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mirrored here for historical purposes from:http://www.latimes.com/features/health/medicine/la-me-kaiser29jan29,1,3326511.story?ctrack=1&cset=true
Administrator at Kaiser's Fresno hospital steps down
Susan Ryan's resignation comes after a federal report faults the hospital for its slow response to complaints about a physician.The administrator of Kaiser Permanente's Fresno hospital stepped down Monday, days after the release of a federal report that criticized the way the medical center responded to complaints about a doctor who handled high-risk pregnancies.
In a written statement released late Monday, Kaiser said Fresno hospital administrator Susan Ryan had resigned, effective immediately.
Last week, the U.S. Centers for Medicare and Medicaid Services released a report suggesting that if Kaiser Fresno had kept a closer watch over its medical staff, two babies might still be alive.
The review was the latest in a series of critical assessments of the giant health maintenance organization, the nation's largest with 6.5 million members in California.
The Medicare agency investigated the Fresno hospital after the Los Angeles Times reported in October that doctors and nurses had complained repeatedly to higher-ups about perinatologist Hamid Safari's medical and interpersonal skills.
Rather than address their concerns, staffers told the newspaper, hospital leaders allowed Safari to continue handling high-risk pregnancies without restriction.
Safari allegedly botched at least two deliveries after staff members raised their concerns. One baby died in the delivery room in April 2005; another died months after her January 2004 birth. Safari has been accused of gross negligence by the state medical board; his attorney said he did nothing wrong.
Gregory A. Adams, associate regional president and chief operating officer of Kaiser Foundation Health Plan and Hospitals in Northern California, acknowledged in a written statement that the federal report was "highly critical of the Fresno hospital administration's oversight."
"We have reviewed the facts and taken action to address the leadership issues raised in this report," he wrote.
Last week, in response to the federal report, Ryan defended the hospital's quality oversight program and said officials had taken appropriate action after Safari's alleged mishaps.
"When these events occurred, they were thoroughly investigated and corrective actions were taken," she said in a written statement Friday. "This has led to significant improvements in our perinatal safety program."
In July 2005, three months after the second baby's death, Kaiser imposed restrictions on Safari, barring him from performing vaginal deliveries and requiring him to be monitored by another physician or advanced-practice nurse. The restrictions became permanent in April 2007, hospital officials said.
Since September, Safari has not performed any surgeries or C-sections and has served as a consultant at the hospital, Ryan said last week.
Ryan, who took over in August 2005, was not in charge at the time of the allegedly problematic deliveries by Safari. But a Kaiser spokesman said that "the hospital administrator has responsibility and accountability for the systems and processes in the hospital."
Spokesman Mike Lassiter declined to say whether the hospital planned to take action against Dr. Varoujan Altebarmakian, the hospital's physician in chief since 1999, who records show received numerous complaints about Safari.
Linda Monte, current chief operating officer of Kaiser's South San Francisco hospital, has taken over as interim hospital administrator.