Kaiser Left Dead Patients on Kidney Transplant Wait List

Kaiser Permanente’s disgraced San Francisco kidney transplant program had failed to remove the names of 90 dead patients from the national waiting list for organs, state officials discovered after the program shut down amid scandal in May.

Kaiser acknowledged Tuesday that it knew its list included patients who had died -- some as far back as 2004 -- and blamed a data-processing backlog.

“We did have trouble with that, very honestly, and I think we have corrected the problem,” said Mary Ann Thode, president of the Kaiser Foundation Health Plan and Hospitals in Northern California. “We absolutely knew they passed away. I just think we didn’t go through the appropriate notification process.”

The list, maintained by the United Network for Organ Sharing, determines the order in which patients receive donated kidneys.

The administrative lapse further illustrates the chaos that crippled Kaiser’s kidney program, which opened for transplants in late 2004.

The Times reported in May that the fledgling program had endangered hundreds of patients, in some cases delaying critical surgeries or losing track of patients altogether. The program announced that it would shut down May 12.

The state Department of Managed Health Care learned of the deceased patients as it helped Kaiser prepare to transfer 2,300 people awaiting kidneys to other hospitals, said Kevin Donohue, the agency’s deputy director. The department announced Tuesday that it had completed its review of all patient files and had sent them on to established programs at UC Davis and UC San Francisco medical centers.

Initially, the state agency had estimated that all of Kaiser’s patients could be transferred to the two UC hospitals within weeks of the program’s announcement that it would close.

But the transfer process was more complicated than officials had expected. They now estimate that all patients will be officially shifted by the end of the year.

So far, more than 1,100 Kaiser patients have been transferred to the two UC hospitals. Because the Davis hospital requires an in-person medical evaluation upfront, the process has gone slower there than at UC San Francisco, which examines patients closer to the time of transplant.

“When we get complaints, it’s usually more from people who are transferred to the UC Davis list,” Thode said, adding that the Davis hospital still believes it can complete the process by year’s end.

A UC Davis official said Tuesday that national transplant rules require the hospital to complete the work-ups before adding patients to its waiting list. Programs in San Francisco do not have to meet that standard.

Nabil Musallam, a senior associate director of the UC Davis Health System, said his program has discovered that about 20% to 25% of the 200 Kaiser patients it has reviewed so far did not meet the requirements to be placed on its kidney waiting list.

Since May 12, 48 Kaiser patients have received new kidneys at Kaiser and other hospitals, a 50% increase over the same period last year, Donohue said. More than 50 patients waiting for the organs have died.

Other patients have been deemed too sick for a transplant, moved away from Northern California or dropped Kaiser as their health insurer.

Transplant experts say it is not unusual for large programs to miss changes in the status of some kidney patients, because they are not tracked as regularly as patients awaiting new hearts or livers.

Dr. Gabriel Danovitch, medical director of the kidney and pancreas transplant program at Harbor-UCLA Medical Center, said Kaiser’s failure to remove patients from the waiting list pales in comparison to some of its other problems. “We know damn well that they weren’t keeping up with what’s going on,” he said.

In August, Kaiser agreed to pay a $2-million fine to the managed-care department and contribute $3 million to promote organ donation in the state.

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charles.ornstein@latimes.com

tracy.weber@latimes.com