UCSD gives consent for sharing medical records without patient approval

I got an interesting letter from UCSD three days ago. It told me that I had consented to share my electronic medical records.

The trouble is--I had NOT given my consent. I never signed a consent form. I never clicked a box on the Internet agreeing to share my records.

And the letter from UCSD did NOT arrive in my home mailbox or even in my email. It was purely by chance that I found it on MyUCSDChart—NOT among the MyChart emails. If it had been among the MyChart emails, I would have received an alert about it in my regular email.

UCSD was definitely NOT trying to make sure that I found out about my “consent”.

Today, each time I have clicked on the link about sharing electronic medical records on MyUCSDChart, I found myself unceremoniously thrown back to the sign-in page. Automatically signed out. They really don't like it when I click on the link!

UCSD seems to be remarkably fond of both signing me in and signing me out--without my involvement--whenever it feels like it.

I found this page on the UCSD site about sharing electronic records. It seems that I am now part of two databases: The San Diego Beacon Health Information Exchange, and something called Care Everywhere.

It's not that I want to keep my records secret. In fact, I think sharing electronic records is basically a good idea. It's just that I've had problems with health providers hiding my own test results from me, so I'm sensitive about doctors violating the law regarding medical records.

Apparently the VA is also part of this system, but the VA has a more transparent consent process.

I've heard of falsified medical records, but this is the first time I heard of a falsified consent for release of medical records.



I found some interesting stuff about UCSD's informed consent process for patients in research projects:

iDASH Integrating Data for Analysis, Anonymization and SHaring

Informed Consent

Paper Consent versus Electronic Consent

Traditionally, paper-based consent has been the medium through which researchers and physicians conducted the informed consent process. The paper-based process consists of giving a hard copy consent form to a patient for him or her to review. Then a care provider answers any questions from the patient and in some cases assists the patient in reviewing the paper consent forms. The issues surrounding this procedure are that the paper-based consent form tends to be long and monotonous, and the retrieval of paper forms are often time consuming.

The new electronic consent forms use tablets or computers as the medium for communicating information and seeking consent from the patient...The iDASH team is also currently working on two systems, iCONS and iCONCUR, which are intended for such open source use in the future.

iDASH electronic informed consent management system

iCONS is a system currently being tested in a clinical trials environment at Moores Cancer Center Biorepository. The system supports informed consent electronically by enhancing the consent process for patients and researchers by acting as a consent broker and by adding multimedia aspects to the process. This consent process is opt-in, meaning no patient information is shared with researchers until the patient specifies what specific information he or she would like to share with researchers. The iCONS system creates a permission ontology to model the consent choices of the patient to assist in the process of releasing data and specimens to researchers for their consented uses.

iCONCUR is a pilot study within the University of California - San Diego Health System. This system transforms the sharing of electronic records from the opt-out system that is currently in place, meaning a patient’s record is automatically entered into the system unless the patient specifically requests to have their records taken out, to an opt-in system. The tool presents the patient with a taxonomy of his or her medical record allowing the patient to dictate what parts of the medical record to share and with whom it may be shared with.

HOSPITAL FAXED MEDICAL RECORDS TO PATIENT'S WORKPLACE

Tufts Medical Center sued for faxing patient records without consent
July 15, 2011
By Karen Cheung-Larivee
FierceHealthcare

Tufts Medical Center in Boston faces a lawsuit after a patient said the hospital faxed her medical records to her workplace without her consent, causing her embarrassment, reports The Boston Globe yesterday.

"I feel like I might have walked in (the office) naked," said patient Kimberly White.

White requested Tufts to send a form for a disability claim, but instead the hospital allegedly sent four pages of medical records about her hysterectomy to a shared fax machine at her workplace.

White filed a complaint in Plymouth County Superior Court. The hospital denies any wrongdoing, according to the article.

Tufts spokeswoman Julie Jette said, "In this matter, we complied with a patient's request to share information. We firmly believe we responded to the patient's request appropriately."

"I can't go back there," White said. "I am so embarrassed. ... I couldn't live with knowing what these people knew about me."

Earlier this year, another Boston hospital, Massachusetts General Hospital, faced accusations that an employee lost records of 192 patients on the subway. The hospital in February settled the federal case for $1 million, according to the article.

UCLA HIPAA VIOLATIONS

UCLA Health System pays $865G to settle HIPAA violation charges
July 8, 2011
FierceHealthIT
By Ken Terry

UCLA Health System has agreed to pay a fine of $865,000 and to develop a correction action plan to settle potential HIPAA privacy violations involving improper disclosures of medical records at its three hospitals, the federal Office of Civil Rights (OCR) reports.

OCR launched the investigation in 2009, following complaints by two unnamed celebrities that their medical records had been compromised. The government probe revealed that from 2005 to 2008, "unauthorized employees repeatedly looked at the electronic protected health information of numerous other UCLAHS patients," according to an OCR press release.

The Los Angeles Times reports that violations allegedly occurred at all three UCLAHS hospitals: Ronald Reagan UCLA Medical Center, Santa Monica UCLA Medical Center, and Orthopaedic Hospital and Resnick Neuropsychiatric Hospital, which are regarded as a single unit.

The hospital had disclosed in April 2008 that it had discovered that several employees had snooped into the patient records of dozens of celebrities, including Britney Spears, Tom Cruise and Maria Shriver.

When the alleged violations came to light in 2008, the California legislature passed a law that imposed escalating fines on hospitals for patient privacy breaches. The state fined UCLAHS $95,000 in 2009, reportedly in connection with the medical records of the late Michael Jackson.

The UCLAHS settlement with OCR is much smaller than previous HIPAA settlements, including those involving CVS Caremark ($2.25 million) and Rite Aid ($1 million).

As part of its settlement, UCLAHS agreed to institute new security and privacy policies, improve employee training, take action against employees who violate privacy rules, and designate an independent monitor to oversee compliance.

In a statement, UCLAHS said, "The UCLA Health System considers patient confidentiality a critical part of our mission of patient care, teaching and research. Over the past three years, we have worked diligently to strengthen our staff training, implement enhanced data security systems and increase our auditing capabilities."


MEDICAL ETHICS--RESEARCH ON MEDICAL RECORDS WITHOUT INFORMED CONSENT

J Law Med Ethics. 2008 Fall;36(3):560-6. doi: 10.1111/j.1748-720X.2008.304.x.
Research on medical records without informed consent.
Miller FG.

Observational research involving access to personally identifiable data in medical records has often been conducted without informed consent, owing to practical barriers to soliciting consent and concerns about selection bias. Nevertheless, medical records research without informed consent appears to conflict with basic ethical norms relating to clinical research and personal privacy. This article analyzes the scope of these norms and provides an ethical justification for research using personally identifiable medical information without consent.

PMID: 18840249 [PubMed - indexed for MEDLINE]

VA treatment records falsified, probe finds

See all posts re false records.

VA treatment records falsified, probe finds
Gregg Zoroya
USA TODAY
May 4, 2014

A VA investigation of one of its outpatient clinics in Colorado reveals how ingrained delays in medical care may be for an agency struggling to rapidly treat nearly 9 million veterans a year amid allegations that dozens have died because of delays.

Clerks at the Department of Veterans Affairs clinic in Fort Collins were instructed last year how to falsify appointment records so it appeared the small staff of doctors was seeing patients within the agency's goal of 14 days, according to the investigation.

A copy of the findings by the VA's Office of Medical Inspector was provided to USA TODAY.

Many of the 6,300 veterans treated at the outpatient clinic waited months to be seen. If the clerical staff allowed records to reflect that veterans waited longer than 14 days, they were punished by being placed on a "bad boy list," the report shows.

"Employees reported that scheduling was 'fixed,' " the findings say.

After the VA endured a year of criticism that it took too long to deliver earned compensation to disabled veterans, the agency faces a new wave of attacks over slow medical care.

Department officials revealed last month that 23 deaths of veterans were linked to delayed cancer screenings dating back four years. More recently, a retired doctor, Sam Foote, alleged that 40 other veterans died because of treatment delays at a VA hospital in Phoenix. VA officials say there's no evidence so far to support those claims, but the hospital administrator was placed on leave pending an investigation by the agency's inspector general.

Sally Eliano, an Arizona woman, complained that her 71-year-old father-in-law, a Navy veteran, died after delays at the VA hospital in Phoenix in the treatment of bladder cancer.

The Medical Inspector's probe in the Fort Collins case could not confirm that patients had been harmed "due to the lack of specific cases evaluation."

A key allegation by the whistle-blowing retired doctor in Phoenix is that staff members manipulated records to hide delays. The same practice was found by the VA Office of Medical Inspector at the clinic in Fort Collins.

While investigators found that VA policies were violated, local medical leaders concluded that the violations were less intentional than the result of confusion and no disciplinary action was taken, says a VA statement released Saturday. Retraining and weekly audits were implemented, the statement says.

The VA in 2013 revamped some of its tracking procedures to better gauge wait times for nearly 100 million medical appointments each year at 151 hospitals and 820 clinics.

The agency found that only 41% of new VA medical patients were seen within 14 days last year, down from 90% reported in 2012 under an old, now-abandoned measurement method.

The VA found it wasn't doing so well with first-time mental health appointments, either. The agency reported in 2011 that 95% of new mental health patients were seen within 14 days, but the new tracking system found the rate in 2013 was 66%.

Mike Davies, the VA director of access, says the revised system for tracking new-patient appointments has finally provided accurate measurements on wait times. He says the department's commitment to track every single appointment is far more stringent than industry standards.

"I don't think there's any other health-care system that does this," Davies says.

He says the VA now can better determine what additional resources it needs to make sure veterans are treated more rapidly.

As a result of what happened at Fort Collins — the Medical Inspector's investigation was completed in December — the VA has done four site inspections to see whether timely treatment standards are being met, Davies says.

They found "other instances of misunderstanding" wait-time tracking requirements, "but we have not found any widespread patterns of misunderstanding," Davies says.

But federal investigators say that despite these efforts, the VA health-care system remains plagued by delays in treatment and opportunities to cover them up.

"Data has to be reliable to be useful," says Debra Draper, who directs an investigative staff for the Government Accountability Office. "So if you've people going in there and doing all kinds of things (to change the data), it really is not reliable."

Draper has led investigations into VA health care problems for years and says the agency has been struggling to accurately assess wait times for decades.

Draper says a key problem is a lack of oversight by top VA officials. The Fort Collins problems, for example, came to light only after a whistle-blower stepped forward.

Numbers of outpatient visits are spiraling, in large part because of an aging veteran population and young combat survivors suffering multiple medical and psychological issues.

At Fort Collins and the nearby VA Medical Center in Cheyenne, Wyo. — which oversees seven clinics, including the one in Fort Collins — officials complained they didn't have enough doctors or supporting staff.

The result is jobs are left undone, VA investigators found. Staff required to follow up with veterans to schedule necessary appointments often didn't have time.

Investigators found that nearly half the clinic's 6,000 veteran patients did not have necessary medical appointments scheduled.

"Many of the (clerks) reported significant stress when trying to explain to veterans why they cannot make earlier appointments for them," the report says. "By entering (false data), the wait time for that patient appears to be zero days. ... The wait times were actually much longer."

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.

Doctor falsely diagnoses patients with cancer so he can give treatment, collect Medicare

Michigan doctor arrested for purposely misdiagnosing cancer
by Jen Hayden
Daily Kos
Aug 07, 2013

Greed knows no bounds. It pushes people to do unspeakable things. For Dr. Farid Fata, a Michigan oncologist, there were no limits:

Dr. Farid Fata, 48, of Oakland Township was arrested Tuesday and charged for allegedly submitting false claims to Medicare for services that were medically unnecessary, including chemotherapy treatments, Positron Emission Tomograph (PET) scans and a variety of cancer and hematology treatments for patients who did not need them. Dr. Fata owns and operates Michigan Hematology Oncology Centers (MHO) which has offices in Clarkston, Bloomfield Hills, Lapeer, Sterling Heights, Troy and Oak Park.

Dr. Fata was scamming Medicare to the tune of $35 million.

In the course of the scheme, prosecutors say Dr. Fata falsified and directed others to falsify documents. MHO billed Medicare for approximately $35 million dollars over a two-year period, approximately $25 of which is attributable to Dr. Fata, federal officials said.

The complaint further alleges that Dr. Fata directed the administration of unnecessary chemotherapy to patients in remission; deliberate misdiagnosis of patients as having cancer to justify unnecessary cancer treatment; administration of chemotherapy to end-of-life patients who will not benefit from the treatment; deliberate misdiagnosis of patients without cancer to justify expensive testing; fabrication of other diagnoses such as anemia and fatigue to justify unnecessary hematology treatments, and distribution of controlled substances to patients without medical necessity or are administered at dangerous levels.

Dr. Fata was prescribing painful and unnecessary treatments to patients:

The feds say he also deliberately misdiagnosed patients “as having cancer to justify unnecessary cancer treatment,” WXYZ reported.

Federal agents say Fata directed the “administration of chemotherapy to end-of-life patients who [would] not benefit from the treatment,” and deliberately misdiagnosed “patients without cancer to justify expensive testing.”

Thankfully, Dr. Fata isn't likely to get out of jail any time soon:

Dr. Fata faced a federal magistrate Tuesday afternoon. Assistant U. S. Attorneys assigned to the case argued Fata is a flight risk because he has access to about $14 million in liquid assets and a home in Lebanon. The magistrate is temporarily detaining Fata until another hearing can be held on Thursday. He faces up to 20 years behind bars if he’s convicted.

Twenty years? Not long enough. Not nearly long enough.

Kaiser Permanente's Robert Pearl runs a two-tiered system regarding patient access to test results

Robert Pearl runs a two-tiered system at Kaiser Permanente: some patients get their test results right away, but other patients might never see their test results--and their doctors might not ever see the results, either.

Here's an example of unavailable--and falsified!--X-ray results. Why would Kaiser do this? Perhaps to cover-up mistakes.

One remark of Dr. Pearl is certainly true: he really does work hard to "keep patients out of the hospital." Unfortunately, this sometimes causes the deaths of Kaiser patients.

See Kaiser executives.

Permanente boss warns of two-tiered health system
December 07, 2011
by Brendon Nafziger , DOTmed News Associate Editor
Travelers to South America can access their bank account from any humble ATM in the airport, but patients admitted to the emergency room with chest pain over the weekend often can't get their hands on electrocardiogram readings taken previously at a doctors office until the following Monday, thus raising health care costs.

Dr. Robert Pearl, the outspoken CEO of the Permanente Medical Group, a division of Kaiser Permanente, used this example to show why health care was lagging behind other industries when it comes to using information technology.

"Why do we provide so much less to our patients than banks do?" he asked attendees at the 8th Annual American Health Care Conference in Anaheim, Calif. on Tuesday.

Pearl said implementing the information technology retail and banking sectors take for granted was one of the only hopes to redeem the American medical system before it devolves into a two-tiered system, with one style of health care for the rich and one for everyone else.

"American health care most closely resembles a 19th century cottage industry," he said, adding that it was a fragmented system, mostly paper-based, with little leadership structure.

While the poor today don't have the same level of health care provision in the United States, he thinks it could get much worse. "I'm talking about a system where the middle class gets less and less, higher and higher deductibles, till there's rationing as the solution to the American health care crisis. Once that happens, we'll never go back. Today is the last great hope, I believe, for American medicine," he said.

Video games

Pearl thinks better integrating technology and employing preventive services is the best shot at boosting efficiency and reining in costs. He noted that the Kaiser Permanente system, the country's largest non-profit health plan, has been pioneering ways to help doctors share information and keep patients out of the hospital.

For instance, in a claim Pearl has made before, he said if every American received the same level of preventive services that Kaiser provides, there would be 200,000 fewer heart attacks and strokes. It's an extrapolation from a New England Journal of Medicine article from June 2010 that found the number of heart attacks at Kaiser fell about a quarter from 1999 to 2008, a drop credited in part to preventive strategies, such as giving patients beta-blockers or statins, and coordinated by Kaiser's complete electronic medical record system.

The technologies Pearl envisions to help are not even terribly cutting-edge. He sees a lot of mileage out of video and e-mail .

"I think video will be a major part of how health care is delivered in the future, if we're successful," he said.

For instance, he said in his system teenagers receiving Accutane acne treatments have tele-dermatology conferences so doctors can make sure the treatment is working and the patient isn't getting depressed, a known side effect of the drug. The conference only takes a few minutes, and doesn't require scheduling weeks in advance.

E-mail has similar productivity-boosting benefits. Pearl estimates the average Kaiser patient sends 5-6 secure e-mails to the health system a year. He thinks if this became widespread, it could lead to billions of dollars in savings. Of course, the trouble is figuring out a way doctors can get reimbursed for these services.

But it wont happen, unless we're able to change the structure, change the financing, and put in place leadership structure to make it happen," he said.

[Maura Larkins comment: Kaiser needs a new leadership structure in place to end the practice of cutting corners to make profits. Kaiser should follow basic medical standards for all patients.]

Is there a cover-up of serious errors at Kaiser hospitals?

(< < < Click on image to enlarge.)

"Since 2007, hospitals have been required to report any errors from a list of 28 “adverse events” that put patients in immediate jeopardy of injury or death."

But if the hospitals don't report the events, then they don't get penalized!

The San Diego Union-Tribune reports (see story below) that Scripps La Jolla is "among most penalized."

But the numbers just don't add up. Kaiser Medical Center in San Diego has a much higher death rate than Scripps Memorial Hospital, but Scripps receives more penalites. Scripps, the nationally-ranked UCSF in San Francisco and Southwest Healthcare in Riverside have received the most penalties from the California Department of Public Health.

How could this happen? Probably because Kaiser is covering up mistakes by falsifying medical records. Kaiser mental health workers recently reported that they were forced to falsify medical records. It's time for other Kaiser workers to tell the truth, too. Kaiser patients would be safer if Kaiser received appropriate administrative penalties.

I have personal experience that Kaiser Permanente in San Diego has falsified medical records. On July 7, 2011 I was sent home from the Emergency Room on Zion because I insisted that doctors look at my X-rays taken on June 15, 2011. The doctors refused to do so. My doctor said she didn't want to "tie up" her "resources", and ordered me to be sent home.

As I was leaving, a nurse stopped me and asked me to sign a form, but she had her hand covering the text on the form. I asked to see what the form said. It said I was leaving against medical advice! I was quite surprised.

I asked the nurse, "I can stay if I want to?"

She said, "No."

I took the form with me when I left, and I heard the nurse tell another worker, "She took it with her!"

"Get another one," her friend said.

Sure enough, when I later obtained my medical records, I found that the nurse had indeed acquired another form, and she and the doctor both signed it! The doctor also wrote in the record that I had left of my own volition. I have attached the signed form to this post, but I covered up the doctor's and nurse's names because I believe that most Kaiser doctors would have done exactly the same thing. I believe they understand that they must work as a "team" with the "Kaiser family." The doctors increase their profits by not "tying up resources."

When I filed a complaint with Member Services, my complaint simply disappeared. I filed a complaint about the disappearance, and that complaint disappeared, too! Finally Kaiser processed another complaint. The "resolution letter" stated, the "issue you have raised will be addressed." I suspect it was addressed and delivered to the trash.


State fines Scripps Memorial for surgery error
Janet Lavelle
SDUT
Dec. 9, 2011

Scripps Memorial Hospital La Jolla was among 14 California hospitals issued administrative penalties Thursday for errors that caused or could cause serious injury or death to patients, state health officials said.

This is the sixth penalty Scripps Memorial has received since the California Department of Public Health began issuing them in 2007 — more than any other hospital in the county.

Statewide, UC San Francisco Medical Center is the only other hospital to get six penalties, exceeded only by Southwest Healthcare System in Riverside County, which has been hit with seven since 2007, state records show.

Scripps La Jolla was fined $100,000 after a one-inch pin was mistakenly left inside a patient’s neck during spinal surgery in October 2010.

The pin was found and removed in a second surgery more than 12 hours later, after the patient complained of pain, and trouble swallowing and breathing throughout the day. Three X-rays were done that day, but the problem wasn’t identified until the surgeon returned to the hospital late that night and spotted the pin on the last X-ray.

Scripps La Jolla was the only San Diego County hospital cited among the 14 on Thursday.

In a phone interview with reporters, Pam Dickfoss, acting deputy director of the state health department’s Center for Health Care Quality, said the penalties are part of a larger effort to make hospitals safer.

“Our goal is to improve the quality of health care in all California hospitals,” Dickfoss said.

Since 2007, hospitals have been required to report any errors from a list of 28 “adverse events” that put patients in immediate jeopardy of injury or death. So far, 214 penalties have been issued to 123 hospitals with assessed fines of more than $7.8 million, Dickfoss said...



Here's the list of local hospitals that reported errors. Isn't it a bit suspicious that Kaiser hasn't reported a single error, when it has higher death rates than Scripps, UCSD, and Sharp?

Hospital Administrative Penalties for San Diego County
Penalties Issued in 2011

Scripps Memorial HospitalNew Window
9888 Genesee Avenue, La Jolla, 92037, San Diego County - The hospital failed to ensure the health and safety of a patient when the hospital did not follow its surgical policies and procedures. This resulted in a patient having to undergo a second surgery to remove a retained foreign object. The penalty is $100,000.

Palomar Medical CenterNew Window
555 E. Valley Parkway, Escondido, 92025, San Diego County - The hospital failed to ensure the health and safety of a patient when it did not implement its established policies and procedures for the safe distribution and administration of medication. This is the second administrative penalty issued to the hospital. The penalty is $75,000.

Pomerado HospitalNew Window
15615 Pomerado Road, Poway, 92064, San Diego County - The hospital failed to ensure the health and safety of a patient when it did not follow its policies and procedures for fall prevention. This is the third administrative penalty issued to the hospital. The penalty is $75,000.

Scripps Memorial HospitalNew Window
354 Santa Fe Drive, Encinitas, 92024, San Diego County - The hospital failed to ensure the health and safety of a patient when it did not follow its surgical policies and procedures. This is the first administrative penalty issued to the hospital. The penalty is $50,000.

Scripps Memorial HospitalNew Window
9888 Genesee Avenue, La Jolla, 92037, San Diego County - The hospital failed to ensure the health and safety of a patient when a patient was not adequately supervised during a surgical procedure. This is the second administrative penalty issued to the hospital. The penalty is $75,000.

Sharp Memorial HospitalNew Window
7901 Frost Street, San Diego, 92123, San Diego County - The hospital failed to ensure the health and safety of a patient when it failed to accurately administer a prescribed medication. The penalty is $25,000.
Penalties Issued in 2010

Palomar Medical Center (PDF)New Window
555 E. Valley Parkway, Escondino, CA 820211, San Diego County - The hospital failed to ensure the health and safety of a patient when it did not follow its patient care policies and procedures. This is the first administrative penalty issued to this hospital. The penalty is assessed at $50,000. - Administrative penalty issued based on finding during survey completed on 01/25/2010.

Grossmont Hospital (PDF)New Window
5555 Grossmont Center Dr., La Mesa 91942, San Diego County - The hospital staff failed to follow the policies and procedures for surgical and invasive procedures. Administrative penalty issued based on findings during a survey completed 04/03/2009.

Pomerado Hospital (PDF)New Window
15615 Pomerado Rd., Poway 92064, San Diego County - The hospital failed to ensure the health and safety of a patient when the hospital did not follow its policies and procedures for fall prevention. Administrative penalty issued based on findings during a survey completed 09/02/2009.

Rady Children’s Hospital (PDF)New Window
3020 Children's Way, San Diego 92123, San Diego County - The hospital failed to implement its established policies and procedures for the safe and effective administration of medication. Administrative penalty issued based on findings during a survey completed 05/14/2009.

Scripps Green Hospital (PDF)New Window
10666 North Torrey Pines Rd., La Jolla 92037, San Diego County - The hospital failed to ensure the health and safety of a patient when the hospital did not follow its surgical policies and procedures for equipment cleaning. Administrative penalty issued based on finding during survey completed on 10/15/09.

Scripps Green Hospital (PDF)New Window
10666 North Torrey Pines Rd., La Jolla 92037, San Diego County - The hospital failed to ensure the health and safety of a patient when the hospital did not follow its surgical policies and procedures. Administrative penalty issued based on finding during survey completed on 05/21/09.

Scripps Mercy Hospital (PDF)New Window
4077 Fifth Ave., San Diego 92103, San Diego County - The hospital failed to ensure the health and safety of a patient when the hospital did not follow its surgical policies and procedures. Administrative penalty issued based on finding during survey completed on 07/02/09.

Scripps Memorial Hospital La Jolla (PDF)New Window
9888 Genesee Avenue, La Jolla 92037, San Diego County - The hospital failed to ensure the health and safety of its patients when it failed to follow its surgical policies and procedures. This is the fourth administrative penalty issued to this hospital. The penalty is assessed at $50,000. Administrative Penalty issued based on finding during survey completed on 07/24/2009.

Sharp Memorial Hospital (PDF)New Window
7901 Frost St., San Diego 92123, San Diego County - The hospital failed to ensure the health and safety of a patient when the hospital did not follow its surgical policy and procedure. This resulted in a patient having to undergo a second surgery to remove a retained foreign object. Administrative penalty issued based on findings during a survey completed on 04/06/2009.

Tri-City Medical Center (PDF)New Window
4002 Vista Way, Oceanside 92055, San Diego County - The hospital failed to ensure the health and safety of a patient when the hospital did not follow its surgical policies and procedures. Administrative penalty issued based on finding during survey completed on 10/15/09.

University of California San Diego Medical Center (PDF)New Window
200 West Arbor Dr., San Diego 92109, San Diego County - The hospital failed to ensure the health and safety of a patient when the hospital did not follow its surgical policy and procedure. This resulted in a patient having to undergo a second surgery to remove a retained foreign object. Administrative penalty issued based on findings during a survey completed on 02/24/2009.
Penalties Issued in 2009

Scripps Mercy Hospital (PDF)New Window
4077 Fifth Avenue, San Diego 92103, San Diego County - Administrative penalty issued based on finding during a survey completed on 09/10/2008.

Scripps Mercy Hospital (PDF)New Window
4077 Fifth Avenue, San Diego 92103, San Diego County - The hospital failed to have a safe, effective and timely system for dispensing and administering medications. Administrative penalty issued based on finding during a survey completed on 4/8/2008.

Sharp Chula Vista Medical Center (PDF)New Window
751 Medical Center Ct., Chula Vista 91911, San Diego County - The hospital failed to ensure the health and safety of a patient when the hospital did not follow its surgical policy and procedure. This resulted in a patient having to undergo a second surgery to remove a retained foreign object. Administrative penalty issued based on findings during a survey completed on 01/22/2009.

Sharp Mesa Vista Hospital
7850 Vista Hill Avenue, San Diego 92123, San Diego County - Administrative penalty issued based on findings during survey completed on 12/02/2008. Information specific to the incident resulting in the issuance of this Administrative Penalty can not be released pursuant to Section 5328.15 of the Welfare and Institutions Code.

Tri-City Medical Center (PDF)New Window
4002 Vista Way, Oceanside 92056, San Diego County - The hospital failed to ensure the health and safety of a patient when the hospital did not follow its policies and procedures for fall prevention. Administrative penalty issued based on findings during a survey completed on 03/03/2009.

University of California San Diego Medical Center (PDF)New Window
200 West Arbor Drive, San Diego 92103-8976, San Diego County - Administrative penalty issued based on finding during a survey completed 11/26/2008.
Penalties Issued in 2008

Grossmont Hospital (PDF)New Window
5555 Grossmont Center Drive, La Mesa 91942, San Diego County - The hospital failed to ensure the health and safety of a patient when they failed to activate a stationary ventilator during a transfer of the patient from a transport ventilator resulting in the patient’s death. Administrative penalty issued based on finding during a survey completed on 4/4/2008.

Palomar Pomerado Health System (PDF)New Window
15615 Pomerado Road, Poway 92064, San Diego County - The hospital failed to maintain its anesthesia equipment in proper functioning order. As a result three patients experienced surgical awareness during surgical procedures. Administrative penalty issued based on finding during a survey completed on 4/3/2008.

Promise Hospital of San Diego (PDF)New Window
5550 University Avenue, San Diego 92105, San Diego County - The hospital failed to ensure the health and safety of its patients by allowing an unlicensed staff person to function as a licensed nurse. Administrative penalty issued based on finding during a survey completed on 5/15/2008.

Scripps Green Hospital (PDF)New Window
10666 North Torrey Pines Road, La Jolla 92037, San Diego County - The hospital failed to ensure the patient safety in the surgical department when a patient fell off an operating table during surgery. Administrative penalty issued based on finding during a survey completed on 4/8/2008.

Scripps Green Hospital (PDF)New Window
10666 North Torrey Pines Road, La Jolla 92037, San Diego County - The hospital failed to implement policies and procedures to provide for effective surgical service infection control. Administrative penalty issued based on finding during a survey completed on 11/27/2007.

Scripps Memorial Hospital (PDF)New Window
9888 Genesee Avenue, La Jolla 92037, San Diego County - The hospital failed to implement policies and procedures related to the safe and accurate use of medications in emergent situations. Administrative penalty issued based on finding during a survey completed 11/27/2007.

Scripps Memorial Hospital (PDF)New Window
9888 Genesee Avenue, La Jolla 92037, San Diego County - The hospital failed to develop and implement policies a procedures to protect patient safety related to the use of controlled substances. Administrative penalty issued based on finding during a survey completed 11/27/2007.

Scripps Memorial Hospital (PDF)New Window
9888 Genesee Avenue, La Jolla 92037, San Diego County - The hospital failed to protect a patient's right to considerate and respectful care. Administrative penalty issued based on finding during a survey completed on 8/30/2007.

University of California, San Diego Medical Center (PDF)New Window
200 West Arbor Drive, San Diego 92103-8976, San Diego County - The hospital failed to develop and implement policies and procedures to protect patient safety by failing to ensure the safe administration of medications. Administrative penalty issued based on finding during a survey completed on 9/18/2007.

Survey Reveals Problems With Mental Health Care At Kaiser Permanente

Who sits on the boards of those "independent rating agencies" and State of California offices that "recognize the quality" of Kaiser Permanente's mental health services? And who sits on the boards of "independent" agencies who rate other aspects of Kaiser's medicalcare? Kaiser doctors and administrators!

Survey Reveals Problems With Mental Health Care At Kaiser Permanente
November 14, 2011
By Kenny Goldberg
KPBS

SAN DIEGO — A union-backed survey of providers at Kaiser Permanente shows widespread dissatisfaction with the HMOs' mental health services. The union representing mental health professionals has been negotiating a new contract.

The National Union of Healthcare Workers surveyed more than 300 mental-health providers at Kaiser facilities in California. Many said they're not given enough time to evaluate patients, and they're not able to schedule return appointments in a timely way.

Jim Clifford has been a therapist at Kaiser's outpatient clinic in Otay Mesa for 10 years. He said mental-health care has gotten short shrift.

"We're trained to know what adequate care is and to provide it," he said. "And it's very troubling ethically to be in a position due to poor staffing not to be able to provide that. And it's been a chronic situation at Kaiser."

Clifford said Kaiser has refused to beef up staffing so that mental-health patients can get better care.

In a written statement, Kaiser officials said the quality of their mental health services has been recognized by independent rating agencies, and the state of California. The HMO said the NUHW survey was inaccurate and biased.



Long Wait Times The Norm At Kaiser Mental Health, Study Finds
Says company posting record profits while patients being denied the care they need.
Suisun City Patch
By Karina Ioffee
Nov. 15, 2011

Patients who seek mental health services at Kaiser Permanente have to wait for weeks for appointments, are routed into group therapy even when they need individual attention and are not given proper initial evaluations, according to a new report by the National Union of Healthcare Workers, that represents some 2,500 mental health clinicians.

The study is based on a survey of over 300 Kaiser mental health professionals practicing at 57 Kaiser facilities in Northern and Southern California, along with dozens of open-ended interviews with clinicians and patients.

Among its findings:

Kaiser mental health clinics are insufficiently staffed, with patients often forced to wait four weeks or longer for return appointments. That’s despite the fact that California state regulations require that patients be seen within ten business days,

Staff conduct accelerated initial patient evaluations that fall short of recommended clinical standards, which are then miscoded incorrectly in order to avoid penalties,

Patients that are funneled into group therapy even when their diagnoses call for individual therapy,

Falsified patient scheduling records that conceal appointment delays from state regulators, through practices such as "shadow" paper records and deliberately canceling and rescheduling patients' appointments while falsely attributing the cancellation to the patient.

Clinicians interviewed for the study describe a pattern of “deceptive practices by Kaiser administrators that routinely compromise the health and safety of thousands of patients suffering from emotional pain and distress in order to save the company money,” according to the report, titled “Care Delayed, Care Denied.”

Kaiser has more than 6.6 million members and is California's largest HMO. Since 2009, it has reported profits of $5.7 million and last year paid its Chief Executive Officer George Halvorson $6.7 million.

“It’s clear to us that decisions are being made from an accounting standpoint, that Kaiser’s approach to treatment is about making money for Kaiser and basically denying patients the treatment they deserve,” said Jim Clifford, a therapist for Kaiser in San Diego.

Click here to listen to interviews with Kaiser mental healthcare providers and patients

In an issued statement, Kaiser said the findings of the study were inconsistent with its patient and provider survey data and that the HMO regularly performs better than the standards set by the state of California.

“We are disappointed that the NUHW is going to such effort to attempt to discredit the great work performed every day by our clinicians and mental health therapists,” the company said. “They (therapists) provide timely, high-quality mental health care services to our patients, day in and day out, and whenever emergencies arise.”

The company went on to say that it offers Urgent Services where patients in crisis can get same-day or next-day appointments along with consultations for patients who have been admitted to a hospital or those who arrive in the emergency room. In addition, Kaiser says it offers a mix of individual and group therapy and defends the latter as a proven and effective method for mental health treatment.

Now, NUHW is demanding an investigation by the California Department of Managed Health Care, that regulates Kaiser's HMO plans and the Department of Insurance, which regulates the company's fee-for-service offerings.

They also want the Attorney General's office to look into potential unfair business practices at Kaiser mental health.

Kaiser Permanente found to be "cooking the books" regarding mental health care

Dr. Robert Schannon and Linda Thornton are in charge of Kaiser Permanente's Behavioral Health Department in San Diego.

Study: Calif. mental patients force to wait past limit
By Kelly Kennedy
USA TODAY
Nov. 13, 2011

WASHINGTON – Mental health patients in California are often forced to wait for care beyond the 10-day limit required by state law, which is a troubling sign for the 2010 federal health care law's requirement to treat mental health patients in the same way as those suffering from other ailments, a survey of providers shows.

A survey of 305 mental health providers at 57 California Kaiser Permanente facilities found that mental health patients do not receive needed care in a timely manner, that managers ask employees to "cook the books" so it appears they meet a California law for an initial appointment within 10 days, that patients are funneled into group therapy because there are not enough clinicians for one-on-one care and that clinicians do not have time to perform basic assessments.

The survey was conducted by the National Union of Healthcare Workers.

The California findings are troubling for the nation because the federal health law requires insurers to pay for mental health issues as they would for any standard health issue, often referred to as parity.

Staffing has "always been a problem," but recent parity laws have made it worse, said Clement Papazian, a Kaiser Permanente licensed clinical social worker out of Oakland, where the organization is based.

That doesn't surprise Patrick Gauthier, director of AHP Healthcare Solutions, a research group that looks at behavioral health. He said that the problem is growing across the nation and that it will continue to grow until "parity" is better defined: what treatments should be covered and who can — or should — provide them. Even so, he said, until mental health care is integrated into the health system — rather than appearing as an extra service — it will be easier for plans to cut costs there.

According to the California survey, more than half of clinicians said their next available appointment was more than 10 business days away, and more than 65% said return appointments took longer than 10 days.

The California Psychological Association released a statement saying its members were "deeply troubled" because "if true, the care of the patient is being compromised."

Don Mordecai, the regional director of mental health and chemical dependency services for Kaiser Permanente in Northern California said his clinicians "provide timely access to high-quality mental health care for our members."

"The survey information described to us does not align in any way with our own data, nor with independent evaluations of our services," he said.

Patient is shocked when reviewing medical record

Medical Malpractice/False Medical Records
posted by Yoko
30 Mar 2006
Medical News Today

When I was pregnant with my 4th child, I was told I was "slightly" high-risk. My OB doctor did not want me to take amnioscentesis test right away. He recomended me to go to this specialist who had 3-D fetal ultrasound. This specialist told me that my baby did not have Down syndrome or any other health problems. When I went back for the second time, she confirmed that everything was just fine. "No problem."

She also told me NOT to take amnioscentesis test since she did not see any signs of Down syndrome or any other problems. I did not reply that time since I believe my OB doctor would follow up with me. However, nobody did.

Three months later, my baby was born with Down syndrome and two VERY large heart defects, which needed to be repaired within 3 months.

A few weeks after, I went back to my OB's office to view my medical records. I was shocked to find out that both my OB doctor and this specialist were filling false statements in my record. For example, "she recommended me to take amnioscentesis test, but the patient declined it." And my OB doctor also stated he showed this report from the specialist to me - he never did. I was also shocked to find out I had been at higer risk than my actual age and after the blood test, the lab was suggesting I should get amnioscentesis test.

I am a teacher and finishing up my graduate school work, but with the unexpected pregnancy and a baby born with these problems, I cannot pursue my career any more.

I had a neighbor whose daughter had Down syndrome, which made her severley retarded. Every day I go through a very tough time to understand my family has to go through what this family went through. My baby is precious and I really want to do my best for him, but it is very very hard. What upsets me most is that I was never given an option and time to prepare for this.

Dr Mark Midei's medical license revoked

Dr Mark Midei's medical license revoked
July 13, 2011
Shelley Wood
The heart.org

The Maryland Medical Board has concluded its review of Dr Mark Midei, deciding to revoke his license, calling his violations of the Medical Practice Act "repeated and serious."

The disciplinary actions alert published on the board's website today notes that the board will not accept any application for reinstatement by Midei for at least two years. At that time, it is up to the board whether it will consider reinstatement of his license.

As previously reported by heartwire, Midei is alleged to have implanted hundreds of unneeded stents when he worked at St Joseph Medical Center in Towson, MD. The imbroglio was ultimately taken up by the US Senate Finance Committee, which issued a damning report back in December 2010.

For years, however, watchers have been waiting to hear what the Maryland Board of Physicians concluded, having charged Midei with violating the Medical Practice Act back in July 2010, focusing specifically on five patients it was alleged may have received stents unnecessarily. A subsequent seven-day hearing before an administrative law judge (ALJ) led to her issuing a 77-page "proposed decision" that Midei have his license revoked for having violated five provisions of the act, specifically those prohibiting:

* Unprofessional conduct in the practice of medicine.
* Willfully making a false report or record in the practice of medicine.
* Gross overutilization of health care services.
* Violations of the standard of quality care.
* Failure to keep adequate records...

NYC Doctor Accused of Falsely Telling Patients They Had HIV

NYC Doctor Accused of Falsely Telling Patients They Had HIV
June 4, 2011
Billy Hallowell

It’s a hard-to-believe accusation, but one that prosecutors believe to be true. A New York City doctor allegedly told about a dozen patients that they were infected with the HIV virus. Then, he purportedly treated them and billed Medicaid $700,000. As a result, he may face 15 years behind bars. FOX News has more:

Suresh Hemrajani, 57, was arraigned Friday in Manhattan Supreme Court on felony charges of grand larceny, fraud and falsifying business records. He was being held in lieu of $250,000 bail…

The doctor also created false records of his purported repeated treatments of the patients, even though most of them never visited his office more than once.

The scam was only revealed after the patients later attempted to obtain prescriptions from a hospital, were tested, and found to be HIV-negative, Vance said...

Doctors falsely diagnose patient HIV positive based on claims by Sheriff's deputy

Dr’s Falsely Diagnosed Larry HIV+ Positive Based On Claims of Sheriff Deputy???
Larry Sinclair
Apr• 05•11

Today we received records which were requested concerning Larry’s suicide attempt last September 27th. While reading the records we came across not one, not two, but four (4) Progress Reports and one (1) Discharge Summary where West Virginia Doctors “diagnosed” Larry as being HIV Positive. Not only did these Doctors make this incorrect diagnosis repeatedly, they did so without EVER having performed a single HIV test.

Today we contacted one of the Doctors who reported this false diagnosis to ask how they had come to such a diagnosis. The Doctor was kind enough to take our call and after reviewing the file called back and apologized for the diagnosis. The Doctor informed us they did not know exactly where the information had come from, but they believed it was relayed through the Emergency Room by the Deputy who had Larry taken to the hospital.

Larry is NOT HIV Positive nor has he ever been HIV Positive and to have a medical facility and multiple Doctors record such a diagnosis without ever conducting a test is reckless an unacceptable.

We have just received a call from the Hospital Administrator concerning the HIV Positive diagnosis entered in their records. They too have confirmed that upon review of all notes, reports, and diagnostic test there is NOTHING whatsoever that would suggest a diagnosis of HIV Positive. However, they explained that the diagnosis cannot be removed from the records but the Doctor can go back an add an amendment to the record noting it is erroneous. Anti-Sinclair bloggers have since 2008 posted on the Internet statements that Larry was HIV Positive and now we have a University Medical facility and Doctors placing the same in Larry’s medical records without any medical evidence to support it. This facility even transmitted the false diagnosis to a second medical facility.

We have sent a written request to Jefferson County Sheriff Robert Shirley to inquire as to whether his employee Cpl. Kevin J. Boyce told medical personnel that Larry was HIV Positive (which he is not) and why.

Death case doctor "knew he had made false record"

Death case doctor "knew he had made false record"
28 January 2010
Dewsbury Reporter

A JURY is deciding if a doctor lied to an inquest about signing the medical form of a woman who died after leaving hospital.

Dr Rohit Sinha has pleaded not guilty to perjury at the inquest of Wanda 'Jenny' Murphy, a widow from Brunswick Street, Westborough, in 2008.

Mrs Murphy cut short a trip to Malta in 2007 when she began having dizzy spells.

She was seen by Sinha at Dewsbury and District Hospital on August 13, and allegedly signed a self-discharge form and went home.

She later fell and broke her neck, and died in hospital on September 1 after contracting bronchial pneumonia.

A medical form suggested that Mrs Murphy had discharged herself from hospital, but after a complaint by her family who claimed that was not true, an inquiry started.

Prosecutor Paul Williams said: "Dr Sinha said he had signed her record card on August 13, 2007, to witness her signature and decision to self-discharge. But he had in fact signed it at a later date.

"He had made a false record and he knew it."

He said a photocopy of the form did not show Sinha's signature.

Leeds Crown Court heard Susan Terry, a friend and neighbour of Mrs Murphy, saw her the day after she left hospital, and she was clearly unwell.

She said: "She said she had been discharged and was very angry."

During the inquiry a senior nurse was asked to retrieve the document on August 24 and showed it to Sinha, of Hopton Drive, Sunderland. At that stage it had not been signed.

Mr Williams said: "When it appeared later in the investigation it had a signature. The doctor realised his mistake and put the signature in later."

Sinha then requested the contact details of a nurse involved in the inquiry, Nicola Royal.

Mr Williams said: "He said there should be no discrepancies between his statement and that of nurse Royal. There is an indication that he knew he had done wrong and was trying to cover up."

Sinha, 31, has no previous convictions. Christopher Hague, consultant gastroenterologist at Wansbeck Hospital, worked with him between August 2008 and August 2009.

"I would call him an excellent junior doctor and someone who should have an excellent future in the medical field. I would work with him again at any time," he told the court.

Michael Bowes QC, defending Sinha, said Sinha had never told the coroner he had 'definitely' signed the card on August 13.

He added: "Being pretty sure he signed it, is not the same as definitely signing it. Therefore, it is not perjury."

UCI doctor disciplined for false surgery record

UCI doctor disciplined for false surgery record
May 20, 2010
By COURTNEY PERKES
OC Register.com

An anesthesiologist at UC Irvine Medical Center was disciplined Thursday by the California Medical Board for falsely pre-filling out a patient record before surgery.

Dr. Peter Breen, former chairman of the anesthesiology department, reached a settlement with the board for a public letter of reprimand, the least severe form of discipline. Neither Breen nor his attorney, Peter Osinoff, could be reached for comment Thursday.

In 2008, inspectors for the Centers for Medicare and Medicaid Services discovered that UCI anesthesiologists were attempting to save time by filling out operating room records in advance. In one case, inspectors found a completed form that said a patient left the operating table that day at 10:30 a.m. However, it was 9:30 a.m. and the patient was still in surgery.

A short time later, the board sought to discipline Breen.

According to legal documents, Breen admitted that in 2006 he falsely filled out a surgery form for a cataract patient in advance of surgery, indicating that the patient was stable and comfortable.