Kaiser Did Not Alert Regulators About Transfers
Kaiser Permanente launched its kidney transplant program in September 2004 "without holding basic discussions with regulators about how to safely transfer up to 1,500 of its patients" from other hospitals to its new center, the Los Angeles Times reports (Ornstein/Weber, Los Angeles Times, 5/5).
A Times investigation of the kidney program found that Kaiser performed 56 transplants during its first full year of operation in 2005 but that twice as many Kaiser members died while waiting for transplants. Delays involving paperwork errors and staff problems contributed to the problems.
In addition, the Times reported on Thursday that Kaiser did not properly complete the paperwork to transfer patients from the University of California Medical Center to the Kaiser facility, but would not authorize the University of California-San Francisco to perform Kaiser members' transplants -- even in the case of 25 patients who were nearly perfectly matched to offered kidneys.
The analysis concluded that Kaiser "endangered patients" awaiting kidney transplants by "forcing them into a fledgling program unprepared to handle the caseload." The Department of Managed Health Care is investigating the program (California Healthline, 5/4).
Kaiser was not required to notify the United Network for Organ Sharing, which oversees the nation's transplant system, that it would be submitting a large amount of paperwork related to the patient transfers.
UNOS spokesperson Joel Newman said the organization usually handles one or two transfers at a time. As a result, UNOS "was virtually blindsided" by the transfer requests, the Times reports. Newman said the organization had to develop a new computer program to handle the volume of transfers.
In addition, Newman said in an e-mail to the Times that Kaiser's paperwork was full of "errors or inconsistencies" and that some Kaiser patients were not previously listed on the national database of people awaiting transplants.
Patients were not notified of the delays or problems, according to the Times.
As of September 2005, about 330 Kaiser patients had not been transferred because of paperwork errors, UNOS said. However, the Times reports that "the agency never stepped in to stop the transition, nor did it investigate whether patients were being harmed by the move."
Currently, more than 220 Kaiser patients remain on UCSF's kidney transplant list because their wait times have not been transferred, and six transplant patients remain on the UC-Davis Medical Center list. Before opening its own transplant center, Kaiser contracted with the two hospitals to provide transplants.
Kaiser spokesperson Rick Malaspina on Thursday said Kaiser had launched a "high-level, full-scale internal investigation" into the program and would not comment further until all facts had been verified. Malaspina said there is "a high level of concern about the accuracy" of information hospital administrators received from kidney program officials.
According to the Times, "Kaiser doctors and administrators have provided misleading or inaccurate information" to the newspaper "several times in the last week."
Kaiser officials also acknowledged that one patient who received a kidney transplant at the center died, after they previously had said no transfer recipients have died since the center opened (Los Angeles Times, 5/5).