Former physician for John Muir Well being says hospitals put cash forward of affected person security, cites baby’s loss of life

A former John Muir Health doctor alleges in a lawsuit that the nonprofit group, which operates hospitals in Walnut Creek and Concord, put money ahead of patient safety and ignored her warnings about surgical hazards that have resulted in illness and death.

Hospital officials dismissed the claims made by Dr. Alicia Kalamas in a lawsuit filed Wednesday in Contra Costa County Superior Court.

Kalamas, who worked at John Muir Health for eight years, said she has repeatedly raised red flags at executives about improper surgical practices, only to be ignored because she was viewed as a woman with “sharp elbows” or because officials feared that Changes that would signal past practices were dangerous.

In one example, she said she warned officials not to authorize complicated surgery on a child and told them other regional hospitals were better prepared to perform the surgery. But because the hospital group’s executives wanted to build a children’s brand, they ignored her concerns, she claims in the lawsuit. Surgeons from John Muir Health performed the surgery and the child died.

In their response to that claim, John Muir Health officials said Kalamas was not directly involved in the case and could not assess the “significant risks” of continuing or not having the surgery.

Kalamas, 50, of Piedmont, sued the nonprofit and its two top executives, Cal Knight, CEO of John Muir Health, and Taejoon Ahn, president and CEO of John Muir Medical Group, alleging the group violated its contract and forced her out of her position after labeling her a troublemaker.

“People at the top of the organization have lost their way,” Kalamas told The Chronicle. “They care more about the bottom line than patient safety.”

John Muir Medical Center on Wednesday, January 12, 2022 in Walnut Creek, California.

Santiago Mejia / The Chronicle

dr Russell Rodriguez, chief medical officer at John Muir Health, said that any feedback from employees is appreciated and that before executives decided not to renew Kalamas’ contract, they decided to restructure the program she administered to include “the better meet today’s patient needs”.

“The fact that the clinical consensus can differ from an individual physician’s views does not mean that he or she has been ignored,” Rodriguez said in a statement to The Chronicle. “Despite efforts to offer coaching and other support, Dr. Kalama’s reality and something she found difficult to understand and accept.”

He said that senior executives make patient safety their number one priority, noting that all the money John Muir Health makes is reinvested in the healthcare system.

Kalamas specializes in anesthesiology with a focus on perioperative medicine, which ensures that the many factors that influence surgical success – before, during and after an operation – are properly managed. In 2013, Kalamas was recruited from UCSF to join John Muir Health as medical director of the perioperative medicine program.

She quickly sought to fix the hospitals’ readmission rate for the highest-volume surgeries, which the lawsuit said was higher than the region’s 6.9% rate.

Her research found a simple problem, she says. When prescribing opiates as pain relievers after surgery, particularly for knee and hip replacements, there was no protocol to educate and provide medication to prevent constipation, resulting in patients returning to the hospital for a variety of issues.

“Millions of dollars were paid to JMH for failing to provide their patients with a 50-cent over-the-counter stool softener, a glass of water, and some basic advice,” Kalamas alleges in her lawsuit.

After her changes were implemented, the hospital saw a 27% decrease in readmissions for joint replacements, reducing costs for medical providers and taxpayers, she says.

Kalamas dealt with postoperative wound infections. Patients who have developed such infections are 60% more likely to be admitted to the ICU and five times more likely to be readmitted research. Yearly such problems costs the US health care system $3.5 to $10 billion.

In the past, John Muir Health has earned revenue from such complications and billed patients for the additional treatment, the lawsuit says. However, the federal government began to force the hospital to pay millions of dollars Punish, says Kalamas, eventually forcing it to improve. Still, Kalamas says executives and others ignored numerous emails she sent warning them that the lack of pre- and post-surgery blood glucose monitors was harming and killing patients.

The lawsuit cites an example of a diabetic who required a second operation after an infection. His heart wasn’t strong enough and he suffered a massive heart attack at home in front of his wife on the first day and later died, according to the lawsuit. Another young patient with kidney failure and diabetes did not have her blood sugar controlled and died shortly after receiving anesthesia; Her blood sugar was high when she coded, Kalamas says.

Rodriguez, John Muir’s chief medical officer, said eliminating postoperative wound infection is a “critical focus” and that restructuring the perioperative program will further reduce infections.

“Peroperative services needed to be made available to a larger proportion of the operated population, and care needed to be extended beyond the clinical setting,” he said.

Kalamas said her whistleblowing and criticism as a woman was bothersome or, as one manager told her, developed a reputation for “sharp elbows”.

“I’ve been in other institutions … and I’ve never felt dismissed,” Kalamas told The Chronicle. “I felt like at John Muir Health I was warning of very serious health and safety concerns and no one was paying attention.”

When she found out about the young child’s planned surgery, it fell outside of her area of ​​responsibility at the hospital, but she felt compelled to speak out, she says. Due to medical privacy laws, neither Kalamas nor her attorney, Dan Horowitz, could provide details about the child and the procedure.

“The case should have been referred to a qualified medical center, which Dr. Kalamas strongly encouraged her,” the lawsuit reads. “In particular, Dr. Kalamas told medical leadership that she had extensive experience with similar cases at UCSF and that JMH was massively underprepared.”

She said she told John Muir Health executives if they did the surgery it would be a “clean kill.”

After the child died, Kalamas requested a review of the case by the Medical Executive Committee, which could result in disciplinary action for those involved, disclosure to parents, and other safeguards. In a 2021 email shared with The Chronicle, Kalamas was informed that the case never went to the committee.

She recalled her earlier concerns about the surgery in an email, explaining how liver transplant and anesthesia experts agreed with her reservations.

“I was angry that JMH misrepresented the capabilities of their clinicians and the institutions’ ability to provide parents (redacted) with safe care given that UCSF, Stanford and Oakland Childrens’ are all much better equipped to to handle cases of this complexity,” she wrote. She added that she was told that John Muir health officials wanted their new pediatric center and needed to avoid disruption.

Horowitz said the child’s parents are still unaware of Kalamas’ concerns to this day.

In response to the pediatric death, Rodriguez said some cases had “extremely advanced life-threatening conditions for which any intervention is a high risk and not having an intervention is also a high risk.” He said all options were discussed with the family before the operation and since Kalamas is not part of the treatment team she would not know all the details.

He said a post-case review was conducted through the peer review process, but Kalamas would not be aware of any assessment as it is confidential.

As of May 31, 2021, Kalamas said her contract was allowed to expire. Since then she has not returned to a hospital.

Matthias Gafni is a contributor to the San Francisco Chronicle. E-mail: matthias.gafni@sfchronicle.com Twitter: @mgafni

Prime Minister Boris Johnson says not less than one affected person has died with omicron

UK Prime Minister Boris Johnson leaves Downing Street to attend Prime Minister’s Questions at the House of Parliament on July 7, 2021 in London, England.

Chris J. Ratcliffe | Getty Images News | Getty Images

LONDON – British Prime Minister Boris Johnson confirmed on Monday that at least one patient infected with the new Omicron variant of Covid-19 has died in the country.

“Unfortunately, yes, Omicron leads to hospital admissions and unfortunately at least one patient has been confirmed to have died with Omicron,” Johnson told reporters during a visit to a vaccination clinic near Paddington, London. according to Sky News.

“So I think the idea that this is kind of a milder version of the virus is something that we need to put aside and just see the sheer pace at which it is accelerating through the population. So the best we can do , is “everyone gets our boosters.” he said.

British Health Minister Sajid Javid said earlier on Monday said the BBC that currently 10 people were hospitalized after being infected with the Omicron variant. Javid said Omicron was spreading at a “phenomenal rate” and cases doubling every few days.

It comes after studying announced the University of Oxford on Monday found that two cans of either the OxfordAstraZeneca or PfizerBioNTech The Covid-19 vaccine was significantly less effective in fighting off Omicron when compared to previous variants of the coronavirus.

However, the scientists were optimistic that booster vaccinations would improve immunity to the new, highly transmissible variant.

This is breaking news, please check back later to find out more.

Snowflake CEO urges buyers to be affected person with inventory throughout cloud transition

Frank Slootman, CEO of Snowflake, said Wednesday that shareholders will have to be patient with the company’s stock as the cloud transition won’t happen overnight.

“Our business is really going to be real for significant, long periods of time,” Slootman said in an interview with CNBC’s Jim Cramer on “Bad money.” “This is kind of a message to investors to really understand that we are signing up for a trip here that will last five to ten years.”

The comments came when Snowflake’s shares fell as much as 8% in post-company expanded trading reported first quarter results.

While revenue rose 110% year over year to a better than expected $ 228.9 million, the data analytics software company also posted a net loss of $ 203.2 million. That’s an increase of $ 93.6 million over the same period last year. At the same time, Snowflake has raised its full-year forecast for product sales.

Snowflake went public in September a record-breaking IPOThe shares close this first day of trading at $ 253.93. However, the stock was below that level at the close of trading on Wednesday. Snowflake shares have also fallen 16% since the start of the year as investors moved from high-flying growth names to economically sensitive companies that can benefit from Covid’s rebound.

Despite recent moves on Wall Street, Slootman emphasized that the company’s software becomes increasingly important as companies move away from databases that are tied to hardware.

“These are big, big changes we’re seeing in the marketplace and we’re just super happy to be in the thick of it and make it possible,” he said, adding that Snowflake has its focus on large-scale growth. “We are not a company that grows at any price.”

Commentary: Well being care value transparency will develop affected person choices, lower your expenses | Commentary

The Center for Medicare and Medicaid Services directed healthcare systems to disclose the negotiated (actual) rates insurance companies pay for certain services effective Jan. 1. The American Hospital Association sued to thwart the execution, but the judicial system refused to stop implementing it.

Aside from the hospitals’ legal argument about their contracts with insurance companies, their argument was that patients really didn’t care what the insurance companies paid the providers. They only dealt with their costs after the deductible and co-payment.

That’s probably true to some extent. However, the majority of all payments to health systems come from employers’ health plans and those with high-deductible plans. These groups take care of the total cost and become the first direct beneficiaries of transparency.

There are basically two different purchasing groups for health care. One includes patients facing an emergency who do not have the time or resources to make health care purchasing decisions, and patients with very complex care needs rely on the health system to ensure they receive adequate care at high levels Quality receive reasonable pricing.

A third-party attorney who is familiar with the local hospitals and doctors could ensure they are receiving quality treatment. Lawyers could be embedded in groups of first responders. Price transparency provides cost information.

With appropriate quality information, the lawyer can help the patient to find their way around the provider environment. When someone needs an emergency room for an accident or traumatic health condition, having the closest facility with the ability to handle the situation is the deciding factor. In emergency situations and in the context of complex care, price transparency will soon be discovered by first aiders and lawyers. When this is combined with quality data, convenience, and technical ability to provide emergency and complex care and then inform the public, it will provide the incentive for groups of providers to deliver value.

The other group are patients who have the time to make a decision about who to use for elective surgery, imaging, and chronic disease management in primary care. Companies can incentivize their employees to use the lower-cost, higher-quality facilities.

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Individuals with high deductible plans can choose providers based on cost, quality, and convenience. Why pay double for an MRI or knee replacement when quality and comfort are the same? Even with trauma and complex care, employers can encourage employees to use facilities that offer the best value.

Not much has been done in South Carolina to conform to the spirit and intent of the new federal regulation.

In a recent Deloitte survey, only a third of nationwide hospital systems met the requirements. However, there is cost information recently released by Healthcare Dive. At California Pacific Medical Center Van Ness, the price of a specific joint replacement ranges from $ 22,865 to $ 101,571. In Chicago, the price ranges from $ 4,613 to $ 50,680. In New York, the range was between $ 14,202 and $ 45,387. At Florida Health Shands in Gainesville, the price ranged from $ 8,114 to $ 66,734.

These prices represent the highest and lowest fees that insurance companies pay for the same common replacement procedure. Same facility, same surgeon, insane price difference. There is no reason to believe that we will see anything else in South Carolina’s health systems.

With prices published, corporate health plans and high-deductible policyholders can use this information to make material changes to the way they purchase health benefits. Another point: private groups of doctors do not have to publish their tariffs, although some do.

Studies have shown that outpatient surgery centers run by private doctors are paid around 40% less for outpatient operations than for health systems. The same surgeon again, the same quality result, lower costs. The more transparency we have, the better our system becomes.

James H. Suddeth Jr. is the past chairman of Palmetto Richland Hospital and vice chairman of Palmetto Health, now Prisma Midlands, and CEO of Suddeth Healthcare Solutions.