Fired for Reporting ICU Risks, Kaiser Nurse Says

OAKLAND, Calif. (CN) - A nurse claims that Kaiser Permanente managers fired her after she complained about sub-standard conditions in the neonatal intensive care unit of a newly-opened facility.

Dawn Smith sued the Permanente Medical Group, Kaiser Foundation Hospitals, Kaiser Foundation Health Plan and two managers at Kaiser's Modesto, Calif. facility. Besides the safety code violations, Smith also brings defamation and wrongful termination actions in the suit filed in Alameda County court.

Smith claims that after Kaiser opened its Modesto facility and hired her in 2008, she complained about "patient, hospital and staffing safety" in its neonatal intensive care unit (NICU). According to her complaint, Smith says she brought the issues to the attention of hospital management at monthly staffing meetings.

According to the complaint, most of Smith's concerns centered on the lack of admission criteria and lack of staffing in the NICU. She also voiced concerns that premature newborns were sent to post-partum too quickly, and that babies were sent home despite being jaundiced with high bilirubin levels.

Smith says Kaiser staff started harassing her after she complained that a doctor did not properly "bag" a baby after delivery, while another failed to order blood work, an IV or monitoring equipment for a baby who showed signs of distress. In 2011, hospital managers Judy Moore and Gail Willingham - both defendants in the complaint - placed Smith on 30-day administrative leave "to look into some concerns we have."

According to Smith, Moore and Willingham falsely accused her of failing to follow "neonatal resuscitation guidelines on three separate instances. The nurse says that in each of the three instances, she was either not at fault or the managers failed to interview all the parties involved in the deliveries - but Kaiser management handed her a second 30-day suspension without pay, the complaint states.

After several other incidents at the end of 2011 - including the near-death of a term infant - Smith says she complained again to Moore and Willingham. They responded by firing her, according to the complaint.

"Plaintiff's termination letter was authored by Willingham and Moore and alleges '... a witness saw you vigorously handling the newborn, without taping the central [IV] lines securely in place. Your actions resulted in the central lines dislodging, which required replacement at a time when delay in care could be detrimental to the child. ... Following a thorough investigation, it has been concluded that this incident was inappropriate; you have failed to follow the following policy: Policy on Obligations Regarding Umbilical Vessel Catheter Management - "Once placement has been verified, tape securely in place using the goal post method" [and] "Ensure the umbilical catheter is securely anchored to the skin." [Due to] your continued failure to adhere to our policies and work rules, your employment with Kaiser Foundation Hospitals is being terminated effectively immediately," Smith says in her complaint. (Ellipses in original.)

Smith says that in reality, the delivery doctor failed to secure the catheters in the newborn's umbilical cord during the incident that cost her her job. She says she actually held the catheters in place until the doctor returned and reinserted the IV.

In addition to Kaiser's refusal to address her safety concerns, Smith says the blame Willingham and Moore placed on her shoulders for troubles in the NICU damaged her occupation and reputation. She seeks compensatory and punitive damages for both the defamation and her wrongful termination.

Smith is represented by Lawrance Bohm of Sacramento.

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