Report criticizes Kaiser for lack of action

The U.S. Centers for Medicare and Medicaid Services began investigating the hospital in October, two days after the Los Angeles Times reported that doctors and nurses had complained repeatedly to higher-ups about perinatologist Hamid Safari's medical and interpersonal skills.

Rather than address their concerns, hospital leaders allowed Safari to continue treating high-risk pregnant women without restriction, staffers told the newspaper.

Safari allegedly botched at least two deliveries after staff members had raised concerns. One baby died in the delivery room; another, months after her birth.

In its report, the Medicare agency criticized the way Kaiser Fresno responded to those deliveries, both of which were detailed in The Times story. At least one staffer told inspectors that Kaiser had received complaints about Safari as far back as 1998.

In a written response to the report, Kaiser Fresno administrator Susan Ryan defended the hospital's quality oversight program and said officials took appropriate action after Safari's alleged mistakes.

In a statement to The Times on Friday, Ryan said, "These are difficult and emotional situations, and we empathize with all involved. When these events occurred, they were thoroughly investigated and corrective actions were taken. This has led to significant improvements in our perinatal safety program."

In one of the two cases cited by inspectors, Safari waited more than three hours before he performed a caesarean section on a patient in 2004 -- even though there was clear evidence that her baby was in distress, the report said. The baby was severely deprived of oxygen and died months later.

One Kaiser nurse told inspectors that she fruitlessly voiced concerns about the baby's condition to Safari, and that after the delivery, the perinatologist "was hounding nurses" and telling them how to describe the incident in the medical records.

Another staffer told inspectors there was a "violation of common sense and standard of practice" during that delivery.

In the other case, in April 2005, Safari allegedly severed the spinal cord of a baby after repeatedly and vigorously attempting to draw him out with a vacuum extractor. When the baby finally emerged, he was "white as a sheet" and unresponsive, staffers told inspectors. He died.