The Kaiser foundation health plan now includes more than 12.5 million members throughout the Country more than 8 million members in California. Although Kaiser has membership in ten states, headquarters are in Oakland, California. Under the health plan agreement, Kaiser members have no choice in selecting hospitals outside the Kaiser system, or doctors outside of the Permanente Medical Group if adequate care can be provided at Kaiser facilities a utilizing Permanente Group partner or employee doctor. Importantly in California, members do not have the right to go to court to seek justice in the event of medical malpractice. All members under 65 are tied to the one-sided Kaiser arbitration system. This arbitration requirement is imposed by the Kaiser contract – and it is critical that members retain lawyers who know the arbitration system inside – out when malpractice occurs.
The Kaiser Medical Malpractice team at Walkup has skilled and experienced malpractice lawyers with more cumulative years of experience prosecuting Kaiser malpractice claims than any other plaintiffs personal injury firm in California. We don’t just do this work occasionally: we do it every day. At any one time we have as many as 10 cases against Kaiser going on at the same time. We handle serious Kaiser cases from the Oregon border to the Mexican border. Since 1980 The Walkup firm has successfully prosecuted, settled, arbitrated and mediated more than 300 cases on behalf of Kaiser members.
Until they are injured by a medical error or mistake, most Kaiser members do not know that Kaiser has its own private system for resolving malpractice claims. Since 1978, Kaiser has included a mandatory provision in all group policies requiring the use of a private arbitration procedure for all Kaiser malpractice, KFH negligence, product liability, prescription drug and medical negligence claims against Kaiser employees and Permanente Medical group doctors. Claims for infants, children, teens and adults must be arbitrated.
Kaiser pays a private administrator, The Office of the Independent Administrator (OIA) to run its private court system for all claims made against Kaiser doctors. There are complex and unique rules which govern the process, timing and disposition of claims for Kaiser personal injury and wrongful death brought by Kaiser members. These are Kaiser Rules that differ from court rules. These include strict time tables for resolving claims which require that all claims be resolved through arbitration in less than 18 months from the date the claim is filed. For more information, please see our materials on a general timeline for Kaiser proceedings and About the OIA.
Our Proven Record In Prevailing Against Kaiser: More Than $350 Million Has Been Paid To Our Clients by Kaiser
At Walkup, Melodia, Kelly & Schoenberger, in San Francisco, California, we have been successfully prosecuting malpractice cases against Kaiser since 1970, more than 50 years. Our Kaiser team has won in arbitration against Kaiser in obstetrical cases, failure to diagnose cases, surgical error cases, delayed diagnosis cases, wrongful death cases, pediatric cases, medication cases, brain injury cases, cerebral palsy cases, radiology cases and paralysis cases. We have recovered hundreds of millions of dollars in medical claims against Kaiser Permanente HMO since 1978. We are experts in helping Kaiser members unravel the intricacies of the Kaiser Permanente arbitration procedures. We know how to protect the legal rights of Kaiser members. Unlike other firms our Kaiser malpractice team includes a lawyer who is also a doctor.
Examples Of Our Recoveries On Behalf Of Injured Kaiser Members
Wrongful Life / Failure to Provide Genetic Counselling – $9,000,000 Settlement
Failure to Treat Post – Operative Thiamine Deficiency Resulting in Brain Injuries –$8,750,000 Settlement
Negligently Performed Pediatric Neurosurgery Resulting in Quadriplegia — $6,350,000 Settlement
Failure to Recognize Fetal Distress – Quadriplegia/Brain Damage – Wrongful Death — $5+ Million Settlement
Failure to Perform Timely Cesarean Section Cerebral Palsy — $4,100,000 Million Arbitration Verdict
Undiagnosed Cardiac Tamponade – Brain Damage — $3.2 Million Annuity Settlement
Death of a Mother In Childbirth — $3,158,000 – Binding Arbitration Award
Death Resulting from Advice Nurse Error – $2,400,000 Arbitration Verdict
Negligent Care Litigation Case — $2+ Million Arbitration Award
Failure to Diagnose Spinal Cord Abscess / Wheelchair Confinement — $1.9 Million Settlement
Shoulder Dystocia Obstetrical case — $1,600,000 Arbitration Award
Failure To Diagnose Bladder Cancer – Wrongful Death — $1,300,000 Settlement
Misdiagnosis of Aortic Dissection – Amputation/Brain Damage — $1.1 Million Settlement
Heart Catheterization Mistake Causing Death – $850,000 Settlement
Failure to Timely Diagnose Lung Cancer – Metastatic Spread – Shortened Life Expectancy — $600,000 Settlement
Delay in Diagnosis of Breast Cancer – Shortened Life Expectancy — $250,000 Settlement
*Click on the individual result to see details regarding the case.
In 2021 and 2022 We Obtained A Record-Breaking Kaiser Arbitration Awards
We have a track record of historic awards against Kaiser, both in negotiated mediations and in litigated arbitrations. Two recent settlements were for amounts in excess of 8 million dollars. In one case we recovered nearly nine million dollars on behalf of a child who was born with birth defects that would have been identified if appropriate screening had been offered to the parents. In another case our team obtained an 8.5 million dollar payment was achieved in a settlement on behalf of a health plan member who sustained brain injury when his thiamine deficiency was not identified after gastric bypass surgery.
In arbitration, Walkup attorneys Doris Cheng and Sara Peters obtained a $3,158,000 verdict this year against Kaiser for the wrongful death of a delivering mother when uncontrolled post operative hemorrhaging caused fatal cardiac arrest. Before the arbitration Kaiser made no settlement offer in the case. Kaiser claimed that the mother suffered a pulmonary embolus that was unforeseeable and unpreventable. Our team proved otherwise.
In 2021 Walkup Kaiser Team attorneys Sara Peters and Christian Jagusch M.D. J.D. obtained a binding arbitration award against Kaiser in the amount of $1,600,000 after a 10 day arbitration. That case involved an improper obstetrical delivery where our infant client was subjected to excessive neck and shoulder traction during delivery, with the result that the child was left with a partially paralyzed arm caused by a shoulder dystocia. Kaiser refused to settle the case before arbitration.
Five years earlier Walkup attorneys Michael A. Kelly and Valerie Rose obtained a binding arbitration award of $2,400,000 in favor of the surviving family members of a 42-year-old Alameda County woman who died from an untreated infection when her telephone messages for help to a Kaiser advice nurse were never given to her doctors. The Arbitrator’s verdict followed five days of testimony and came after Kaiser refused to negotiate with the family or make any pre-trial offer of settlement. Our lawyers showed that Kaiser’s advice nurse system was flawed and dangerous. Their program for telephone screening in order to save time and money caused a patient death.
The patient had twice called with complaints of worsening symptoms of cough and chest pain signaling pneumonia. Instead of directing her to an emergency room, she was routed to yet another telephone evaluation with a Kaiser Permanente physician who decided without a physical examination that she did not need to be seen by a doctor. By the time she was seen in the ER on the fifth day of her illness, she was in irreversible septic shock which claimed her life. Michael Kelly commented after the verdict “This advice nurse system is supposed to be the front gate to the Kaiser system – the problem is, once you’re through the door, the doctors have no idea what information the patient has given to the gatekeeper.”
Other Walkup Law office Kaiser malpractice team members have arbitrated cases against Kaiser involving failure to properly manage infections, neurological problems, labor and delivery, delayed diagnose of fetal distress during birth, improper surgical technique, failure to diagnose brain aneurysms and cardiac problems, and a host of other conditions and treatable illnesses.
Kaiser Patients Need Lawyers Familiar With Arbitration
Kaiser patients need a lawyer who understands how to arbitrate and settle malpractice cases in the unique Kaiser arbitration system. Kaiser’s own internal statistics show that where patients don’t have a lawyer, more than 50% of the time they lose the case in a process where a judge decides the case before any hearing ever takes place.
Most Kaiser Permanente HMO members do not know that Kaiser has established specific rules for medical claims processing that prohibits members from suing Kaiser in court.
Walkup Melodia lawyers have successfully settled or arbitrated more ceases against Kaiser than any other California firm. We are the go-to firm for Kaiser members with serious injuries. We know how to access and use Kaiser’s own internal guidelines, policies and procedures to help establish the standard of care and demonstrate that a breach has occurred.
Because we are trial lawyers we treat arbitrations like trials. We have the arbitrator manage the proceedings consistent with the California Code of Civil Procedure and the California evidence code. We believe Kaiser patient’s need experienced Kaiser malpractice lawyers. Informality works to the disadvantage of the Kaiser member and to the advantage of Kaiser. The lawyer representing a Kaiser member must stress for the arbitrator that this is the patient’s only opportunity for justice, that the Kaiser member did not bargain for this private arbitration forum, and now that they are here, without any right of appeal in an entirely secret proceeding, only the evidence code and the ethics of the arbitrator guarantee fairness for the patient.
A lawyer who knows how to represent clients in Kaiser cases knows that this is their clients only “day in court”. Just as jurors often learn best through exhibits, visual aids, demonstrations, models, charts and diagrams, so do arbitrators. Our lawyers take advantage of the opportunity to make a presentation that is the equal of what would be done in trial: we retain and present highly qualified experts; we use visual aids, we play sections of critical videotape testimony, blow-up and refer to the key pages in the medical record
Any a lawyer bringing suit for a patient against Kaiser must be familiar with Kaiser’s system of electronic medical records, how the Kaiser electronic medical record system can potentially hide evidence of malpractice, where Kaiser stores its internal algorithms and procedures for making diagnoses, how policies and procedures govern referrals and where to locate Kaiser’s ” rules of the road” for patient care.
In final argument, the lawyer representing a Kaiser patient must marshal the evidence and prepare a verdict form as would be done in Superior Court. A special verdict form gives the arbitrator a roadmap on how to find for the patient. A good Kaiser arbitration lawyer must highlight and use the critical and applicable jury instructions to remind the arbitrator of the applicable law, the important facts and the burden of proof. The arbitrator must be reminded regularly of the importance of her/his task and that while there are no jurors in the room, and the hearing is not in the county courthouse, it is every bit as solemn and important for this client (whose right to a jury trial was taken away by Kaiser’s superior bargaining power.)
At Walkup Melodia, our lawyers do not just understand the process, they actually teach other lawyers about it! Walkup senior partner Michael Kelly annually chairs a special statewide continuing legal education program to teach other lawyers on how to successfully prosecute cases against Kaiser. In addition, Walkup lawyers Doris Cheng, Andrew McDevitt, Sara Peters and Christian Jagusch have all taught other lawyers how to win against Kaiser.
Kaiser Permanente Locations
Our lawyers prosecute injuries caused by Permanente group doctors, Kaiser foundation hospitals and Kaiser Permanente negligence arising from injuries occurring in numerous areas throughout Southern California, Northern California, and the West, including Sacramento, Santa Clara, Santa Rosa, San Jose, Oregon, Washington, Hawaii and Nevada.
Learn More About How To Pursue Recovery
The Walkup Law Firm has a dedicated Board Certified physician-attorney on staff to assist in the screening of medical malpractice cases against Kaiser. We also utilize outside consultants to work with us in the evaluation and preparation of Kaiser claims. Injured patients are the survivors of patients who lost their lives as a result of Kaiser medical malpractice should contact us online or call (415) 889-2919 to schedule a free initial consultation. We do not charge a fee for reviewing your Kaiser case, or for prosecuting the case, unless we successfully recover financial compensation for you.
We are on call seven days a week for your convenience.