Body Farm

Kaiser Put Kidney Patients at Risk
By opening its own transplant center in the Bay Area, the HMO harmed recipients' odds of obtaining organs, a Times probe finds.

By Charles Ornstein and Tracy Weber, Times Staff Writers
May 3, 2006

In mid-2004, more than 1,500 Kaiser Permanente patients awaiting kidney transplants in Northern California got form letters that forced them to change the course of their treatment.

Kaiser would no longer pay for transplants at outside hospitals, even established programs with thousands of successes. Instead, adult patients would be transferred to a new transplant center run by Kaiser itself — the first ever opened by the nation's largest HMO.

Within months after Kaiser's kidney program in San Francisco started up, its waiting list ranked among the longest in the country. No other center had ever put together such a list so fast.

The patients didn't know it, but their odds of getting a kidney had plummeted.

Kaiser's massive rollout in Northern California endangered patients, forcing them into a fledgling program unprepared to handle the caseload, according to a Times investigation based on statistical analyses, confidential documents and dozens of interviews.

Hundreds of patients were stuck in transplant limbo for months because Kaiser failed to properly handle paperwork. Meanwhile, doctors attempting to build a record of success shied away from riskier organs and patients, slowing the rate of transplants performed.

National transplant regulators apparently did not notice the program's failures, though some were obvious in the statistics the regulators themselves posted on the Internet.

In 2005, the program's first full year, Kaiser performed only 56 transplants, while twice that many people on the waiting list died, according to a Times analysis of national transplant statistics.

At transplant centers statewide, the pattern was the reverse: More than twice as many people received kidneys than died.

Kaiser is one of the primary HMOs in California and is making inroads elsewhere. This is a scandal.