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Waiting on Kaiser
Kidney center's woes put patients in limbo
By Dorsey Griffith -- Bee Medical Writer
Published 12:01 am PDT Friday, May 19, 2006
You might think Christy Pimental has had enough: A diabetes diagnosis at 24, full-blown renal failure two years later, sitting in limbo on a Kaiser Permanente kidney transplant list ever since. Now 31, she is blind in one eye, has lost sensation in her feet and has been hobbling on crutches the past seven months due to a cascade of disease-related problems.
With all that, the bubbly Pimental now faces a
slew of new obstacles to her shot at a better life.
"Is Kaiser trying to kill us?" the Rancho Cordova resident asked, half-jokingly last week upon learning the health plan's kidney transplant program would close. "What is it going to take for me to get an organ?"
Pimental and nearly 2,000 others awaiting kidneys may not know for several weeks. Government officials, Kaiser and two University of California medical centers continue to scramble for a plan to move Kaiser's patients into alternate transplant programs without compromising their already fragile health.
The giant HMO announced last Friday it was closing its troubled kidney transplant program in San Francisco and transferring the patients to kidney transplant lists at the UC Davis or UC San Francisco medical centers. The move came after the Los Angeles Times reported that only 56 transplants were performed at the San Francisco center while twice as many people died waiting for a kidney.
In 2004, Kaiser forced its patients awaiting transplants at the UC centers to switch to its own Northern California facility, or risk losing insurance coverage for their transplants.
Now Kaiser is facing mounting legal challenges and a state investigation into alleged administrative bungling of those cases.
During a teleconference Thursday, Kaiser officials pledged to improve communication with patients and ease their transfer.
"We are making every effort to ... transition our kidney transplant program appropriately," said the health plan's Northern California president, Mary Ann Thode.
Cindy Ehnes, director of the managed health care department, said, "Our goal is to transfer patients as quickly as possible, but do so very efficiently and properly so no one will lose time on the waiting list."
"That list is your hope," said Denise Okamoto, a 38-year-old Sacramento woman. "And you have to rely on the people who are constructing the
list to be thorough and fair. When you find out there has been mismanagement, it is very scary."
Okamoto, who has an autoimmune disorder that caused kidney failure, received her first transplant at age 30 at Sutter Memorial Hospital in Sacramento.
The kidney functioned beautifully, she said, until 2004, when she developed lymphoma, a type of cancer. The lesions that grew on her brain stem and in her lungs were related to drugs she was taking to suppress her immune system, medicines she needed to prevent her body's rejection of the new kidney.
Once she stopped taking the drugs, the kidney failed. Now a Kaiser patient, Okamoto is back on a transplant list and dialysis three days a week, a ritual she describes as "a never-ending marathon."
Now cancer-free, Okamoto worries about a disruption in her care; she doesn't know which center she will be sent to or where on the list she will fall, given her fairly recent bout with lymphoma.
And she
worries even more about the patients who have waited longer or lost someone in the interim. "The ones who fell through the cracks, the families who must live with the loss of a loved one knowing that something more could have been done," she said.
Pimental, the Rancho Cordova resident, is holding tight to hope, as well, even if her patience has worn thin.
In the five years she has waited for a kidney, her health -- if not her sunny outlook -- has deteriorated.
Diabetes, which runs in her family, claimed her sight in one eye and led to neuropathy, a painful nerve disorder, affecting her feet.
More recently, a surgery designed to ease the method by which she receives dialysis treatments left her with a staph infection, a nine-day hospital stay and months of antibiotic treatment. The illness weakened the bones in her feet. She broke her heel.
"I've been on crutches since November," she said.
When her boyfriend picked up The Bee on
Saturday and learned Kaiser's transplant program had closed, she said, he hid the newspaper from her to spare her the bad news.
"There are times I wake up and say, 'Dear God, how much longer is it going to take? What did I do in a prior life that I don't get the lucky lottery draw?' " she said.
Like other patients in her situation, Pimental said she is considering legal action. Kaiser's bungling already has resulted in several lawsuits, including one on behalf of two patients and the wife of another, who has since died.
"It's really a horrible situation where you have people who are dependent upon a company like Kaiser to act in the patient's best interest, and they simply didn't do that," said Eric Ratinoff, a Sacramento attorney involved in the suit alleging negligence, fraud, medical malpractice and wrongful death.
"There is an insurance obligation under their contract to provide these services," said Ratinoff. "I think it's something
Kaiser really needs to be taken to task for and held accountable."
Kaiser had no comment on the pending litigation.
The demise of Kaiser's transplant program saddens Janet Arunyakasem, 64, who in January received her new kidney there from a living donor, a 38-year-old man who is very close and whom she considers a son.
"This surgery was like a breeze," Arunyakasem said. "The doctors told us later that if they had known it would be so textbook perfect they would have filmed it for training purposes."
Arunyakasem returned to work on April 24 as the lead teacher in a before- and after-school program at Sacramento's Martin Luther King K-8 School.
"I'm tired at the end of the day, but not as tired as I was before," she said. "I have a lot more energy."
It's the kind of energy Okamoto and Pimental hope to experience themselves one day.
"This is the hardest thing I've ever been through in my life," Okamoto said of her experience
with kidney failure. "But I feel very hopeful. ... You can last a long time on hope. You really can."
About the writer:
- The Bee's Dorsey Griffith can be reached at (916) 321-1089 or dgriffith@....
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