Calif:State Fines Kaiser $500,000 Over Errors in Patient-Referral Case

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Health: The HMO failed to send a man with muscular dystrophy to a specialist, the agency says. He died days later


California medical authorities Thursday fined Kaiser Permanente $500,000 for failing to send a young man with muscular dystrophy to a specialist.

Timothy Joseph Waters, a 19-year-old Stockton resident, died six days after his mother's last frantic request for a referral to a specialist, according to documents filed with the California Department of Managed Care.

"This case involves multiple, egregious errors by Kaiser in its care and treatment of the enrollee," the department said. In addition, Kaiser subsequently failed to implement a corrective plan to avoid the errors that led to Waters' death, said Daniel Zingale, head of the Department of Managed Care.

Junette Lalonde, Waters' mother, said her son began to have trouble breathing during the summer of 2000. When a Kaiser nurse came to check his oxygen level during a regular August visit, it was low, according to Lalonde and the state.

Lalonde immediately phoned Kaiser, and Waters was seen the next day, according to the documents. But the doctor did not order oxygen for him. Ten days later, Waters could not sit up, and his mother phoned the health maintenance organization again.

The doctor said he would refer Waters to specialists in muscular dystrophy at UC Davis. But the referral paperwork never arrived, according to the state.

Six days later, Waters died in his sleep.

"I went in to check on him at about 1:30 in the morning, to make sure his covers were OK," Lalonde said. "And at 8:30 when I went in to check on him, he was dead."

Said Zingale: "The mother had been very aggressive and vigilant in looking out for her son. She had called Kaiser repeatedly."

A Kaiser representative said Thursday that it is investigating Waters' death but has not yet reached a conclusion. Spokesman Jim Anderson said the HMO was "confused" about the state's action and was considering appealing the case.

"We want to express our sympathy to the family of the young man," Anderson said. "He had been suffering from an incurable disease."

But Anderson said he had not seen the state's accusation, which contained details of the fine.

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