Satellite Site

This page is a satellite site from the main healthcare site focusing on the good and the bad medical culture at Kaiser Permanente health plan and particularly what this writer experienced at the Walnut Creek Kaiser facilities over a period of 40 years.


Pros and Cons of HMOs, Such As Kaiser Permanente

The benefits include:

The negatives include:

Factual information acquired over a period of time shows a changing culture among a rogue group of physicians at Kaiser Permanente, and specifically at the Walnut Creek, California facilities that meet the definition of corrupt, and even criminal. Left unpublicized, that culture will spread, and more lives will be tragically affected, and in some cases leading to premature death.

Yet-to-be-recognized by the American public are the pockets of criminal and homicidal acts in the medical industry, with particular emphasis on HMOs such as Kaiser Permanente. A legal treatise on this can be found at http://papers.ssrn.com/sol3/papers.cfm?abstract_id=273434.


Sample of Incompetence Experienced by
This Writer from Kaiser Physicians

For many years the integrity of physicians at Kaiser Walnut Creek facilities was good at providing tests and treatment. But like the culture in other segments of government and society, that has changed among certain doctors at Kaiser, especially among oncologists. The following are examples of how this culture made permanent changes in the life of this writer:


Forced to Obtain Out-of-Plan
Diagnosis of Advanced Kidney Cancer

Corrupt Denial of Test and Treatment For Cancer

The following is an experience showing the need for a patient, or his or her partner, to be knowledgeable and aggressive, if needed, in the event of encountering medical corruption or incompetence from a member/s of the medical community. The following happened to Captain Rodney Stich as a member of the Kaiser Permanente health plan. (Most of their doctors are honorable, but there are pockets of them that act as death doctors, knowingly acting as such to top corporate management in the home office of the Kaiser Permanente organization.)

Test for Cancer Symptoms Ignored, With Probable Death Outcome

In 2009 and 2010, Captain Rodney Stich reported to three different Kaiser Permanente primary care physicians serious symptoms that were later discovered to be kidney cancer. (Back pain over right kidney, following an earlier massive blood loss due to a ruptured right kidney cyst, abdominal discomfort, etc.) Two primary care physicians responded to the alternating constipation and diarrhea problems by recommending frequent enemas! A third Kaiser physician, Dr. Richard R. Unger, stated that the normal diagnostic tests for those symptoms, a CT scan, were not done for members of that age (despite the fact that payments were made under the health care contract and that tests were normally done anywhere else).


Forced to Obtain Out-of-Plan
Diagnosis of Advanced Stage 3 Kidney Cancer

Out of plan physician. In May 2011, Stich had to go to an out-of-plan physician, who promptly ordered a CT scan when he was told of the symptoms. That scan showed an advanced Stage III cancer in the right kidney and related lymph node, and on the verge of going to a mostly incurable Stage IV.

Kidney cancer report was then given to Kaiser physicians. Kaiser physicians, upon being presented with the cancer report and disk, continued to deny treatment. Stich encountered a pattern of excuses. Upon receiving the out-of-plan kidney cancer report, a series of Kaiser physicians, acting in unison, engaged in repeated efforts to deny any treatment, stating that nothing would be done until he experienced personal symptoms of the advancing cancer.

This could be expected to occur after the curative and remission-enabling effects of expensive kidney cancer drugs would no longer be effective or needed. Relatively inexpensive palliative care would then be in a hospice environment (that would then result in a greater year-end profit for the for-profit Kaiser physician group). This was criminal!

Most patients would have accepted on blind fate that the doctors were acting in  an honest manner, and not issuing an early premature death plan.


Out of Plan Pathology Report Showed
 Critical Progression of Cancer

The pathology report on the removed kidney showed the progression of the cancer from a probable curable Stage III to a possible Stage IV mostly incurable condition.

On July 29, 2011, approximately 12 weeks after the Kaiser Permanente Health Plan physicians were notified of the kidney cancer determination, visits with oncologists occurred.

 

On August 5, 2011, obviously concerned about the spreading cancer cells, Stich requested an appointment with oncologist Michael P. Russin. He showed no concern for the spreading cancer that was on the verge of entering an incurable Stage IV. September 12, 2011, was the first appointmentalmost six weeks lateras the pattern of delaying treatment continued.

Surgery was Finally Performed
Weeks Later

No concern was shown for the imminent extension of the curable Stage III cancer to the mostly incurable Stage IV cancer. Finally, after eight weeks of protests by Stich, surgical removal of the cancerous right kidney and lymph node was performed, which was about 18 months after first symptoms appeared and Stich brought the matter to the attention of Kaiser Permanente doctors.


Post-Surgery Pattern of Denying Universally-Recognized
Scans and Blood Tests

After surgery, there are universwally recognized tests to be routinely done. The purpose being  to promptly start chemo or radiation treatment to either put the cancer in remission or prolong the length of life. Again, Kaiser doctors refused to do any of them, despite being paid to provide the tests and the universal recognition of their life-saving value.

Sham Money-Saving Arguments Used
To Deny Treatment and Premature Death

One excuse for not doing the routine CT scans, stated by Kaiser Permanente Dr. Michael Russin. was the argument that there was too great a danger from contrast agent in CT scans. [Thousands of CT scans are done yearly on people with only one kidney, mostly with reduced amount of contrast agent, or no contrast agent.

Toxic effects of curative or remission enabling cancer drugs are too great, was the sham excuse by the next Kaiser Permanent Dr. Aram Roy Canin (Nov. 2, 2011). In the event that it was found that the cancer had spread, he stated that the side effects from cancer drugs are too great. Do nothing, prepare for final hospice care, and give up on the either curable or remission cancer drugs for which billions of dollars a year are spent, resulting in either cures or extended life.

Dr. Canin falsely stated that approach was the recommendation of NCCN/NCCI, known for their recognized cancer treatment guidelines. The cancer patient told him that he had those recommendations (and many more), and they strongly said the very opposite. Not a single source stated to do nothing after nephrectomy until the patient experienced symptoms

The next Kaiser Permanente doctor was newly hired Oakland oncologist Dr. Jeanette Cu Yu, on November 10, 2011. Her sham and deadly argument was that cancer drugs do not extend life, so no cancer testing will be done. After signs of cancer return, then hospice care will be arranged.

She was lying, apparently deliberately supporting the prior doctors. On the walls of the examining room were posters urging cancer patients to enroll in clinical trials using drugs, and also reference to one major cancer site that stated the urgency of periodic CT scans and blood tests. Her flat-out statement that cancer drugs did not extend life was preposterous, and made in an examination room with posters promoting participation in clinical trial, and making reference to NCCN organizations that promote the early and periodic CT scans.

Complaints to California and federal healthcare government regulators encountered the standard aiding and abetting conduct found in other government agencies.

Relief came from Kaiser Permanent oncologist, Dr. Kaufman, who stated that the post-surgery tests were universally recognized and should have already been done. Her then ordered the tests.

Worsening the Stress on Stich's Partner, Glenda, Suffering from Cancer

The potentially deadly denial of cancer treatment was occurring while he was caregiver to his domestic partner of 18 years, Glenda. She had been diagnosed four years earlier with Stage IV esophageal cancer. She had a very difficult treatment with a closed esophagus and needed to feed through a stomach feeding tube. The death-panel misconduct by Kaiser oncologists created additional distress upon his partner. Fortunately, she was not a member of Kaiser, and had the basically excellent medical under Medicare and Healthnet PPO. However, on February 1, 2012, Glenda was put to death by a morphine overdose following a series of documented corrupt medical acts.

Standard Post-Surgery Tests

Periodic CT-scans, usually starting at six months after nephrectomy, and continuing at six-month intervals for as long as five years,  is widely recommended, including at such sites  as NCCN and NCCI.
 

Delaying testing or treatment the cancer patient experiences positive symptoms of the spreading cancer defies medically accepted practices:

End-of-year bonus for Kaiser Permanente physicians result from reduction in the cost of ordered treatment from the amount of money allocated at the beginning of the year. There are three sections to the Kaiser Permanente organization: The not-for-profit Kaiser Foundation Hospitals and the Kaiser Foundation Health Plan, Inc. The physicians are in a for-profit group known as the  Permanente Medical Groups.

By denying standard and universally recognized cancer care, Kaiser Permanente physicians violate the contract with the members, and where the member is enrolled under a Medicare program, the fraud is also against the federal government. Also, the cancer victim often suffers excruciating pain from the advancing cancer that could have been avoided, and the patient usually dies years before he or she would have.


Criminal Aspects of Withholding Universally Recognized
Prepaid Medical Plan Care

The need for, and the laws permitting, criminal prosecutions of HMO denial of care decisions are thoroughly addressed in an article written by Ohio State University professor, John A. Humbach with dozens of legal citations showing criminal offense from HMO withholding of life-affecting treatment.

A Boston Globe article at www.boston.com (April 13, 2011) under the heading, "Woman who withheld son’s cancer drugs found guilty," stated:

LaBrie’s attorney, Kevin James, said yesterday that the jury apparently did not understand the burden his client experienced in caring for an autistic son who developed cancer. He had also argued that social workers and doctors at Massachusetts General Hospital, where Jeremy was treated, should have done more to make sure she was fit to care for her child and administer the medications.

"What we wanted to get across to the jury is the tremendous burden my client had to carry, as well as the fact that the support that should have been in place for her was not in place,’’ James said in an interview.

James said he asked for the sentencing to be postponed at least until Friday in part so that he could gather evidence of support his client has received from many people who never met her, but who understand the difficulties of raising a developmentally disabled child with cancer.

O'Keefe, LaBrie’s sister, said she understood jurors were required to follow the legal directives given to them, but that her sister never sought to hurt Jeremy.

“It’s too hard for them to know what my sister was going through at that time,’’ O’Keefe said, holding back tears. “I don’t think my sister had any intentions of hurting Jeremy, ever. I never will believe that in my life, never.’’

Prosecutors said they will not comment on the case until LaBrie is sentenced.

Legal analysts said yesterday that the case was the most unusual since prosecutors brought manslaughter charges two decades ago against a couple who refused to authorize surgery for their toddler, who was suffering from a treatable bowel condition. The couple, David and Ginger Twitchell, then of Hyde Park, were Christian Scientists and believed the boy could be healed by spiritual treatment. He died within several days after his diagnosis in 1986.

The state Supreme Judicial Court, in reviewing that case, determined in a landmark decision that parents have a legal duty to provide medical care for gravely ill children, regardless of religious faith.

Boston attorney J.W. Carney Jr., of Carney & Bassil, said LaBrie’s case was troubling in that she was portrayed as a mother who was overwhelmed. He said the case should have also focused on the failure of LaBrie’s doctors to intervene quicker, once it became obvious that she was not administering medications.

"It can be so overwhelming for a single parent to deal with a child who is autistic, nonverbal, and developmentally delayed,’’ he said. “It is cruel to add to that burden a diagnosis of cancer and a requirement that the mom administer medicine that will cause the child even more pain."

The attempted murder conviction carries a maximum penalty of 20 years in prison. Under state sentencing guidelines, LaBrie — who does not have a criminal record — could face up to 7 ˝ years in prison, according to legal analysts. That determination will be made by Judge Richard Welch, who could consider outside factors.

“A judge is authorized to go downward, with mitigating factors, or depart upward if there are aggravated factors,’’ Carney said.

Valencia can be reached at mvalencia@globe.com; Ballou at bballou@globe.com. Article at the following address:

http://articles.boston.com/2011-04-13/news/29414342_1_hospice-care-medication-young-son/2.


The above corrupt  conduct appeared to be orchestrated to bring about the premature death of a corruption fighter, who was a threat to powerful people in government.

See sampling of medical industry homicide examples: www.defraudingamerica.com/medical_industry_homicide.

Also,  www.defraudingamerica.com/glenda.


Criminal Aspects of Withholding Universally Recognized
Prepaid Medical Plan Care

The need for, and the laws permitting, criminal prosecutions of HMO denial of care decisions are thoroughly addressed in an article written by Ohio State University professor, John A. Humbach with dozens of legal citations showing criminal offense from HMO withholding of life-affecting treatment.

A Boston Globe article at www.boston.com (April 13, 2011) under the heading, "Woman who withheld son’s cancer drugs found guilty," stated:

LaBrie’s attorney, Kevin James, said yesterday that the jury apparently did not understand the burden his client experienced in caring for an autistic son who developed cancer. He had also argued that social workers and doctors at Massachusetts General Hospital, where Jeremy was treated, should have done more to make sure she was fit to care for her child and administer the medications.

"What we wanted to get across to the jury is the tremendous burden my client had to carry, as well as the fact that the support that should have been in place for her was not in place,’’ James said in an interview.

James said he asked for the sentencing to be postponed at least until Friday in part so that he could gather evidence of support his client has received from many people who never met her, but who understand the difficulties of raising a developmentally disabled child with cancer.

O'Keefe, LaBrie’s sister, said she understood jurors were required to follow the legal directives given to them, but that her sister never sought to hurt Jeremy.

“It’s too hard for them to know what my sister was going through at that time,’’ O’Keefe said, holding back tears. “I don’t think my sister had any intentions of hurting Jeremy, ever. I never will believe that in my life, never.’’

Prosecutors said they will not comment on the case until LaBrie is sentenced.

Legal analysts said yesterday that the case was the most unusual since prosecutors brought manslaughter charges two decades ago against a couple who refused to authorize surgery for their toddler, who was suffering from a treatable bowel condition. The couple, David and Ginger Twitchell, then of Hyde Park, were Christian Scientists and believed the boy could be healed by spiritual treatment. He died within several days after his diagnosis in 1986.

The state Supreme Judicial Court, in reviewing that case, determined in a landmark decision that parents have a legal duty to provide medical care for gravely ill children, regardless of religious faith.

Boston attorney J.W. Carney Jr., of Carney & Bassil, said LaBrie’s case was troubling in that she was portrayed as a mother who was overwhelmed. He said the case should have also focused on the failure of LaBrie’s doctors to intervene quicker, once it became obvious that she was not administering medications.

"It can be so overwhelming for a single parent to deal with a child who is autistic, nonverbal, and developmentally delayed,’’ he said. “It is cruel to add to that burden a diagnosis of cancer and a requirement that the mom administer medicine that will cause the child even more pain."

The attempted murder conviction carries a maximum penalty of 20 years in prison. Under state sentencing guidelines, LaBrie — who does not have a criminal record — could face up to 7 ˝ years in prison, according to legal analysts. That determination will be made by Judge Richard Welch, who could consider outside factors.

“A judge is authorized to go downward, with mitigating factors, or depart upward if there are aggravated factors,’’ Carney said.

Valencia can be reached at mvalencia@globe.com; Ballou at bballou@globe.com. Article at the following address:

http://articles.boston.com/2011-04-13/news/29414342_1_hospice-care-medication-young-son/2.


Sampling of Related Communications
Concerning Premature Death Tactics

Sampling of  letters/faxes relating to series of deceptions and lies used to withhold contractual cancer care to senior citizen sent by a HMO member with advance stage of kidney cancerwho was also the caregiver for a woman diagnosed four years earlier with Stage IV esophagus cancer. (Fortunately, she was not a member of the HMO Kaiser corporation health plan corporation!)


Kaiser Physician's Blood Money

Despite their claims, there are profits at Kaiser Permanente by denying tests and treatment. Kaiser Permanente physicians receive 50% of every dollar collected from patients and the government that are not spent on care, salaries and administrative expenses. Huge profits are split with the physician partners. Every costly test, such as CT scans, and every treatment ordered by a Kaiser physician, reduces the physician's profits. For many Kaiser physicians, this factor does not affect their medical responsibilities. (This was discovered by this writer in the Walnut Creek facilities, of the large profit to be gained through denial of care versus early deaths by untreated cancers.) Numerous letters and faxes that were sent to the executives of for-profit parent organization, Kaiser Permanente, were ignored. They stood to profit from bonuses by reducing the costs in the underlying not-for-profit Kaiser Health Plan and Kaiser Hospitals.

Kaiser Physician's Bonus Compensation Plan

The Kaiser Permanente physicians operate under a capitated group plan in which any money saved by not providing medical care results in an extra bonus for the physicians. In addition to deliberate medical malpractice, this conduct arguably constitutes a criminal offense by refusing to provide the care under their contract with the federal government, and withholding the contracted care with the medical plan enrollee: me.

The cancer patient, denied urgently needed cancer care, had been the caregiver for a woman who was diagnosed in early 2008 with Stage IV esophagus cancer. Fortunately, she was not a member of Kaiser. If she had been, she probably would have experienced the same denial of cancer care as this Kaiser Permanente cancer victim was encountering. She would have first been told, when reporting difficulty in swallowing, that tests were not done at her age. Then, after she obtained the diagnosis of Stage IV esophagus cancer from an out-of-plan physician, she would have been told to do nothing, giving up the chance of remission and insuring an early death.

The Kaiser group includes the Kaiser Foundation Hospitals, the Kaiser Foundation Health Plan and the Permanente Medical Group. The group, comprised of physicians, have a capitated compensation plan in which a given amount of funds are allocated by the parent corporation. At the end of the year, when the cost of the care ordered by the physicians is less than the money allocated, the physicians receive a bonus in addition to their salary.

Any care withheld, such as in kidney cancer with it's more expensive kidney cancer drugs, ends up as profit for the physicians. In other fee-for-service medical service, there is not the incentive for withholding care. Most physicians would not change their concern for patient's health on this matter, but as experienced in this one example, there are all types of morality issues among physicians.


Kaiser Physicians Profit from
Denial of Costly Medical Treatment

The for-profit capitated physician plan may be the motive for denying life-or-death care for health plan members with costly care requirements. Physicians receive a bonus at the end of the year if the treatment they order cost less than the amount allocated by the health plan. Kaiser physician's capitated type of financial contracts that probably motivates the denial of costly treatment.

Medical care at the Kaiser Permanente group involves three separate corporate entities

In Northern California and  Southern California, the for-profit parent corporation—Kaiser Permanente—have Kaiser physicians as employees and partners that share in any profit that is the difference between the fees collected from enrollees, including such government payments as from senior Medicare, and the cost of the services.

The denial of diagnostic tests to the patient referred to in this report helped in a small way to boost the profits and benefit the physicians. The repeated attempts to deny expensive surgery would be a major cost saving and profit generation.

While it probably won't save a senior from cancer sufferings and early death from the death-decree some experienced at Kaiser, there are law firms that can at least cause minor financial inconvenience for Kaiser physicians and the for-profit corporation. One such firm advertises at  Kaiser Medical Malpractice website and resource page.

And if the offense is worse then medical malpracticethe repeated denial of care, knowing that the cancer will spread, becomes a criminal offense.


Simultaneous Struggle Arranging Repeated Hospital
And Other Cancer Care for 18-Year Companion
While Fighting Rogue Kaiser Physicians

 

While engaging in combat against the treatment fraud by Kaiser physicians, this writer was in the fourth year of an exhaustive caregiver role for his companion of 18 years, Glenda, with frequent hospital trips, sometimes in the middle of the night. By the end of 2011, the papers consisting of complaints, appeals, and efforts to get help from government and non-government (donation-seeking) groups filled a legal size box. All in vain! After seeking relief from a breathing problem, Glenda experienced another form of corruption in the medical industry. First, she became a victim of greed by a skilled nursing facility, denied ordered and authorized pulmonary treatment, and then put to death (February 1, 2012) through a morphine overdose! 

 

A pathetic sight. Two senior citizens, stricken by cancer, gravely affected by the culture at this facility, known to top management. Throughout this entire period, these Kaiser Permanente Health Plan physicians knew that the patient was under considerable stress caring for a Stage IV esophagus cancer victim, Glenda, who had undergone major cancer emergencies, including closing of esophagus, installation of a stomach feeding tube, numerous trips to hospital emergency rooms. The added stress repeatedly inflicted by  the Kaiser Permanente personnel were creating compound emergencies.

 

Conspiracy Theorists Could Have a Field Day
 

This writer has been the head of a coalition of former government agents, professionals, that for the past 40 years has been exposing corruption in key government positions and the resulting national tragedies. Among the revealing Internet sites that were exposing powerful people in government was www.defraudingamerica.com.


Reversal of Denial of Cancer Treatment After
Six Months of Complaints, Appeals
And Internet Publicity—
by Courageous Kaiser Oncologist

In December 2011, after six months of fighting the denial of universally recognized cancer treatment by the three Kaiser oncologists and the chief physician in charge, Kaiser surgeon Dr. Raymond Rosenbaum stated he would order the standard CT test in December. This function was then carried out by Kaiser oncologist Dr. Douglas Kaufman, who admitted that the tests should have been started three months earlier. These were courageous decisions that reveal the misconduct by the Physician in Charge in the Walnut Creek facility and by three Kaiser oncologists.

Dr. Kaufman followed the many guidelines calling for tests to begin at three months after surgery when the kidney lymph node was also cancerous, and starting at six months and every six months after surgery there would be blood tests and CT scans. After a long six month battle, universally recognized cancer treatment was finally achieved (unless treatment is denied when the tests show cancer spread).

Whether the tests will be followed with costly kidney cancer drugs is yet to be seen.

During this long battle, Stich was arranging for continual cancer treatment and emergency hospital stays for his other half, and copilot, Glenda. No one should be subjected to this abuse!


Arrogance and Denial of Medical Treatment Continued
Into 2012, During Grief Over Glenda's Recent Death

During December 2011 and January 2012, this writer was suffering increasingly from the leg muscle problems that had existed for several years. Because of the round-the-clock caring for Glenda as she went from hospital to hospital, and other medical facilitates, this writer had no time to seek another Kaiser physician.

Finally, several days after the funeral services for Glenda, I made arrangements for change of primary care physician to Dr. Charles C. Fang. An office appointment was made for February 14, 2012, at the Walnut Creek facilities.

Several days after the funeral services, this writer had an appointment with Kaiser primary care physician Dr. Charles C. Fang seeking relief from increasing pain in the legs and imminent need  for a wheelchair due to walking difficulty.

Like a common street thug, Fang barged into the examining room, refused to listen to the symptoms and barged out of the door, all within 30 seconds. He was the designated primary care physician.

In pain, still in grief over Glenda's very painful death, and facing a literal thug-like medical provider, the future became even more bleak. At the age of 88, without my "caregiver," Glenda, and unable to find suitable other medical insurance due to the existing cancer and leg problems, there seemed no where to turn. Certainly not to the California or federal healthcare regulators, or the many cancer groups that continually seek public financial donations, none of whom provided any help in the past!

Acting and Looking Like a Thug

As Dr. Fang entered the examining room, he was offered talking points that listed the new symptoms that were affecting the ability to walk, including pain and additional symptoms. Fang was ready for combat the moment his foot entered the room. He refused to discuss the new symptoms, and angrily stated he examined the record, that Dr. Unger knew more about medicine than he did, and rushed out the door, having stayed only about 30 seconds. (Talking points of February 14, 2012, stating the symptoms, the pain, and the need for medical relief that Dr. Fang arrogantly ignored.)

A similar reaction was displayed two months earlier by Kaiser oncologist Dr. Aram Canin, who stated that he would not order any of the universally recognized post nephrectomy cancer treatment, which amounted to a death edict. He angrily rushed out of the office when this writer stated that his denial of cancer treatment was contrary to the universally recognized post-nephrectomy treatment.

People with cancer have serious medical problems facing them, and depression; it is a scary time. They need competent and caring doctors.  Many cancer victims find a cancer diagnosis difficult to cope with, and go into stages of depression. Many groups are formed for the sole purpose of providing counseling to cancer victims.

 

And this is the care that major cancer centers stress, totally foreign to the rogue group of Kaiser physicians that this writer encountered during his time of need.


The Enormous Pain and Suffering That Accompanies
Cancer Compounds the Criminality of
Rogue Kaiser Physicians

Most people nearing death from cancer, or their caregivers, learn about the months or years of pain and suffering that comes with most cancer. This writer saw and was part of the endless pain and suffering that Glenda experienced during the four years of fighting esophagus cancer. It is criminal for any physician to act in any way that deprives a cancer victim of the recognized care.


Thousands of Deaths Yearly Due to Medical "Errors"
Or Deliberate Physician Misconduct

Some studies state that over 200,000 people die a year in the United States due to medical malpractice. It is reportedly the third leading cause of death in the United States. One study broke down the deaths as follows:

Another site stated that accidental deaths caused by physicians average about 120,000 a year.

One Internet site stated: Doctors Are the Third Leading Cause of Death in the U.S. and cause 250,000 Deaths Every Year. Those statistics were obtained from an article in the  Journal of the American Medical Association (JAMA) by Dr. Starfield. It is unknown if these figures include the deaths caused by denial of treatment, as in this example.

Horror stories about medical personnel misconduct are detailed in the book, Congress and Other Cesspools. This matter will be added.


Phony Quality Performance Ratings
Given to Kaiser Permanente

Like the ratings given to Wall Street firms preceding the financial debacles starting in 2008, healthcare evaluators/raters covered up for serious problems at Kaiser Permanente facilities. They issue high performance ratings despite the many reports of serious denial of medical care or medical errors. Further, Kaiser Permanente spends millions of dollars every year advertising itself and boosting its high quality culture.


Relative Freedom From Being Sued Encourages
Deadly Misconduct by Rogue Kaiser Physicians

Because of the law in California, medical misconduct lawsuits are relatively rare because of the restrictions and limits placed on medical malpractice lawsuits.

Medical malpractice involves professional negligence or misconduct.  That could be by a health care provider when it deviates from accepted standards of practice in the medical community, as in this matter, and causes injury or death to the patient. Standards and regulations for medical malpractice vary by country and jurisdiction within countries. Here are a few examples of medical malpractice:

A plaintiff must establish four elements of the tort of negligence for a successful medical malpractice claim.

  1. A duty was owed: a legal duty exists whenever a hospital or health care provider undertakes care or treatment of a patient.
     
  2. A duty was breached: the provider failed to conform to the relevant standard care.
     
  3. The breach caused an injury: The breach of duty was a proximate cause of the injury.
     
  4. Damages: Without damages (losses which may be pecuniary or emotional), there is no basis for a claim, regardless of whether the medical provider was negligent. Likewise, damages can occur without negligence, for example, when someone dies from a fatal disease.

However, deliberate misconduct, as in the above case, does not require arbitration, and can proceed in court.

Another Self-Protecting Tactic at Kaiser

To enroll in a Kaiser health plan, Kaiser protects itself against medical malpractice and negligence, unlike private doctors and hospitals, that requires that the enrollee sign a waiver preventing the enrollee from suing Kaiser and submitting any malpractice or deliberate withholding of medical care to arbitration. They require medical plan members to sign arbitration agreements, denying members the right to seek legal action in court.

Kaiser abused this system, protecting themselves from liability for their wrongful acts, while denying their victims their day in court. Their abuse of enrollees' rights were partly reduced by the formation of a semi-independent administrator. That administrator provides the attorney for Kaiser, and the attorney for the plaintiff, with a list of 12 names. The arbitrator's decision is binding and not subject to any appeal process.

While the patient that has been subjected to intentional withholding of treatment that they know will result in cancer spreading, or death, is not helped, heirs can file lawsuits outside of the arbitration limitations, and include punitive damages.

Los Angeles Times article (June 30, 2003):

Six years ago, the California Supreme Court ruled that Kaiser Foundation Health Plan's system for arbitrating legal disputes was poorly regulated, prone to long delays and generally stacked against the best interests of Kaiser's members.

The court's harshly worded decision came in the landmark case of Wilfredo Engalla, a 51-year-old Filipino immigrant who claimed in a malpractice lawsuit that Kaiser doctors misdiagnosed him with colds and allergies for years before finally informing him he had terminal lung cancer.


Sampling of Articles on HMO
Denial of Medical Treatment

The following describes the pattern of Kaiser Health Plan corporate physicians denying standard treatment for which payment was made under a Medicare contract, causing an early-stage easily curable kidney cancer to progress to a highly probable incurable form, and then to deny the standard, universally recognized cancer treatment, using a series of sham arguments to support their sordid and deadly misconduct. The sometimes deadly consequences become a crime scene as contracted medical care is withheld, resulting in early death, while the withholding physician group enjoy larger end-of-year bonuses under their capitated compensation plan.

Series of articles addressing culture of HMO denial of treatment, sometimes with fatal consequences.

Dangerous ethics in HMO type medical plans described in report to Congress.

Serious HMO problems and responsibilities in article by Dr. Richard C. Hall, University of Florida


Sham Nature of Appeal to Medicare for Denial Of
Nationally Recognized Cancer Treatment

Like most other federal regulatory groups, the improper or even corrupt withholding of life-affecting universally accepted medical care under the flat-fee HMO Medicare policies is aided and abetted by the regulatory agency personnel paid to provide relief. This is standard aiding and abetting as found in other regulatory agencies, such as seen in the Wall Street scandals, the Housing mess, the aviation safety agency, and others. The consequences are in money lost, homes lost, deaths in otherwise preventable aviation disasters, or deaths by denial of standard universally recognized care.

In denial of health care such as cancer treatment, a  Medicare HMO policy for which the Health plan is paid a specific financial amount for providing coverage can easily withhold costly cancer treatment using sham and medically irresponsible arguments. The primary so-called appeal rights is to file an appeal with Maximum Federal Service, which is empowered to review and decide if the health plan was improperly withholding care under the Medicare HMO plan. This problem is unlikely to occur in a few-for-service Medicare plan.

In one example, the first indication that the appeal procedure was a sham became obvious when the Medicare HMO recipient was blocked from seeing the argument presented by the health plan to justify their refusal to provide cancer care. The HMO health plan corporation can openly lie in response to the complaint, and the person filing the complaint is unaware of the false statements and cannot respond to them. Nor could an honest Maximus panel reach a honest decision under these conditions.

The final decision by the Maximum group can easily omit the key reasons for the complaint, and by legal trickery aid and abet the powerful HMO health care corporation. In  the appeal number, 1-847801106, the request to obtain an out of Kaiser cancer treatment referral was based upon the following:

In the November 14, 2011, decision, Maximus Project Director Janice Eidem denied the Medicare cancer patient's request for an out-of-plan treatment determination, claiming that treatment decisions were available within the plan. She and the Maximum group ignored the fact that a group of rogue oncologists were refusing to provide the standard and universally recognized treatment, and using sham and medically ridiculous arguments for their cost-saving denial of cancer treatment. Fax of November 27, 2011, protesting Maximus complicity with Kaiser corporation.

In this way, regulators aid and abet the death decree to HMO Medicare patients, and the aiding, weakened, and often time elderly cancer victims have no where to turn. Although the cancer patient can file a further appeal with an Administrative Law Judge, the cost and time consumed is usually beyond the ability of the suffering and often senior Medicare patient.

Further, even when the HMO Kaiser corporation refused to recognize denial of care complaints, thereby nullifying the Medicare appear process, the Maximum group refused to respond.

Sampling of deception and lies used to withhold mandatory contractual medical care to kidney cancer patient by Kaiser Permanente physicians and management, as stated in a December 8, 2011, fax; and sampling (December 12, 2011) of the deceptive decisions by Medicare's appeal group, Maximus Federal Services, showing their complicity. One of several notices to U.S. Department of Health and Human Services making the controlling agency aware of the pattern of criminal misconduct.

The remedy under Medicare for denial of government-paid health care is through a Medicare designated group. The appeal procedures are grossly unsuited for recognized appeal process. Medicare appeals sided with the Kaiser oncologists, and every other cancer group (soliciting for donations) that had been made aware of these medical atrocitiesas in the Penn State scandal and countless othersdid nothing after being informed

Appeal papers sent to Maximus Federal Services (Appeal source for denial health care under Medicare (FAX 1-585-425-5292.) In response to the Medicare fraud, the denial of recognized cancer care, and the literal death sentence, the letter of denial (Nov. 16, 2011) by the Medicare Project Director, Janice Eidem, without any explanation, denied the appeal. That practice was in line with the conduct of other government regulators in the Wall Street and endless series of other frauds.


Kaiser Permanente Doctor Sues Kaiser for
Denying Medical Care to Thousands

KPCC, Los Angeles, Oct. 8, 2010 | Patricia Nazario
(http://www.scpr.org/news/2010/10/08/19979/kaiser-lawsuit/.)

 
A former Kaiser Permanente doctor is suing the health care provider. He claims the non-profit organization denies adequate care to thousands of chronically-ill patients to save money. At issue is Kaiser Permanente’s Special Needs population. It’s a group of about 60,000 people, mainly in California. Some are chronically ill children and adults, most are seniors. All are covered by Medicaid/Medi-Cal.

“And Kaiser has what are called Special Needs Plans in which these members belong," said Dr. Richard Della Penna. Della Penna worked for Kaiser Permanente for 23 years and coordinated national programs for the health plan’s special-needs population. The doctor says there were never any written internal directives, but he says there was a general consensus to provide minimal care to about 95 percent of the patient pool to save money. Della Penna says when he spoke out on behalf of his patients he was forced to an early retirement.  “As a result of my advocacy for geriatrics, elder care, for the special needs population, for the people with advanced illness, I found myself being more and more marginalized.”

Della Penna’s lawsuit against Kaiser lists several claims, including retaliation against a physician for patient advocacy and violation of public policy.

Physicians, not members of Kaiser Permanente, private and VA, have admitted to this writer that they see patients that have left Kaiser because of the denial of cancer treatment by Kaiser physicians.


Sampling of Kaiser Scandals Exposed by the Media

Many physicians in the Kaiser health plans are competent and caring of their patients. Many features at the HMO are excellent and medical advancements. But as in any other group, there are rogue individuals that perform in an incompetent or even corrupt manner.  And the cowardice, or fear of retaliation by others keep them from speaking out. And health regulators are often as incompetent or protective of the people they are paid to supervise to keep the misfits in position.

From the Los Angeles Times: February 27th, 2007

State lists worst hospitals for care of pneumonia — Five Kaiser facilities have among the highest mortality rates.
By Francisco Vara-Orta, Times Staff Writer Five Kaiser Permanente hospitals were among the 28 institutions with the worst hospitals for care of pneumonia.

Five Kaiser Permanente hospitals were among the 28 institutions with the highest death rates in California for patients with pneumonia, according to a state report to be released today. The Kaiser hospitals in Sacramento, South Sacramento, Panorama City, Riverside and Roseville all had higher than average mortality rates between 2002 and 2004, said the California Office of Statewide Health Planning and Development.
Sacramento Bee: Case now includes accusations by 13 female patients. By Christina Jewett — Bee Staff Writer

The former Kaiser plastic surgeon charged in June with sexually exploiting a patient now faces charges of sexual misconduct toward 13 patients, according to an updated criminal complaint. Dr. Scott Takasugi is alleged to have unnecessarily touched and photographed women’s genitalia when they sought his care for unrelated surgeries since 1996. The charges filed Friday in Sacramento Superior Court significantly change the case, which initially accused Takasugi of eight weapon violations and two counts of sexual exploitation against one woman. The Carmichael surgeon is now charged with 18 counts of sexual exploitation, including 15 felony counts of sexual penetration. Three weapon charges remain in the criminal complaint. http://www.kaiserthrive.org/2006/08/15/new-sexual-misconduct-charges-against-kaiser-surgeon.

Sacramento Bee: July 3rd, 2006
By Mareva Brown — Bee Staff Writer. Six more patients of a Kaiser Permanente plastic surgeon have filed civil cases alleging he sexually assaulted and exploited them by improperly touching them and photographing them nude under the guise of medical care.

Multiple Deaths in Dialysis Section

Many deaths from dialysis, including drugs to advance the availability of organ transplants. Details at http://www.lawyersandsettlements.com/articles/drugs-medical/Kaiser_Permanente-00274.html.

Hastening the Death for Organ Removal

From KTVU.com: (July 30, 2007)
LOS ANGELES — A surgeon with close ties to the Bay Area was charged Monday with prescribing excessive drugs to a comatose, disabled patient to hasten his death and harvest his organs for transplantation. (Google this for more information.)


Could There Be a Sinister Reason for Wanting To
Bring About an Early Death?

That senior citizen is nationally known for his 40 years of exposing grave misconduct involving key people in the government of the United States and the great harm, sometimes deaths, and sometimes catastrophic events, caused or enabled by the documented misconduct that he and his coalition of concerned former government agents had discovered during their professional duties.

One of his Internet sites is www.defraudingamerica.com. A list of his books are at www.defraudingamerica.com/list_of_books.

Were it not for the standard do-nothing conduct of California and federal health care regulators, the deep-seated deadly culture adversely affecting the lives and the deaths of the most senior and vulnerable members of this group would be front page headlines.

This page and related links provides facts on serious and deadly problems with denial of universally recognized basic care by several Kaiser Permanente physicians, primarily where costly routine care, such as for cancer, is involved, and effects the year-end profit under the capitated for-profit arrangement for Kaiser Permanente physicians. It is reported that approximately 200,000 people die each year from medical malpractice, including denial of medical care.


Google Search for Medical Horror Stories
Kaiser Permanente Medical Group

The following are a small sampling of the many reports found by a Google search under the search words, "Kaiser Health Plan malpractice" or Kaiser Permanente malpractice.

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Army of Lawyers and Law Firms
Fueled by Victims of Kaiser's Medical Misconduct

Denial of universally accepted medical care and incompetence by certain Kaiser Permanente physicians, fuels armies of lawyers. The following are sampling of Internet sites for lawyers that have filed malpractice lawsuits against Kaiser doctors or the Kaiser allegedly not-for-profit health plan or hospital groups, and the for-profit Kaiser Permanente parent corporation.

Putting Kaiser Permanente into a Google search engine reveals an endless series of deaths caused by denial of medical treatment. Further problems at that HMO are revealed in the book, Making a Killing-HMOs and the Threat to Your Health.


Sampling of Cancer Treatment Sites
Relating to Kidney Cancer

The following sites describe in detail the standard universally recognized kidney cancer treatment, each of which were withheld by oncologists at the Kaiser Permanente HMO medical plan, who refused to provide any treatment, using sham and medically-ridiculous reasons for decreeing a premature death.


Physician misconduct in another area, affecting two people sharing the fate of cancer victims.

An organization focusing on medical problems and misconduct at Kaiser Permanente medical group: http://kaiserpapers.org/

Kaiser Permanente reform committee: http://kaiserpapers.org/kprc.html.


 

 

 

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