224) on Twitter

Life is truly wonderful when you love what you do and you have someone very special to share your life!

[Maura Larkins response: Seriously, Lynette? You love doing stuff like this? Do you get paid a lot to do it? And get lots of appreciation from other extremely highly-paid executives? Perhaps you are blocking out the reality that life isn't truly wonderful when one's medical records are concealed by happy folks like you.]

See all posts re Lynette Seid.

CAN BAD DOCTORS CREATE GOOD KNOWLEDGE?

I believe the answer is YES. Kaiser Permanente, for example, has guidelines that require doctors to sacrifice many patients for the purpose of increasing profits. At the same time, Kaiser collects information that helps it improve the treatment of patients who can be treated without sacrificing profits.

"IN MAY 1988, Dr Robert Pozos, a hypothermia researcher at the University of Minnesota, said he planned to analyse and republish a contemporary 56-page report on infamous Dachau experiments in which almost 300 male prisoners were placed in vats of freezing water.

"The men were observed, measured and analysed, sometimes to the point of death; sometimes they were warmed up again with boiling water. Pozos said he could learn how to treat people with hypothermia better if he understood what went on at Dachau."

This sparked off a passionate debate about the ethics of knowledge. Conferences, seminars, letters and speeches the world over have struggled with what to do about Pozos's approach. Some argued the knowledge should never be used because it was gained immorally. Others asked: "Should we not look at the pyramids because they were built using slave labour?" Eventually, Pozos used the knowledge, but the debate continues. The New England Journal of Medicine, for example, does not publish citations of the work.

Contacts and staff : Information : Nature Reviews Urology
www.nature.com/nrurol/info/info_contacts.html‎
Nature
Chief Editor: Annette Fenner, MBBS, PhD Acting Chief Editor: Sarah Payton, PhD Senior Editor: Melanie ... PhD; David Killock, PhD Cross-Journal Associate Editors: Tim Geach, PhD Editorial Support Manager: ... Clinical Practice & Research.

Patient: Kaiser Told Me 'Redheads Bleed More'

This patient was lucky that one person at Kaiser was looking out for her. This surgery might have had an even worse outcome if someone had tried to put her back to sleep when she awoke and saw a problem. I suggest an award for the staff member who insisted, "We can't give her any more medication."

Patient: Kaiser Told Me 'Redheads Bleed More'
(Click link to see documents)
By BARBARA WALLACE
Courthouse News Service
August 05, 2013

ROSEVILLE, Calif. (CN) - Kaiser staff dismissed "blood pouring uncontrollably out of" a woman's hand during surgery and "unbearable" pain afterward by saying "redheads bleed more," she claims in court.

Deborah Kossick woke up during surgery for carpal tunnel syndrome to see "blood pouring uncontrollably out of her hand and extremity, while there was chaos amongst the staff conducting the surgery, one of which kept yelling, 'we can't give her any more medication,'" she says in a complaint filed in Placer County Superior Court.

"Several days after the surgery, plaintiff was in unbearable and uncontrollable pain in her right hand," which was swollen and blackened, the complaint continues. Kossick says she "advised defendants that the pain was unbearable, and she believed that something had gone wrong during the surgery, as there was too much blood. Defendants advised plaintiff that she had nothing to worry about because 'redheads bleed more' than other patients."

At a follow-up appointment with her surgeon, Steven Hatton Ryder, M.D., a month after the operation, Kossick says she complained of continuing pain, swelling and discoloration of her hand. "Defendant showed no sympathy or concern whatsoever, and, instead, told her that there was nothing more he could do for her," the complaint says.

"To this date, plaintiff Deborah Kossick continues to be in an extreme amount of pain in her right hand, which is now permanent. The hand is also swollen and blackened, which will impact her ability to work and care for herself for the remainder of her life," according to the complaint.

Plaintiff seeks general, special and punitive damages, attorney's fees and costs of suit. Her husband, Robert Kossick, sued for loss of consortium. They are represented by David M. Poore of Brown Poore in Walnut Creek, Calif.

Woman Blames Kaiser for Multi-Organ Failure

Woman Blames Kaiser for Multi-Organ Failure
By BARBARA WALLACE
Courthouse News Service
July 31, 2013

PORTLAND, Ore. (CN) - A Kaiser patient started to bleed internally during an elective surgery to remove a mass from her kidney, and within days she was debilitated due to Kaiser's slow response, she claims in Multnomah County Circuit Court.

Patricia and Joseph Moore sued Northwest Permanente, Kaiser Foundation Hospitals and Kaiser Foundation Healthplan of the Northwest dba Kaiser Permanente for $9.5 million for medical malpractice and loss of consortium.

Within hours of the surgery Moore's abdomen was distended. Other symptoms "consistent with acute hemorrhage" followed, but it was not until shortly after midnight the next day that Kaiser "initiated their rapid transfusion protocol," according to the complaint.

Over the next two days Moore's complications escalated, including falling blood pressure, increasing abdominal distention, rapid heart beat and breathing problems, the complaint says.

"Following numerous transfusions, Patricia Moore sustained respiratory failure and was intubated. During the intubation she aspirated abdominal contents into her airway."

The next morning, "Patricia Moore was diagnosed with acute renal failure," and this was followed by removal of her left kidney and three months on a ventilator, after which she was discharged to a care facility, according to the complaint.

Moore blames Kaiser's failure to timely diagnose and surgically correct the internal bleeding for a host of problems she has experienced, including hemorrhagic shock, multisystem organ failure, acute respiratory failure, gangrene of her left leg and foot, anoxic brain injury and prolonged ventilator dependence.

The plaintiffs are represented by Timothy J. Jones and Ken L. Ammann of Salem, Ore.

Infection Ate Shoulder, Kaiser Patient Claims

Infection Ate Shoulder, Kaiser Patient Claims
By TISH KRAFT
Courthouse News Service
July 25, 2013

ANNAPOLIS, Md. (CN) - Kaiser's failure to diagnose and treat a woman's oozing bone infection resulted in part of her shoulder being eaten away, she claims in Anne Arundel County Circuit Court. Billie Jo and Ron Bonolis have sued Kaiser Foundation Health Plan of the Mid-Atlantic States Inc. and Mid-Atlantic Permanente Medical Group for malpractice and loss of consortium.

After Mrs. Bonolis had shoulder surgery, her Kaiser doctor thought she had an infection of the shoulder tissue for five months, when it actually was osteomyelitis, a bone infection, her complaint says. Within a month of the surgery, an MRI report suggested that the problem may be osteomyelitis, but no further testing was done, according to the complaint.

Three months after the surgery, and after several courses of antibiotics and attempts to clean out the surgical area, an infection consultant reported that a piece of bone used as an "anchor" during the surgery, was positive for MRSA, a "superbug" resistant to antibiotics, according to the complaint.

The infection had gone so long unchecked that it had eaten away the humoral head (the ball in the socket), and her new doctor was unable to estimate how many surgeries it would take to get rid of the painful infection, according to the complaint.

Once more of the bone had been removed to get rid of the infection, and Mrs. Bonolis was able to have her shoulder replaced, she went through a painful recovery and has suffered great mental anguish, in part due to knowing that she could have died from a superbug infection.

Mrs. Bonolis has a limited range of motion in her dominant arm and is no longer able to write normally, crochet, swim or take care of her grandchildren, among other things. Also, she needs help with personal hygiene, such as washing and combing her hair.

The new doctor told her it is unlikely that she will ever have full use of the right shoulder, the complaint says.

Roy L. Mason represents the plaintiffs, who are seeking $75,000.

Transgender teen settles with Kaiser Permanente in landmark health case

Kaiser Permanente's motive was simple: any excuse to save money. Kaiser has narrow treatment guidelines that harm patients, not infrequently causing death, but save a fortune. This is the reason Kaiser, a non-profit company, makes billions in profits each year. Kaiser then channels these untaxed profits into its for-profit Permanente companies.

Transgender teen settles landmark health case
Posted on 17 July 2013
By Katie Kerwin McCrimmon
Healthypolicysolutions.org

FORT COLLINS — An 18-year-old college student who grew up as a girl and now identifies as a young man has settled a landmark civil rights case against Kaiser Permanente of Colorado.

In the rare case, the Colorado Civil Rights Commission found in March that there was probable cause that Miki Alexander Manigault suffered discrimination and unequal access to health care specifically because he is transgender. (Click here to read the determination of probable cause.)

On the same day, after pressure from advocates at One Colorado, Colorado’s Division of Insurance issued a bulletin and became the third state in the country to specifically bar health insurance companies from discriminating against people who are gay, lesbian, bisexual or transgender. (California and Oregon preceded Colorado. The District of Columbia also bans discrimination against LGBT patients and Vermont has since followed suit.)

Faced with charges of unequal treatment, Kaiser Permanente quietly settled Manigault’s case before it was slated to go to a hearing in June. Amy Whited, a spokeswoman for Kaiser Permanente, declined to discuss Manigault’s case. As a result of a settlement with the Civil Rights Commission, however, Kaiser, one of Colorado’s largest health insurance companies, has agreed to work with the commission to convene discussions among insurers regarding health care for transgender people.

Manigault’s case has already prompted at least one other complaint to the Civil Rights Commission and may open the doors for equal health care for LGBT patients in Colorado and elsewhere in the U.S. (Coming next week: read about Kelly Costello, another transgender person who has also filed a civil rights complaint.)

Manigault grew up as Michaela, a girl with irresistible Shirley Temple dimples who nonetheless loathed girly dresses. She has now evolved into Alex, a young man embracing the gender that he believes he was born with. It just never matched his body. Until now.

Alex finally had the chest reconstruction surgery that doctors deemed medically necessary but Kaiser previously failed to cover, according to the determination and complaint.

Alex and his family cannot discuss any details of his settlement with Kaiser. But the Colorado State University art major agreed to share his story of struggle and transformation.

Alex recently traveled to San Francisco to have an experienced surgeon remove his female breast tissue and sculpt a male chest.

They felt like tumors on my chest or phantom limbs,” Alex said of the female breasts, which he used to bind to try to flatten them.

He and his mom decided to bring the civil rights complaint and filed it in January of 2012, when Alex was just 17, because insurance companies provide all sorts of breast surgeries for other patients, including reconstruction for psychological well-being for cancer patients. It seemed fair to them that health insurance should also provide coverage that makes transgender people healthier.v “A lot of transgender people go through so much drama and so much heartache and waiting for years and sometimes decades to even talk about what it is they want and need,” said Alex. “When you can finally admit what you want and feel safe, then the insurance company tells you ‘No,’ and puts another obstacle in front of you, that’s wrong.

“I’m just as surprised as you that I’m transgender,” Alex says.

Alex credits his mom for being in his corner and pressing the case. Deborah Manigault is a civil rights law enforcement officer for the U.S. Department of Housing and Urban Development. So she knew how to file a civil rights complaint and felt it was clear that Alex deserved to win.

“These are not elective surgeries. They are medically necessary for their health, for their mental health and their medical well-being,” she said. “There are many insurance companies who are claiming to be LGBT-friendly, but they are denying coverage based on transgender status.” Alex has not decided how to proceed with what transgender people call bottom surgery. Many transgender people evolving from female to male don’t bother seeking a surgically created penis since the options are poor. Results are much better for males becoming female because an experienced surgeon can essentially tuck the penis into the body and retain sensation. Alex has been taking testosterone injections since his junior year of high school, so his voice is now deep and body hair has sprouted on his stomach and will fill his chest once it fully heals. Now a sophomore in college, he still thinks he looks somewhat feminine because of a long, graceful neck and fine cheekbones that any model would envy. But the testosterone he must inject every two weeks literally empowers him as it bulks up his muscles. In contrast to the famous “It Gets Better” campaign, http://www.itgetsbetter.org/ Alex says it doesn’t get better overnight. Still, he is no longer hiding from friends and the world, afraid to hear his own voice. At last, he is embracing his manhood. He is becoming Alex. ‘I didn’t want to be transgender’ Alex doesn’t remember a light bulb moment when he suddenly knew that he should have been a boy. Instead, growing up in Maryland and the conservative South, he remembers being a weird kid who could beat all the boys in running races, but never fit in. “I went through a long process of feeling I was different in some way and not knowing what that difference was,” Alex says. Way back, at age 2, Michaela was a flower girl in a relative’s wedding. An outgoing toddler, Michaela pitched a fit over wearing the poufy floral dress for the ceremony. At the time, Deborah Manigault attributed the tantrum to a 2-year-old’s fickle independence. Now Deborah wonders if it was an early sign that Michaela didn’t feel right in her body. As a fifth-grader, Michaela remembers once being teased by a group of classmates for not fitting in. She sought solace in a large cubby where she curled up and hid.

Kaiser incorrectly told patient that surgery would be "routine"; kidney and lung damage resulted

Bleeding Risk Not Revealed, Kaiser Patient Says
By BARBARA WALLACE
Courthouse News
May 21, 2013

PORTLAND, Ore. (CN) - When a 410-pound woman consulted a Kaiser obstetrician-gynecologist about the feasibility of becoming pregnant, the doctor recommended uterine surgery but did not warn her about the risk of complications due to her weight, the woman claims in court.

Dr. Rachel Algenio told plaintiff Karen Carmocan about a fibroid tumor on her uterus in 2008, according to the complaint. Yet, "it was not until 2011 when Dr. Algenio advised Karen that the said growth would interfere with her ability to have children and because of such, Dr. Algenio recommended that Karen have surgery to remove the growth from her uterus. Dr. Algenio represented to Karen that if she had the tumor removed she should be able to give birth to a child," the complaint states.

Carmocan initiated a discussion with Dr. Algenio about pre-surgical blood storage in case she needed a transfusion, according to the complaint. However, Dr. Algenio dissuaded her, saying it was not necessary because the procedure was "routine," the complaint continues.

Carmocan lost a higher than usual amount of blood and she began to have complications in the days following the operation, the complaint says. The complications included nausea and vomiting, breathing difficulties, excessive coughing and an unusually high level of white blood cells, according to the complaint. "An elevated white blood cell count can be an indication of an infection in the body," the complaint says. She needed to use a walker to walk because the blood loss had made her anemic, the complaint continues. After another two days, Carmocan was given a transfusion, but the anemia symptoms continued, as well as the coughing and vomiting, according to the complaint.

A day after she went home, Carmocan was back in the hospital because of her continuing problems, where she was diagnosed with pneumonia and sepsis, the complaint says.

Carmocan blames Kaiser for the pneumonia and subsequent permanent lung damage, alleging it was caused by aspirated stomach contents from her untreated post-operative vomiting. She also claims excessive use of the antibiotic Vancomycin, given for the pneumonia, caused kidney failure and irreversible kidney damage. "Anemia played a significant role in the events that followed Karen's surgery," the complaint says, depriving her brain and other organs of red blood cells and oxygen for an extended period. Carmocan says Dr. Algenio breached the standard of care by causing the excessive blood loss, not anticipating anemia as a likely result and not replacing the lost blood sufficiently before sending her home.

Carmocan says Kaiser should have anticipated and warned her about "the problems that can occur during and following surgery performed on a person weighing 400 pounds," including "the increased risk of intraoperative bleeding in a patient when the surgical field is deep below an abdominal wall that is several inches thick" as well as "the increased risk of post-operative pneumonia in a patient whose extremely large body reduces the ability to breathe deeply and move about in the bed."

"Had Karen been advised by Dr. Algenio of the severity of risk of the procedure, especially the risks related to Karen's excessive weight, such as the increased risk of intraoperative bleeding," she would have decided not to pursue the surgery, she says.

Karen Carmocan gave up an educational goal of becoming a family counselor so that she and her husband, Dan, could try to have a family of their own, according to the complaint. However, "defendant's staff has represented to Karen that if she were to now become pregnant she would need to be placed on kidney dialysis during the time of the pregnancy, and even if she were to be placed on kidney dialysis, Karen would still have little chance of being able to bear a child," she says.

Karen and Dan Carmocan are suing in Multnomah County Circuit Court for $1.3 million.

Patient Says Kaiser Surgeon Cut Wrist Nerve

Patient Says Kaiser Surgeon Cut Wrist Nerve
By BARBARA WALLACE
Courthouse News
May 15, 2013

PORTLAND, Ore. (CN) - A woman lost strength and function in her right thumb, palm, wrist, index finger and middle finger and has continuing severe pain and numbness because a Kaiser surgeon cut her median nerve while doing a carpal tunnel release, she claims in court.

The personal injury and medical malpractice suit alleges Dr. Annie Links did not use all the diagnostic imaging or other equipment at her disposal to correctly identify the nerve and avoid cutting it. Dr. Link and (nonparty) Dr. Sam Weirich later tried to fix the damage, but were unsuccessful, according to the complaint.

Linda Raab is suing in Multnomah County Circuit Court for $497,000.

Medical Board of California, led by Kaiser doctor Sharon Levine, has an inept, do-nothing approach to oversight

Legislature should pull plug on inept Medical Board of California
Legislators should sunset the medical board's do-nothing, know-nothing membership and executive director, and start over fresh.
By Michael Hiltzik
Los Angeles Times
April 26, 2013

The time has come to put the Medical Board of California out of its misery.

The board oversees the licensing of doctors and their discipline for misdeeds or incompetence. It also has jurisdiction over doctor-owned surgical clinics. Long ago the board acquired the reputation of being one of the least effective regulatory bodies in Sacramento.

But evidence has mounted that it's worse: It's a danger to the community.

Because of its ineffectiveness in a variety of spheres, patients have died. Dangerous doctors have been allowed to continue operating for years after their malpractice first surfaced; surgical clinics allowed to remain open for years after dangerous conditions there were identified.

Today the board is facing a sort of medical crisis of its own: It's up for legislative re-authorization under the state's sunset rules. The legislators in charge of that procedure are talking about rubbing out the current membership and their executive director as of Jan. 1, and starting over fresh.

"That's not an idle threat," says Sen. Curren Price (D-Los Angeles), who chairs the board's sunset review with Assemblyman Richard Gordon (D-Menlo Park).

Let's hope not.

The board has sat inertly by while its disciplinary program against incompetent and dangerous doctors falls to pieces. Its regulation of the 1,200 physician-owned outpatient surgical centers under its jurisdiction — settings where patients routinely undergo surgery under potentially life-threatening conditions — is almost nonexistent.

"People are dying at these outpatient centers and your paramount responsibility is to keep that from happening," Julie D'Angelo Fellmeth, a San Diego public interest lawyer who was appointed by the legislature to monitor the board's enforcement program in 2003-2005, lectured the members last week. One would think the board knew that, but the news seemed to strike the members like a bolt from the blue.

The board's enforcement record is dismal. Since 2007 California has typically ranked among the worst states in terms of serious disciplinary actions per 1,000 licensed physicians; the public interest group Public Citizen reported in 2011 that the board had failed to take action against more than 700 physicians whose privileges had been reduced or revoked by hospitals or other clinical settings, including 102 who had been found to pose an "immediate threat" to patients.

The board says statewide hiring freezes and furloughs have eroded its enforcement staff. But in 2010 it was given the authority to hire 18 investigators despite the freeze. It still hasn't filled the positions.

The real crime of the medical board's nonfeasance is that it's a fraud on the public. Today's board is largely the product of a major change in malpractice oversight in 1975. That's when the legislature enacted MICRA, the Medical Injury Compensation Reform Act, to address a largely fabricated malpractice insurance "crisis." MICRA limited payouts for malpractice judgments so severely that it effectively made malpractice lawsuits extinct in California.

In return for the elimination of patient lawsuits as a check on dangerous doctors, the medical profession agreed to accept tougher disciplinary standards and procedures from regulators. After a few more legislative tweaks, the medical board was born.

But the promise of tougher enforcement never was fulfilled. The legislature and governor's office deserve plenty of blame for that. Although the board is funded entirely from license fees paid by doctors, not from taxpayer revenue, it wasn't exempted from the layoffs and furloughs imposed by the Schwarzenegger administration as budget-cutting measures. Meanwhile, medical lobbies such as the California Medical Assn. have opposed efforts to increase license fees to adequately fund the board's activities.

The board, which by law comprises eight physicians and seven "public" members, is unpaid except for expenses and per diems while on official business. (Four seats subject to appointment by Gov. Jerry Brown are currently vacant.) Californians get what they pay for: The members don't seem to have any conception of the breadth of their authority, and precious little inclination to use it.

That was made evident by board President Sharon Levine's appearance on March 11 before the sunset committee headed by Price and Gordon. Levine, an executive at Kaiser Permanente, made some remarkable assertions in her testimony. For example, she excused the board's terrible record on discipline by explaining that it must wait for a complaint from a patient or other outside source before opening an investigation of a doctor.

In deference to Levine's tenure on the medical board, which started in 2009 (she became president last year), I'm inclined to take a charitable view of this statement. So I'll merely call it the single most ignorant description by a government regulator of his or her authority I've heard in 30 years.

The fact is that the board has all the power it needs to act on its own, with or without a complaint; indeed, such proactivity is the hallmark of effective state medical boards. In a blistering letter following the hearing, Price and Gordon cited the specific provision of California law that "unequivocally authorizes" the board to initiate its own investigations.

More blunders came when Levine addressed the board's oversight of outpatient surgery centers owned by physicians, which came under its jurisdiction as the result of a state court ruling in 2007.

The board has outsourced oversight of these clinics, which perform an increasing number of such serious procedures as weight-loss and cosmetic surgeries, to four private, nonprofit accreditation organizations. These accreditors are not government regulators. They don't have subpoena power or the authority to close down a dangerous clinic, and they don't have consistent standards or procedures for granting accreditation.

"Horrific" consequences of Kaiser Permanente's failure to properly monitor bladder patient during and after surgery

See comparison of Kaiser urology department with other medical centers.

Patient Blames Kaiser for 'Horrific Events'
By BARBARA WALLACE
Courthouse News Service
May 08, 2013

DENVER (CN) - Two Kaiser doctors and a nurse practitioner overlooked an important lab test for a patient about to undergo bladder surgery, and both doctors made mistakes during the surgery, resulting in a "cascade of horrifying complications," the patient says in a complaint filed in Denver District Court.

Urologist Mina Shabnam Lee diagnosed 71-year-old Josephine Jansen with a mass in her bladder in April of 2011 and recommended a surgical procedure called a "bladder transurethral resection neoplasm," according to Jansen's complaint.

A nurse practitioner, Andrea Anderson, performed a pre-operative examination and Dr. Lee ordered lab work, the complaint states. Nonetheless, neither they nor the anesthesiologist, Thomas Arthur Gettelman, ordered a test of Jansen's sodium level, according to the complaint. "Either defendant Anderson or defendant Lee or defendant Gettelman could have easily ordered a simple blood test which would have included a panel of electrolytes such as sodium. The ordering of a sodium lab value is extremely easy, and non harmful to the patient, and would only take a matter of minutes to obtain. However, the priorities of each defendant were such as not to obtain this test. Moreover at least one of the drugs that the plaintiff was taking, Hydrochlorothiazide, (HCTZ) is a diuretic and has the effect of lowering some electrolyte lab values," Jansen says in her complaint.

"During the surgical procedure performed by defendant Lee, various and serious complications occurred," the complaint continues, including a ruptured bladder, and aspiration of stomach contents into Jansen's airway because Dr. Gettelman was "negligent in the performance of his duties as an anesthesiologist during the operative period," according to the complaint.

The complaint states that Dr. Lee, failed "to adequately consider the effects of fluid absorption as a result of the surgical misadventure."

"Defendant's superficial approach to this patient - particularly in having no understanding of her sodium prior to surgery - set into motion the cascade of horrifying complications which followed the surgery. And her operative and post operative mismanagement (especially in not ordering serum sodium immediately post surgery) caused further and increased harm to plaintiff," the complaint states.

"Following the surgery the plaintiff sustained severe and irreparable injury. She went into shock caused by abnormal and an almost deadly level of sodium, plaintiff's bladder was ruptured during the surgery and shortly following the surgery it was determined that plaintiff had developed severe hyponatremia which was complicated by acute cardiac decompression due to the stress induced cardiomyopathy, respiratory failure, renal failure requiring dialysis, prolonged ventilation, and significant neurological injuries. This cascade of horrific events including multi organ failure, were caused by the negligence of the defendants," Jansen's complaint says.

"Much of her damages are permanent in nature and her life has been forever changed," the complaint states. "The plaintiff has incurred substantial economic losses including the loss of her career."

Plaintiff is represented by John Astuno, Jr. of Denver.

Kaiser surgeon, or surgical resident, bungles colostomy closure, patient passes stool through vagina

Woman Blames Kaiser for Poop Through Vagina
By BARBARA WALLACE
Courthouse News
April 25, 2013

PORTLAND (CN) - A Kaiser surgeon, or a surgical resident practicing under a surgeon, bungled Vicki Lopez-Lunn's colostomy closure, puncturing her vagina with one or more staples and causing an abnormal opening between her colon and vagina, Lopez-Lunn claims in a malpractice lawsuit filed in Multnomah County Circuit Court. "As a result, Ms. Lopez-Lunn began passing stool through her vagina," according to the complaint.

James W. Dennis, M.D. and Emily Bubbers, M.D. are named as defendants.

"Vicki Lopez-Lunn was never informed of the increased risks associated with having a resident surgeon, [such as] Emily Bubbers, M.D. perform surgical procedures like the one performed on plaintiff," the complaint states. "Had Dr. Dennis and /or Dr. Bubbers informed Ms. Lopez-Lunn of the risks associated with this surgery, Ms. Lopez-Lunn would have elected not to proceed with the surgery."

"Defendant Dennis and/or Bubbers knew or in the exercise of reasonable care should have known that puncturing Ms. Lopez-Lunn's vaginal cuff with surgical staples would cause injury to Ms. Lopez-Lunn," the complaint asserts.

The plaintiff is seeking $1.7 million in damages and is represented by Clayton Morrison of Beaverton, Ore.

Was Kaiser Permanente correct, or simply trying to save money, when it said Castleman's patient was "hopeless"?

One of Kaiser Permanente's tricks is to avoid testing patients, or to avoid releasing test results, so Kaiser won't have to pay for treatment.

I agree with Plaintiff's claim in the story below that "...a deliberate strategy and business practice on the part of defendants to systematically deny medically necessary care that Kaiser is unable to provide itself...Based on a consistent pattern and practice, defendants routinely deny medically necessary treatment requested by members' medical professionals on invalid and unjustified and unjustifiable grounds for the sole purpose of saving money and, ultimately, cause the premature death of members, thus relieving defendants of the continuing financial obligation to provide care and treatment to desperately ill people."

It will be interesting to find out exactly how Kaiser handled the following case. It is true that some cases are hopeless. But Kaiser's strategies intentionally make it difficult, if not impossible, to know the truth about a patient's condition.

Here's an update on this case.

Man Says Kaiser Business Model Includes Death
By PHILIP A. JANQUART
Courthouse News Service
March 14, 2013

LOS ANGELES (CN) - Kaiser Foundation Health Plan refuses to pay for care necessary to save a man's life, he claims in court.

Jalal Afshar, 58, suffers from Castleman's disease, a rare condition known as lymphoproliferative disorder. The disease is not cancer, according to the American Cancer Society, but often leads to lymphoma and is treated with chemotherapy or radiation. He also suffers from a rare blood disorder that appears along with Castleman's disease, called POEMS syndrome.

Diagnosed in 2005, Afshar says he developed a growth in his abdomen in January 2012 and sought advice from his Kaiser oncologist, Dr. Iman Abdalla, who told him, "I don't know what to do with you," and that she had "run out of ideas and options" for his treatment, the complaint says.

She attributed his difficulty in breathing, edema in his limbs and stomach, and the growth in his abdomen to "middle-age fat" and a "sedentary lifestyle."

He then sought out a second opinion, ultimately traveling to Arkansas where he was seen by Dr. Frits van Rhee at the University of Arkansas in Little Rock. Afshar began receiving chemotherapy on the advice of Dr. van Rhee who also planned to have stem cells collected for a future stem cell transplant. Kaiser, however, denied any coverage of the treatments, claiming Afshar could get the same treatments under the Kaiser plan.

Afshar twice appealed the decision over the phone because Dr. Abdalla had "already admitted that she did not know how to treat him, and given that all of the past treatment Kaiser had offered had been ineffective." Kaiser refused, causing Afshar to return to Los Angeles where doctors administered a 12-hour course of chemotherapy using a combination of drugs that were not the same as the ones used by Dr. van Rhee, according to the complaint.

By June 8, 2012 Afshar's legs were significantly swollen and his breathing had become more labored and difficult, according to the complaint. He developed a fever and his blood pressure dropped, leading to his admittance to the intensive care unit.

On June 13, Afshar's wife Maryam was told by doctors that his condition was "without hope" and that "there was nothing else they could do," according to the complaint.

A chaplain and a palliative care representative then visited Afshar in his room and told him they believed his case was hopeless, according to the complaint.

Afshar, however, refused to accept defeat, returning to Arkansas where he once again began receiving care from Dr. van Rhee. He has since amassed over $1.8 million in medical bills, which Kaiser refuses to pay.

Afshar has been under Dr. van Rhee's care since June 17, 2012.

"This action arises out of a deliberate strategy and business practice on the part of defendants to systematically deny medically necessary care that Kaiser is unable to provide itself," the complaint states. "Based on a consistent pattern and practice, defendants routinely deny medically necessary treatment requested by members' medical professionals on invalid and unjustified and unjustifiable grounds for the sole purpose of saving money and, ultimately, cause the premature death of members, thus relieving defendants of the continuing financial obligation to provide care and treatment to desperately ill people."

Afshar is suing for breach of contract, violations of California's Business and Professions Code and intentional and negligent infliction of emotional distress.

Scott C. Glovsky and Danae A. McElroy, of Pasadena, represent the plaintiff.

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.

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.

Asphyxia Brain Damaged Second Twin, Mom Says

Asphyxia Brain Damaged Second Twin, Mom Says
By TISH KRAFT
Courthouse News
November 02, 2012

SANTA ANA, Calif. (CN) - Kaiser Permanente's botched prenatal, labor, delivery and post-natal care for a pregnancy, leaving her baby brain damaged, says a newborn's mother in a complaint filed in Orange County Superior Court.

The minor plaintiff, born after his twin, who had died in utero, developed hypoxic ischemic encephalopathy, according to the complaint.

Kaiser botched "the examinations, ultrasounds, evaluations, diagnosis, care and treatment" of mother and son, her complaint says.

Kaiser also "failed to properly advise the plaintiff's mother of any possible alternative methods of diagnosis and treatment and the possible attendant risks or diagnosis or treatment thereby failing to obtain a free and informed consent," according to the complaint.

Because of his illness, the boy will need "past and future medical care, nursing care, attendant, rehabilitation, physical and occupational therapy, speech therapy, educational therapy and attendant expenses," according to the complaint. He also has lost earning capacity, and experienced severe pain and physical and emotional suffering, according to the complaint.

The woman claims in her complaint that defendants, Children's Hospital of Orange County and 10 doctors, were negligent in caring for her newborn's multiple injuries related to his hypoxic ischemic encephalopathy, including, his kidneys, his neurologic system and his heart. These defendants were negligent in failing to appropriately monitor and treat the baby's hypertension, which ultimately caused additional damage to his kidneys, heart and brain, according to the complaint.

Plaintiffs sue for medical malpractice and negligent infliction of emotional distress, and are represented by Marshall Silberberg of Irvine.

Man Wins Lawsuit Against Kaiser Permanente; first time a Fresno jury finds Kaiser guilty of malpractice

I doubt that this was the first time that Fresno Kaiser failed to properly care for a patient. It's just the first time that Kaiser lawyers failed to convince a Fresno jury that Kaiser shouldn't have to pay for patient's damages.

Kerman Man Wins Lawsuit Against Kaiser Permanente
By Audrey Asistio
KSEE24 News
September 4, 2012

It's been a rough three years for Dusten Chevalier. Before the 27-year-old became confined to a wheelchair, he loved the outdoors. Racing dirt bikes, football, baseball, he did it all. But Chevalier says that all changed after he ended up in a Kaiser Permenente emergency room, in Fresno.

“It all started off with my stomach hurting and I actually got my appendix taken out. When I got home my if side was kind of hurting and was a little red. So we went back to the ER. Come to find out, I had an infection but they never told me any of this. I didn't even know I had a blood test pending,” said Chevalier.

He says the hospital failed to tell him that he tested positive for MRSA, an infection that could be fatal. The infection went untreated and he eventually lost the use of his legs and feet.

“At first it didn't seem real. It was hard to even imagine my life now, because before I was really into sports everything I did was outside. It was hard. It still is. Every day is really hard, but I don't know I'm just thankful I'm alive because I could have died,” expressed Chevalier.

Chevalier took Kaiser to court. After a month long battle, The jury verdict included damages in the total amount of $5,000,000.

Kaiser Permanente released a statement regarding this case that reads in part, “Kaiser Permanente, immediately after diagnosing the patient's infection, made repeated attempts to contact him to get him the treatment he needed. This was to no avail, as he provided inaccurate addresses and contact information. Kaiser Permanente went so far as to contact the Clovis Police Department to help locate the patient to get him to come in for treatment. Given these facts the jury found that, for the most part, much of the responsibility in this case fell upon the plaintiff himself, thus reducing the award by 70%.” This means Kaiser will only need to pay Chevalier 1.5 million dollars.

Chevalier claims he provided Kaiser with accurate contact information. Medical experts say the cost of his care will cost millions of dollars over the course of his lifetime.

Chevalier's attorney says this is the first time a Fresno County Jury ruled against Kaiser Permanente in a malpractice case.

Lawsuit against San Diego Kaiser Permanente for problems related to delivery with vacuum device June 2012

UPDATE: I realized why the complaint in this case doesn't talk about malpractice by the doctor. It's becaue Kaiser would simply shift the case to secret, binding arbitration.

I love the new word "mid-evil". It seems perfect, doesn't it? Of course, the teacher in me forces me to admit that the old word "medieval" is also an excellent word, and should probably be used when one is turning in work to a boss or a teacher. But for blogging, I think "mid-evil" will do just fine.

This leaves us with the question, are the actions of Kaiser doctors and administrators too often mid-evil? The sad story below reminds me of the shocking story of Dr. Hamid Safari, who was protected by Kaiser administrators and some Kaiser doctors even after two babies died horribly. In fact, the doctor who complained about Hamid Safari was fired for not keeping his mouth shut!

I am wondering, however, why the complaint does not give more details about the actual events that led up to problems with the birth of Angelina. The deliveries by Dr. Hamid Safari have been described in painful detail, including by the Los Angeles Times. This suit does not name any negligent doctor. Who, exactly, should have warned Plaintiffs about the vacuum device? Was a C-section considered? Who decided against it? I have a sneaking suspicion that not enough education and communication went on in this case. Did the patient speak English? Perhaps the doctor was not at fault, but since Kaiser has falsified so many medical records to cover up problems, we can not know with any certainty what really happened.

See Complaint filed in San Diego Superior Court June 26, 2012.
Complaint can also be seen HERE.

Kaiser Permanente Lawsuit
07/06/2012 10:11:33
by National-Health-Insurance

Soad and Ziad Oraha are suing Kaiser Permanente, they state that Kaiser Permanente used a vacuum device to deliver their baby and caused their baby not only to have a fractured skull but also brain damage.

I am no Doctor but what happened to a C-Section? Using a vacuum device for delivery of a baby sounds down right mid-evil. I wonder if the vacuum device is another one of Kaiser Permanente's money saving devices?

Kaiser May Be Liable for Gabapentin (Neurontin) Prescription

Kaiser May Be Liable for Gabapentin Prescription
By PHILIP A. JANQUART
Courthouse News (CN)
June 28, 2012

Kaiser Permanente cannot dismiss claims over the suicide of a patient taking anti-seizure medication, which occurred six months after the medical consortium won $142 million from drugmaker Pfizer over such dangerous side effects, a federal judge ruled.

Pfizer introduced Neurontin to treat epilepsy in 1994, selling about $200 million worth of the product to Kaiser over the next decade. But in 2004, Pfizer paid $430 million to settle federal charges over its marketing of Neurontin for off-label uses that were actually ineffective.

By March 2010, a jury awarded Kaiser $142 million for Pfizer's fraudulent marketing.

Six months later, Kaiser patient Charles Borreani killed himself. He had been prescribed up to 3,200 mg a day of gabapentin, the generic form of Neurontin, to treat neuropathy, a loss of sensation in the hands and feet.

Borreani's family sued Kaiser in Alameda County Superior Court, claiming that the hospital giant knew about the dangerous side effects associated with Neurontin but still pushed the drug to patients.

They say Kaiser knew that patients taking Neurontin in high doses suffered from feelings of suicide, and that it promised the court after winning the $142 million verdict that it would re-educate its doctors about Neurontin over the next 60 days.

Kaiser removed the case to U.S. District Court for the Northern District of California, claiming that federal jurisdiction arose under the Employee Retirement Income Security Act (ERISA). It moved to dismiss on the same basis since Section 502 of ERISA pre-empts any claims that might otherwise be brought under the federal law.

But U.S. District Judge Richard Seeborg called Kaiser's logic flawed last week and remanded the case to state court.

Borreani bought his Kaiser health care plan through his employer, but his family's claims do not relate to plan administration, the court found.

"Plaintiffs could not have brought this action under § 502 because they do not seek to recover benefits, to enforce their rights, or to clarify future opportunities under the plan," Seeborg wrote. "Rather, they simply assert state tort claims arising from defendants' alleged negligence in maintaining their drug formularies and in educating Kaiser physicians."

"At base, the conduct underlying the FAC does not relate to ERISA plan administration," he added, abbreviating first amended complaint. "Rather, the behavior is grounded soundly in allegations of negligence, fraud, and misrepresentation."