Second Grady Dialysis Suit Dismissed as Some Patients Have Died
This article contains additional reporting by Matthew Cardinale
(APN) ATLANTA — A Fulton County Superior Court judge on Tuesday, December 15, 2009, dismissed a class action lawsuit brought on behalf of uninsured dialysis patients, some of whom are undocumented, against the Grady Health System.
With little comment, Judge Ural Glanville dismissed the case after hearing an hour of arguments from Atlanta attorney Lindsay Jones and Grady attorney Bernard Taylor.
Jones argued the closure of the Grady Memorial Hospital Outpatient Dialysis Clinic in October 2009 violates patients’ state and federal constitutional rights to health care service. The suit also argued closing the clinic represents medical abandonment, placing the patients’ lives in danger and causing them mental anguish.
Taylor argued, and the judge apparently concurred, that Grady is not legally obligated under state or federal law to provide dialysis services. Taylor also argued Grady did not abandon patients because the hospital notified and counseled patients on the coming closure.
As this article goes to press, Glanville still has not published his opinion on the case, Dorothy Leone-Glasser, a leader with Grady Advocates for Responsible Care, told APN. The group plans to appeal to the state court of appeals, but is waiting for the judge to publish his opinion first.
The Grady Memorial Hospital Corporation (GMHC), the private, non-profit board that controls the daily operations of the system, announced in August 2009 its intent to close the clinic and began offering patients other options. However, the options were not sufficient to help everyone affected by the closure.
So far, at least two patients–Adrianna Sosa and Tabores Nelson–have died because of complications stemming from not receiving regular dialysis treatment, Leone-Glasser said. She has confirmed the deaths of the two patients, and has heard through other patients that at least an additional two have died in Mexico, she said.
Sosa returned to Mexico immediately after hearing that Grady would close the clinic, Leone-Glasser said. She returned to Durango, Mexico, on August 11, and died November 28, 2009, Leone-Glasser said.
Nelson, of Tucker, Georgia, had previously gone to court in a stretcher as part of the first class action suit, which was also dismissed, Leone-Glasser said. He died in early December, Leone-Glasser said.
Many insured or self-paying dialysis patients from Grady had no trouble receiving continued care from Fresenius Medical Care, which entered into a contract with Grady in September 2009 to provide services for many of the clinic’s original 96 patients.
Grady sent letters to uninsured patients informing them of the clinic closure and provided them a list of nearby private dialysis providers along with three options for future care: return to their country of origin, move to another state where they may qualify for emergency Medicaid services [many have attempted but have not been able to qualify], or seek treatment through an emergency room.
Patient advocates blasted this plan as unrealistic and cruel, arguing that–among other issues–uprooting the patients would disrupt their treatment and severely compromise their health.
Georgia law prevents undocumented, uninsured immigrants from receiving emergency Medicaid services. Other patients who are US citizens qualify for Medicaid but have yet to meet Georgia’s in-state residency requirements.
Still others live outside Fulton and DeKalb Counties and claimed they did not originally receive guarantees from Fresenius that they would receive care. However, Leone-Glasser said those patients in that category who have been working with GARC have since been admitted by Fresenius.
Grady staff said in September they were providing airline, moving, and apartment rental assistance for any patients who choose to leave the state. Grady said 10 patients took this option.
But patient advocates claim there are some patients who have not received such assistance while battling MexCare for continued dialysis treatment in Mexico.
The GMHC officially closed the clinic on October 03, after Judge Glanville lifted a temporary restraining order in the first class action case.
Grady agreed to voluntarily provide up to three months of continued outpatient dialysis care for up to 51 patients through Fresenius until January 03, 2010.
Jones said Tuesday the contract stipulates Fresenius provide dialysis care beyond January 03 through September 2010.
According to a copy of the contract obtained by Atlanta Progressive News, Fresenius did agree to provide one year of treatment for the patients referred by Grady, and Grady agreed to pay for the care. If Grady wants to terminate the contract without cause, the contract would still be in effect for 90 days after Fresenius receives notice.
Therefore, it appears that the contract does promise care for these patients until September 2010, despite Grady’s statements otherwise.
“Grady agreed to pay for medical service through September 2010,” Jones told about 15 patients after the hearing. “The contract states that Fresenius is to be your primary option. The contract also says when the contract ends, Grady and Fresenius will agree to find you additional care.”
“[Grady] did not tell you about this contract because they wanted you to leave,” Jones continued. “This court today ignored this contract. We will go before another court and argue this court was wrong.”
Matt Gove, a spokesperson for Grady, offered his analysis of the contract.
“The contract between Fresenius and Grady guarantees Grady access to that discounted rate for dialysis services to any patient we refer [to Fresenius] for those services through September 2010,” he told APN. “Every patient has been given information that Grady will pay for this through January 03.”
Gove said every patient has been notified, in writing, that Grady has agreed to pay through January 03. He said any patient that did not sign that acknowledgement form signed a different form that said they declined to sign the former document.
“Every patient will be taken on a case-by-case basis on how to proceed beyond January 03,” Gove said. “It’s not a case that on January 03, every patient will be locked out. We will have to start making decisions based on where residents reside. Have the patients been working on a long-term plan? Have the patients been working with our social workers and advocates as well to find a long-term solution?”
Leone-Glasser told APN they will file an appeal with the Georgia Court of Appeals and ask that court to issue a temporary restraining order.
She said that order, if issued, would prevent Grady and Fresenius from discontinuing any care even if January 03 comes and goes before the appeal has a hearing.
Reina Andrade and Anabel Quintanilla, the two plaintiffs named in the suit, spoke to reporters after the hearing.
“We go home saddened and a little disappointed but we’re confident with the help of Lindsay Jones, we will succeed,” Quintanilla, 34, said.
Quintanilla came to the US from Mexico 15 years ago and has been receiving dialysis treatment from Grady for five years.
She said she fears for elderly dialysis patients who cannot risk ceasing treatment.
“I am worried not only for me but also for the elderly in our group,” she said. “I’m young and can still make it with one dialysis treatment per week but that’s not necessarily the case for others.”
Both Quintanilla and Andrade do not wish to return to their home countries because they fear they will not be able to receive proper care there.
“I’m very sad and disappointed today because the judge’s ruling is uncalled for,” Andrade, 32, said. “I love life and want to live. I don’t want to return to my country because I know I will die.”
Andrade moved to the US from Honduras eight years ago and has been receiving dialysis through Grady for the last three years.
She said today’s ruling has motivated her to begin thinking about contingency plans.
“Before I got here, I still felt there was going to be a ruling in our favor,” Andrade said. “I’m going to see if there are other options available.”
Quintanilla, like Andrade, is considering returning to Mexico “if push comes to shove.”
“I’m still fearful,” she said. “It’s sad for one person’s life to be in another’s hands.”
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Jonathan Springston is a Senior Staff Writer for Atlanta Progressive News and is reachable at firstname.lastname@example.org.
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