Kaiser Transfer Blamed for Brain Damage

     GREENBELT, Md. (CN) - A woman has severe brain damage after a financially-motivated hospital transfer led to respiratory and cardiac arrest in the ambulance, her husband claims in the U.S. District Court for the District of Maryland.
     On behalf of himself and as guardian of Maaza O'Brien, Daniel O'Brien sued Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.; Mid-Atlantic Permanente Medical Group, PC; Civista Health, Inc. dba The University of Maryland Charles Regional Health, Inc.; Civista Care Partners, Inc., dba The University of Maryland Charles Regional Care Partners, Inc.; Emergency Medicine Associates, P.A.; and Lifestar Response of Maryland, Inc.
     Maaza O'Brien, 55, was healthy until she contracted pneumonia in Jan. 2013, according to the complaint.
     She was initially seen at her local Kaiser Permanente office, but when her condition got worse over the next two days, Kaiser staff told Daniel O'Brien to take her to an emergency room, Mr. O'Brien says in his complaint.
     He took her to the University of Maryland Charles Regional Medical Center (UMCRMC) emergency room where "triage providers documented that she had been diagnosed with pneumonia two days before with increased shortness of breath starting one day before. She complained of pain on breathing and noted that she had had some nausea and vomiting. Her breath sounds were diminished," and she was given Dilaudid, "which is known to suppress respirations even further," the complaint states.
     Mrs. O'Brien's emergency room doctor and a doctor at a nearby Kaiser hospital "decided to transfer the patient from UMCRMC in LaPlata to Holy Cross Hospital in Silver Spring, a distance of about 50 miles," via a Basic Life Support ambulance "which offered only minimal respiratory monitoring and little or no respiratory support for a patient suffering respiratory compromise," the complaint continues.
     Mrs. O'Brien's transfer "was instigated and requested by the Kaiser entities, which together constitute the health maintenance organization responsible for payment of Mrs. O'Brien's medical and hospital bills. . . . The Kaiser entities and Holy Cross Hospital have a favorable financial arrangement which was allowed to influence the transfer of this patient. The transfer occurred without obtaining the patient's informed consent and without explaining to the patient the risks and lack of benefit of such a transfer," the complaint states.
     Mrs. O'Brien was unresponsive when the ambulance came, and remained so throughout the 50 mile trip, during which her breathing was not monitored, "other than by [seeing] chest movement at 11:30 p.m. and 11:50 p.m. This level of respiratory monitoring and support was wholly inadequate for a patient in the condition of Maaza O'Brien," according to the complaint.
     Consequently, her respiratory and cardiac arrest were not discovered until she arrived at Holy Cross Hospital at 12:10 a.m., 20 minutes after the ambulance personnel had last noticed her breathing, according to the timeline stated in the complaint.
     "Lifestar Response personnel and a nurse from Holy Cross Hospital began chest compressions. A code was called. . . . After approximately a 15-minute resuscitative effort at Holy Cross Hospital, the patient's pulse and cardiac function returned. At this time she was intubated and on a ventilator, but had suffered a severe hypoxic insult to her brain," the complaint states.
     Now Maaza O'Brien "has major deficits in motor function, cognitive function, memory, executive function, speech and attention. She has been rendered unable to work. She needs constant care and supervision. She is no longer able to perform any of her normal daily activities in the home, socially, or at work," according to the complaint.
     The O'Briens have two children in college and Mr. O'Brien has had to quit his job to take care of his wife full time, he says in the complaint.
     Mr. O'Brien says the Kaiser and University of Maryland entities violated the Emergency Medical Treatment and Active Labor Act by moving Mrs. O'Brien while she was unresponsive and unstable. He accuses them, Emergency Medical Associates, and Lifestar Response of negligence and lack of informed consent, and sues all defendants for loss of consortium. He is represented by Gerard E. Mitchell and Denis C. Mitchell of Stein, Mitchell, Muse & Cipollone of Washington, DC.