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Kaiser aims for mediation to avoid nurse’s $41.5 million retaliation award

Both sides could benefit from mediation. Kaiser might see a reduced payout, while the nurse might get a smaller award quickly, rather than waiting for the appeals process to drag out.

LOS ANGELES (CN) — Kaiser Permanente, which operates 40 hospitals predominantly in the western United States, is hoping for mediation to avoid paying an unprecedented $41.5 million in damages that a jury awarded to a nurse who claims she was fired for raising too many concerns about patient safety.

Attorneys for the nurse, Maria Gatchalian, convinced jurors at the Los Angeles Superior Court last month that the health care juggernaut was compromising patient care with cost cutting and understaffing. She says she was terminated for spurious reasons because she continued to speak up about problems at the hospital — even after her supervisors told her not to.

"Your voice, your verdict, it might be able to change Kaiser," David deRubertis, one of Gatchalian's lawyers, told the jurors in his closing argument. "It might be able to tell this health care corporation and insurance company that the quality of care, and the protection of those with the courage to speak out on the quality of care, matters more than the business side of what medicine and health insurance has become today."

Those words clearly resonated with the jury, who took only a few hours to return a verdict awarding Gatchalian $2.5 million for past and future lost earnings, $9 million for past and future emotional distress, and after finding that Kaiser had acted with malice, another $30 million in punitive damages — culminating in an unheard-of amount of damages for a wrongful termination lawsuit that meant to send a message.

Following the Dec. 11 jury verdict, Kaiser Foundation Hospitals and Kaiser Foundation Health Plan — the two Kaiser Permanente entities on the hook for the damages — have brought in a new set of lawyers from white-shoe law firm Gibson Dunn. In conjunction with the plaintiff's attorneys, the group has asked the judge to delay entry of judgment while they sit down with a mediator.

Given the verdict's unprecedented price tag, both sides are willing to pursue a post-trial settlement because the stakes have become significantly higher for them in further litigation.

"There are a lot of moving pieces, but with an award this size, there's a bigger chance the judge will reduce it," said Ben Fenton, a litigator with Fenton Law Group in Los Angeles who specializes in health care industry disputes. "Maybe Kaiser didn't look at the case in the right way from the start and didn't realize the strength of the plaintiff's claims."

The judge could slash the jury award pursuant to any Kaiser post-trial motions, or it could be reversed on appeal. In addition, the plaintiff may prefer a smaller payout now than to wait for years as the case winds its way through the appellate process.

Typically, a defendant will try to persuade the trial judge after the verdict that the jury's damages award wasn't supported by the evidence, or that the punitive damages are out of proportion to the compensatory damages.

For Kaiser, aside from the negative publicity, the risk is that the judge will deny its request to modify or vacate the damages and that the court of appeals will see no compelling reasons to overturn the jury's findings. Plus, the health care giant will likely have to pay its new, high-end lawyers a not-insignificant amount of money to litigate the verdict post-trial and on appeal.

"There must have been some pretty egregious evidence to support the retaliation claim," Fenton said.

Gatchalian — 63 years old at the time she sued Kaiser in 2021 — had been working at the Kaiser Permanente Hospital in Woodland Hills, California, for over 30 years when she was fired in June 2019. A patient's purported family member secretly took a picture of her taking a break in a recliner meant for patients or their families in the hospital's neonatal intensive care unit with her bare feet on an isolette, an enclosed incubator, holding a sick newborn.

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The anonymous individual, who Gatchalian's attorneys say was likely a Kaiser employee, filed a complaint. According to Kaiser, Gatchalian initially lied about the incident during a fact-finding meeting to investigate the complaint.

However, the nurse claimed that there was more at work here: Gatchalian claimed she was fired in retaliation for raising numerous issues related to patient safety at the hospital. For one, Kaiser's management lost no time investigating her violation of its policies and firing Gatchalian, whereas, according to her lawyers, months might pass before anything happened with other complaints where nurses were photographed acting inappropriately.

Moreover, the hospital's chief nurse executive admitted on the stand that she didn't know of any other nurse getting fired for a single dress code violation, or a single violation of Kaiser's infection-control policies, according to deRubertis.

The real reason she was immediately fired in spite of her 30 years of solid performance, Gatchalian's attorney said during the trial, was that she had continued to file so-called "unusual occurrence reports" to her supervisors in spite of repeatedly being told that the hospital's chief nurse executive didn't want too many of them.

"Her reports opened up a can of worms," deRubertis told the jurors in his closings. "If they dealt with her reports the right way, they had to look under the hood. But the thing is, they don't want to look under the hood because they knew what was under the hood ... . They were cutting costs, and that was the problem."

One of the reports Gatchalian filed in the months leading up to her termination involved a delivery where the doctor in charge first ignored advice by other staff to perform a cesarean section, even though alarms were going off and the baby's heartbeat was dropping. The doctor then overrode another physician's request for an emergency C-section. The baby survived but suffered severe brain damage, and Kaiser was hit with a malpractice lawsuit.

According to Gatchalian, she had heard rumors from nearly every nurse that the director of nursing for her department, to whom she had reported what happened during the delivery, wanted to fire her because she saw first-hand what went wrong and wouldn't make a good witness for Kaiser.

It wasn't a coincidence, Gatchalian's lawyers said, that Kaiser settled the malpractice lawsuit right before she was scheduled to be deposed.

Another nurse who was present at the botched delivery testified at the trial that she was instructed to stop charting what was happening in the room, supposedly because her charts could be used against the hospital in the expected litigation.

Helen Kersey, the director of nursing who fired Gatchalian in 2019, sued Kaiser herself the following year. She claimed, among other things, that she found herself having to perform not only her own job but also those of managing and supervising nurses without the support of supervising managers who were supposed to help her while Kaiser’s Woodland Hills hospital was understaffed.

The delivery incident had come shortly after a Feb. 5, 2019, meeting Gatchalian had with Kersey at which Gatchalian raised her understaffing concerns. Understaffing can cause patient-to-nurse ratios to drop, which Gatchalian's attorneys say is not only a violation of the law, but could ultimately compromise patient safety and care.

However, Kersey did not take Gatchalian’s concerns seriously, her lawyers said, and instead reprimanded her. They told her she shouldn't file unusual occurrence reports for events that she didn't personally witness, even if it was reported to her as charge nurse.

Not long after, in March 2019, Gatchalian submitted another report after she learned that a newborn baby had missed three consecutive feedings. Again, she was reprimanded by her supervisors, her lawyers said, and told that the chief nurse executive wasn't happy about the report.

Other issues Gatchalian raised during the last two years before she was fired included a report that one of her supervisors knew a father was carrying a knife on his visits to the neonatal intensive care unit but didn't tell the other staff. As a result, Gatchalian claimed, this supervisor started harassing her and even slapped her with a disciplinary action for wearing her face mask incorrectly, whereas other nurses were simply told to put their mask on properly.

She also filed a report when information was provided, in violation of federal law, to a man who wasn't permitted to contact the mother of newborn twins pending a paternity test.

Kaiser declined to comment on the verdict beyond a statement it issued in December.

"The allegations in this lawsuit are at odds with the facts we showed in the courtroom," Murtaza Sanwari, senior vice president and area manager of Kaiser Permanente Woodland Hills/West Ventura County, said in the statement. She said that Gatchalian's placing her bare feet on the isolette with a newborn was egregious and put the baby at risk. "We stand by her termination and are surprised and disappointed in the verdict. Kaiser Permanente plans to appeal this decision and will maintain our high standards in protecting the health and safety of all our patients."

The understaffing issues raised at Gatchalian's trial echoed those of Kaiser hospitals nurses who last year went on strike over what they claimed were unfair labor practices and bad faith on behalf of the health care operation. The nurses' union claimed that staffing levels have dipped, causing dangerously long wait times, mistaken diagnoses and rushed in-person care.

California’s largest health care provider also had to pay $50 million in a settlement with the state's Department of Managed Health Care last year over mismanagement of its behavioral health care services, and commit to an extensive overhaul to better serve people seeking behavioral health support. 

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Categories / Courts, Employment, Health, Regional, Trials

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