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Hospitals Sue
Kaiser Over
Emergency Care
Courthouse News Service
January 05, 2012
Three Los
Angeles-area hospitals
say Kaiser owes them at
least $94 million for
refusing to fully cover
emergency services for
its members.

Kaiser was legally required to
encourage its members to
use the hospitals, but in
some cases pressured
patients to transfer before
their emergency conditions
were stable, the hospitals say
in their lawsuit.

"Because Kaiser elected to
accept the benefit of the
discounts available under the
Multiplan Contracts, Kaiser
was required by law and the
Multiplan Contracts to
actively encourage Kaiser
Members to use the services
of Hospitals, which Kaiser
failed and refused to do," the
complaint says.

"On the contrary, Kaiser
has directed its members
to avoid going to
Hospitals, refused to allow
its members who received
emergency services at
Hospitals to complete
their episodes of
treatment at Hospitals,
and pressured Hospitals'
physicians, patients'
families, and even
patients themselves, to
transfer patients out of
Hospitals for non-medical
reasons before the
patients' emergency
conditions are stabilized,
the complaint continues.

The hospitals are Centinela
Hospital Medical Center,
Encino Hospital Medical
Center and San Dimas
Community Hospital. They
sued for eleven different
causes of action related to
Kaiser's alleged breach of

The hospitals are
represented by Marcia
Augsburger of DLA Piper's
Sacramento office.
Kaiser links
Kaiser failed to pay
for emergency

PLAN, INC.; et al.,

United States Court of Appeals,
Ninth Circuit.
Filed January 12, 2012

...The court's order granting
summary judgment states
Kaiser originally
erroneously denied
Samano plan benefits,
but during the pendency
of the litigation, changed
its coverage position and
paid the discounted sum
to Providence
. Samano
"need not be a `prevailing
party' to be eligible for an
attorney's fees award under
§ 1132(g)(1)," Hardt v.
Reliance Standard Life Ins.
Co., 130 S.Ct. 2149, 2156
(2010), but "must show
`some degree of success on
the merits' before a court
may award attorney's fees,"
id. at 2158. Because he did
not have the opportunity to
timely move for fees,
Samano did not waive his
right to them and he may be
entitled to a fees award. See
San Diego Police Officers'
Ass'n v. San Diego City
Emps.' Ret. Sys., 568 F.3d
725, 742-43 (9th Cir. 2009).
We therefore vacate the
order splitting fees and
costs and remand to the
district court to address
Samano's claim to them. We
express no opinion on the
merits of the request for
attorney's fees. Each party
shall bear its own costs on

AFFIRMED in part;
VACATED in part;

Argued and Submitted
December 9, 2011, Pasadena,

Before: B. FLETCHER,
Circuit Judges.
Kaiser Is Found Liable in Retaliation Case
By Charles Ornstein, Times Staff Writer
June 3, 2006

A Los Angeles County jury found Friday that Kaiser Permanente retaliated
against one of its emergency room physicians after he raised concerns
about the quality of care at Kaiser's Bellflower Medical Center.

Kaiser's affiliated medical group placed
Dr. Mark L. Woods on
administrative leave and
reduced his pay in 2003 after he
complained about filthy treatment rooms, delays in care
and a shortage of supplies
, jurors said. On a 9-3 vote, they awarded
Woods $200,000 for past economic losses.

The Bellflower hospital is the same one that in March was accused of dumping a
patient on the streets of skid row after she was discharged from its care. A Los
Angeles Police Department official said at the time that a taxicab had taken the
woman, wearing a hospital gown and slippers, to the downtown Los Angeles area
against her will. Kaiser apologized.

Friday's courtroom verdict was unusual, because Kaiser and its affiliated
Permanente physicians group generally try to force lawsuits into binding
arbitration, which is not open to the public. The judge in Woods' case, however,
ruled that the arbitration agreement was "unconscionable" and unenforceable. The
arbitration provision has since been changed.

The case publicly spotlighted the problems at the Bellflower hospital. In one e-mail
from May 2003, Woods wrote that a patient found a urinal containing someone
else's urine on a nightstand in his treatment room.   In other e-mails, Woods
detailed bloody instruments left in the sink of a treatment room and a shortage of
nitroglycerin, epinephrine, resuscitation bags and other supplies.

"This is a reoccurring dangerous trend and to date you have offered no
permanent solution," Woods wrote in a January 2003 e-mail to a Kaiser director.
"What is the next step?"

During the trial and in court papers, Kaiser and the Permanente medical group
maintained that the discipline taken against Woods in late 2003 was appropriate,
because he allegedly assaulted Dr. Steve Nguyen, then chief of the emergency
service. Defense lawyers also said that Woods had been the subject of sexual
harassment complaints and that his conduct had been deemed inappropriate.

"We respectfully disagree with the jury's verdict," Kaiser spokeswoman Socorro
Serrano said in a statement. "We encourage our physicians and employees to
advocate for improving patient care whenever and wherever possible, and we do
not condone or engage in any retaliation against individuals for taking part in
protected patient advocacy."

Serrano said Kaiser was pleased that the jury rejected Woods' other retaliation
claims and did not find that the Permanente medical group acted with malice.

Woods had worked at the Bellflower hospital since 1990 and had received
above-average ratings

from patients and fellow physicians, court exhibits show. In late 2004, a year after
he was placed on leave, Woods was reassigned to Kaiser's Fontana hospital.

While jurors were deliberating, and unbeknown to them, Woods said the Fontana
hospital's medical group Thursday voted overwhelmingly to terminate him as a
partner. His attorney, Charles T. Mathews, said he would file another lawsuit as a
result of that action.

"Now they're going to cut him off and kick him out," Mathews said. "His damages
are cataclysmically larger now, and they're directly related to his filing a claim for
retaliation." Most jurors said they believed that Woods was a strong advocate for
his patients and that Kaiser did not take his concerns seriously enough.

"Dr. Woods is the only one that really stood up," said juror Bertha Salinas, 47, of
Los Angeles. "He put his job in jeopardy and his future, but he stood up."  Juror
Denise Nitinthorn, 36, of Temple City said she would consider dropping her Kaiser
insurance based on what she had heard in the case.

"I'm disgusted," she said. "As far as Kaiser, I think they need to step up and do
what they need to do to correct the mistakes."

Woods said he was concerned that his message would be lost on Kaiser because
of the size of the jury's award.  "The only way to get Kaiser to really wake up is to
make them pay money that would get their attention," he said.  Indeed, Kaiser
spokeswoman Serrano noted that "the damages the jury awarded Dr. Woods
represented a very small fraction of what he had been demanding from us as

Evidence gathered by Woods' lawyers showed that their client wasn't the
only one complaining about problems at Kaiser Bellflower. Nguyen,
Woods' boss, wrote in a September 2002 mass e-mail, "As of today, I still
have complaints and personally witnessed bodily fluids from previous
when I examined the current patient in the room…. I am tired of writing
people up for not doing their jobs."

Emergency department clinical director Russell Lo Bue wrote that he, too, was
flustered by the hospital's inability to ensure that the emergency room had proper

"Frankly I do not understand why an organization of our size can not get
this problem solved,"
he wrote in a September 2003 e-mail to colleagues. "My
nurses are upset and threatening to leave because they have to hunt and beg for
basic equipment to care for ED patients. The ED physicians are beginning to voice
their dissatisfaction with the situation.

"Everyone is tired of hearing me say, 'It will get better. Just give the system a little
more time.' "

Serrano said any problems at Bellflower's emergency room had been corrected by
October 2003, when an inspection by a national accrediting group gave the
hospital its highest rating.

Woods and his lawyers contended that Kaiser, rather than fixing the
problems, tried to cover them up. In several memos and e-mails, Kaiser
officials discouraged Woods from putting his complaints in e-mail form,
saying they could be used in lawsuits.

"E-mail is not conducive to the necessary discussion and can be
detrimental if sent or forwarded to parties who are not solely concerned
with quality improvement," area medical director Dr. Martin Gilbert warned
Woods in a July 2003 certified letter.

"I therefore ask you as of this date to stop using e-mail for these
Kaiser Patient Alleges Severe Mistreatment
Courthouse News Service
February 10, 2012           
  LOS ANGELES (CN) - Kaiser Hospital kept a longtime patient suffering from
stroke-like symptoms in a storage room, lying in his own excrement, and abused him,
the man claims in Superior Court.

  Kaiser personnel at the Baldwin Park facility allegedly believed David Stanley was
"homeless" and "a drug addict looking to 'score' drugs."

  The suit names as defendants the Kaiser Foundation Health Plan; its contractor,,
Securitas Security Services of America; and Dr. David Kim.

  Stanley says that he had regularly been treated by Kaiser for medical conditions,
including diabetes, after his stroke in December 2010. After waking to find that he
could not move his legs on Feb. 2, 2011, he took an ambulance to Baldwin Park,
according to the complaint.
  But Kaiser employees allegedly told Stanley that "they could not find his name 'in
their system'" and refused to believe the patient's claims that his wife would soon
arrive with his Kaiser membership card.
  "On a number of occasions, employees of Kaiser [including a doctor, later
identified as defendant Kim] told plaintiff he was lying and that 'there was no one out
there for him,'" the complaint states (brackets in original).
  Refusing to treat him, Kaiser employees allegedly left Stanley on a gurney in the
hallway. He "heard various Kaiser employees [both to his face and amongst
themselves] question his legitimacy as a patient and also complain that they were
being made late for their scheduled break," according to his complaint (brackets in
  "At one point, the emergency personnel who had transported plaintiff to the facility
and who had remained were accused of 'dumping' a homeless man at the facility
and were asked 'where did you find this guy,'" the complaint continues. "Emergency
personnel told Kaiser employees they had picked Stanley up at his home and that
he was not 'homeless.' At one point, the emergency personnel were told to 'get this
guy out of here' and take him to another hospital."
  Kaiser personnel, including Dr. Kim, allegedly accused Stanley of inventing his
symptoms to secure drugs. Stanley "heard Kaiser personnel accuse him of being a
drug addict and claiming that his 'alleged symptoms' were the result of him 'detoxing'
and that they 'saw it all the time,'" according to his complaint.
  Stanley continued to insist he was a legitimate patient and begged for hospital
staff to look for his wife in the waiting area. He says they responded by pushing his
gurney "around a corner away from the Kaiser personnel."
  "While waiting to be treated, plaintiff began to experience extreme gastric distress
and believed he would soon lose control of his bowels," the complaint states.
"Plaintiff repeatedly requested that he be helped to the bathroom or that he be given
a bedpan so that he would not soil himself. His requests were ignored and eventually
plaintiff lost control of his bowels and soiled himself. Thereafter, plaintiff repeatedly
requested that he be cleaned up. Again, his requests were ignored (one nurse
stated, 'don't worry about it') and he was left sitting in a hallway, in full view of others."
  "While waiting for someone at Kaiser to show him any care or kindness
whatsoever, plaintiff heard numerous Kaiser employees accuse him of being,
amongst other things, homeless, a drug addict looking to 'score' drugs and a liar,"
the complaint states. "Eventually, understandably frustrated, plaintiff began to raise
his voice, insisting that he be treated. Kim told him that, unless he 'shut up,' security
and/or the police would be called and plaintiff would be forcibly removed from the
facility. In one exchange, after plaintiff grew more frustrated, a nurse told plaintiff,
'you can lay there in your own shit.'"
  Staffers eventually moved Stanley to an examination room that was being used to
store supplies, he says. But Kaiser employees allegedly refused to treat him or clean
him. He was "left alone in the room, covered in his own excrement," he says.
  Deciding to get up and find his wife, Stanley allegedly began yelling for Kaiser
personnel to help him.
  "As he began to stand, supporting himself with a chair, Kim entered the room
followed by 2-3 guards and 2 nurses," the complaint states. "One of the guards
[named co-defendant John Gonzalez] yelled, 'he's gonna charge' and immediately
rushed plaintiff and tackled him, driving plaintiff into the wall and kneeing plaintiff in
the midsection. Plaintiff's head struck the wall and his arm was scraped as he fell to
the floor, with Gonzalez on top of him. Kim yelled 'get off of him,' but once plaintiff
was on the floor, Gonzalez continued to hit and kick plaintiff, who was defenseless.
Thereafter, someone yelled 'get up,' plaintiff indicated that he could not get up and
that he was injured. Plaintiff's injuries were significant enough to leave blood on the
wall and floor."
  Stanley says that Kaiser employees then told him to stay where he was. They left
him "lying on the floor, covered with his own excrement and now bloodied," the
complaint says.
  An orderly was charged with watching Stanley, but no one attended to his wounds
or treated him, Stanley says.
  After persuading the orderly to find Stanley's wife in the waiting room, the worker
allegedly returned in minutes with Stanley's wife and his Kaiser identification card.
  "The attitude of the Kaiser employees instantly changed," Stanley says. He was
"immediately taken to another area, where he was cleaned and was given treatment
for his complaints ... [and] provided with a bedpan and hot towels."
  "Employees of Kaiser also immediately began to clean the area where plaintiff had
been assaulted, attempting to clean up all evidence of excrement and blood from the
floor and walls," Stanley alleges.
  In addition to being diagnosed with the lingering symptoms of his earlier stroke,
which forced him to seek treatment in the first place, Stanley says he was also
treated for a concussion, cuts and abrasions, the results of being physically
assaulted by Kaiser security.
  Stanley alleges negligence, intentional and negligent infliction of emotional
distress, assault and battery and false imprisonment. He is represented by G. Peter
Nooregard of Irvine, Calif.