When hospitals decide to play rough

By Ed Koch

Monday, Feb. 26, 2007 | 7:13 a.m.

When University Medical Center officials didn't respond to George Williams' e-mails regarding his status as a potential kidney transplant recipient, he called a transplant team coordinator, accusing the staff of lacking communication skills.

A few days later he got a letter from the hospital's transplant boss, clearly communicating to him that he should go somewhere else for his transplant.

Williams was taken aback and angry, especially given that UMC is the county facility that treats everyone - gunshot victims, people mangled in car accidents, the mentally ill, the homeless and the uninsured.

To make matters worse, Williams' insurance company is contracted with just one Southern Nevada hospital to do kidney transplants - UMC. The next closest hospital his insurance company will allow Williams to go to for a kidney transplant is in Tucson.

"I was just trying to tell them that they need to communicate better with their patients, especially when they are dealing with people waiting for life-saving transplants," said Williams, a retired North Las Vegas Housing Authority official. "I did not want them to throw me out."

Williams, a diabetic on dialysis, has been on the national kidney donor list for about three years. He is required by donor networks to work closely with his transplant center so that he and the transplant team can react quickly when a suitable organ is found.

In September UMC officials asked Williams to provide health status updates from his cardiologist and kidney doctor, a bone marrow biopsy and a stress test so that it could be determined that his condition had not worsened and that he was still a viable transplant candidate. He said he complied with the request for updated information.

When he did not hear from hospital officials about his status by late October, Williams began e-mailing the transplant staff for answers. He sent four e-mails over the next month and said he got no responses.

"I wanted to know whether you have received the information you requested," Williams wrote in the first e-mail, on Oct. 31.

He said he heard nothing back.

"Is it asking too much for a simple response?" he wrote in his second e-mail. "I fail to understand why staff cannot communicate with patients. Do you understand the importance of responding to patients' inquiries?"

A week later he wrote in his third e-mail: "Is anyone receiving these communications?"

And then, in his final effort: "A simple response would be greatly appreciated ... after all, this concerns my life."

Williams then got his answer - a Nov. 30 letter that got his blood boiling.

"The patient-healthcare provider relationship is one that must be based upon trust, understanding and mutual respect," Dr. Gary Shen, UMC's transplant services director, wrote. "If these elements are absent, it becomes very difficult for the physician to provide the type of care to the patient that the patient deserves.

"Therefore, I believe it is for the best of our mutual interests that you seek your kidney transplant from another transplant center."

Shen, in his letter, instructed Williams to contact Sunrise Hospital, which also transplants kidneys, and told Williams to alert the hospital within 30 days where he'd undergo the transplant.

There, Williams hit a dead end.

Jenny DesVaux Oakes, assistant vice president of Sierra Health Services, which oversees Williams' Health Plan of Nevada policy, said her company has no contract with Sunrise for kidney transplants.

Oakes said that while she could not discuss Williams' case because of patient-privacy laws - or even confirm he has a policy with Health Plan of Nevada - she noted it is an "unusual occurrence" when a hospital employs what is termed in the medical industry as "divorcement of care."

"They can do it if an unusual pattern is established, but it is usually well documented," she said. "It is not an arbitrary thing. It is not a decision reached capriciously. And it does not generally occur over one incident unless that incident is so outrageous."

Williams, a career bureaucrat whose most recent job was to find government-subsidized housing for more than 200 survivors of Hurricane Katrina, said that because of the nature of his work in dealing with the public, he knows how to talk without being confrontational or off-putting. He said he was not profane toward the UMC staff.

"Yes, I was stressed," he said of his communications with UMC. "I lost my doctor and my transplant center in one sweep of a pen. I had very few viable options and now I have one less.

"What happened is that I said something somebody didn't like and they decided to teach me and others who might dare to criticize them a lesson," Williams said. "This is about revenge."

UMC spokeswoman Cheryl Persinger said the hospital and members of its staff could not comment directly on Williams' situation because of privacy laws.

Persinger said, however, that efforts are under way to set up a meeting with Williams and hospital officials within the next two weeks "to try to resolve any communication issues and other issues and hopefully continue his treatment."

Williams, who also has done work as a kidney patient rights activist, said he has been trying to mend fences with UMC for the last three months without any success.

"I cannot sit by silently and allow them to treat me or any other patient in this manner," Williams said. "If they get away with it this time, they likely will do it again."