Amid all the Pulitzer hubbub a few weeks back, one major newspaper in particular was noticeably absent from the list of winners.
While the Washington Post hauled home four Pulitzers and the New York Times three, the Los Angeles Times — the prestige paper of the West Coast — was shut out for the first time since 1997. After claiming a remarkable 13 Pulitzer Prizes in the previous five years, the Times had four finalists this year, but no winners.
But the Pulitzers by no means tell the whole story — and last week the Times published an explosive set of investigative stories which have provided their own public service.
On Wednesday, Times reporters Charles Ornstein and Tracy Weber got things rolling with a 2,750-word front-page exposé. “Kaiser Put Kidney Patients at Risk” reported on the in-house kidney transplant program that Kaiser Permanente, the state and nation’s largest HMO, launched in Northern California in mid-2004 — the first of several pieces in which Kaiser officials were unusually forced to admit day-by-day the true extent of their program’s problems, despite prior claims to the contrary.
Deciding that it would be able to “achieve higher outcomes” for its kidney transplant patients through its own network of doctors, labs and pharmacies, Kaiser — a “unique healthcare entity that runs both a health plan and a hospital system” — informed more than 1,500 of its patients in June 2004 that it would no longer pay for their kidney transplants at outside hospitals. Instead, the patients were told, they would be transferred for treatment at a new transplant center at a Kaiser hospital in San Francisco.
But instead of helping them, “Kaiser’s massive rollout” endangered its patients, the Times reported: within months, the new program’s waiting list “ranked among the longest in the country. No other center had ever put together such a list so fast.
“The patients didn’t know it,” the paper declared, “but their odds of getting a kidney had plummeted.”
Among a long list of troubling shortcomings the Times highlighted in clear and precise terms, “Hundreds of patients were stuck in transplant limbo for months because Kaiser failed to properly handle paperwork”; “doctors attempting to build a record of success shied away from riskier organs and patients, slowing the rate of transplants performed”; and internal strife led to the quitting or firing of 10 permanent employees out of a staff of 22 since the program’s opening.
In 2005, its program’s first full year, “Kaiser performed only 56 transplants, while twice that many people on the waiting list died,” according to the Times. That ratio was the reverse of a statewide pattern, and the 56 transplants were a mere one-third of the number that two outside hospitals, UC San Francisco and UC Davis, had together performed for Kaiser patients in each of the two years before Kaiser launched its new program.
The Times reported that it was “difficult to say” whether any Kaiser patients “died as a direct result of the program’s faltering start,” but clearly “many fewer patients received transplants than before, forcing them to remain on grueling sessions of dialysis to remove impurities from their blood. Prolonged dialysis can lead to deadly complications and decrease the chances of a successful transplant later.”
In its most close-to-home moments, the piece discussed the excruciating cases of several patients left in the lurch, as the reporters talked with the relatives of four patients who died amid the fumbling.
One such patient was Ruben Porras, a pressman at the Sacramento Bee. Porras had been close to getting a transplant at UC Davis, but found himself again at the bottom of a waiting list after the bureaucratic snafus of his transfer to the Kaiser program put “a new kidney out of reach any time soon.” Porras was forced to remain on dialysis, sapped of energy and facing one complication after another, until he developed a dialysis-related infection and died in October at age 47.
That led to the telling conclusion of the Times‘ first piece, as a Kaiser representative called Porras’ widow after his death to ask for an organ donation. “I was really close to telling them, ‘Yeah, you can have his kidneys,'” she remarked.
In the three days afterward, Ornstein and Weber followed up with three more hard-hitting front-page reports expanding on different threads of the story. On Thursday, the Times focused on how 25 Kaiser patients “were denied the chance for new kidneys that were nearly perfectly matched to them last year” during the transplant program’s “troubled start-up,” while Friday it led off by reporting that Kaiser launched its program “without holding basic discussions with regulators about how to safely transfer up to 1,500 of its patients from other programs to its San Francisco center.” The latest story, published Saturday, related the fear and anger of several Kaiser patients who have thus far waited for kidney transplants in vain, even when some of them already had family members willing to donate one of their own.
This is journalism that is the very definition of a public service — alerting California’s residents, not to mention those in charge of the nation’s organ transplant system, of the Kaiser program’s problems.
The Times‘ digging has also paid immediate dividends. State regulators revealed that they were already investigating Kaiser’s program, while Kaiser said it plans it plans to contact the more than 2,000 patients on its waiting list to hear their concerns, and announced Thursday that it has begun a “high-level, full-scale internal investigation” of its transplant program.
That’s impact.
Edward B. Colby was a writer at CJR Daily.