Davita, risking patients lives.....

[tubes]

Ok, I'm new to Davita and it's only my second week.  Today I heard 2 of the nurses telling another patient to write a letter to Davita. Davita is cutting back on the heparin that the patients need. This guy keeps clotting off his dializer becuz he isn't getting enough heparin. Why would they cut corners like that? Is Davita so cheap that they are willing to risk the lives of dialysis patients. It's unbelievable, I feel so bad for this guy. It's ridiculous. I hope he writes the letter, I doubt anything will come of it. 
Also, when I was at Fresenius, there was a program for patients to receive Nepro. Now I'm at Davita and they have NO program to get, ensure, boost or nepro.
Cheap Bastards! !  !

[flip]

I guess we're in the same boat now, tubes. My center just sold out to Davita and I'm waiting for all the sh** to hit the fan. When Baxter had the bad heparin, most centers switched to Abraxis from PPA. Fresenius just bought PPA so I'm sure Davita is looking at paying more for heparin. I'm still getting Nepro for half price but who knows for how long?

[Sluff]

One of many reasons Epoman despised Davita. 

[MIbarra]

I never needed the protein shakes while I was on dialysis, but I know several patients received some sort of protein shake stuff through a program for free at Davita.

[thegrammalady]

some people at my center receive protine shakes. i was under the impression medicaid paid for it. there is some new company moving into colorado, my doctor is very excited, but shhhhhh you didn't hear it from me.

[circleNthedrain]

Hi all, I'm new to this great site!  Just a quick word about DaVita and heparin.  My unit just changed their policy on heparin delivery but did not change patients doses.  Previously, they just loaded a syringe with a large dose of heparin and let the machine deliver it.  At the end of the treatment the extra heparin would just be tossed out.  In an effort to avoid waste (heparin and money) they now give us a bolus injection in the lines before starting and only load the needed amount (no extra) in the heparin pump.  No patient doses have been cut that I know of.  That is really a crime if they are cutting doses to the point of clotting!!  Come on!!

No program at my unit for Nepro.

[flip]

I get my initial heparin (2500) in a bolus when I first hook up. I get the remainder (1000) after 2 hrs. on the machine. I buy my Nepro directly from Ross for half price. Medicare or Medicaid will pay for Nepro in some cases.

[lola]

Otto starts training at Davita Monday and this is scary.

[flip]

The price of heparin has gone up quite a bit and I think most centers are really being careful not to waste any.

[Hemodoc]

No matter who owns the dialysis unit, all medications and the dialysis presrciption itself is prescribed by the attending nephrologist.  Yes, Davita may give broad incentives or directives, but Davita does NOT prescribe any dialysis or medication regimen.  Proper dispensing of heparin is for a two fold reason.  First, to prevent macro clotting that will clot off the entire system and micro clots in the artificial kidney.  One of the protocols to evaluate when a patient does not meet the proper clearance during dialysis is to evaluate for streaks indicating clotting of the fibers inside the kidney.

Thus, since all physicians have a fiduciary responsibility to their patients, and all nurses do as well by liscensing standards in all US states, take it first to the nurse to evaluate for macro and micro clotting.  Take it to the physician.  If they are not responsive, take it to your patient representatives.  If that does not remedy the problem after taking it to the nurse, the MD and the health care group, then by all means report it to OSHA and the state.

Davita is NOT above the law.  Your nurse and your MD are not above their fiduciary responsibility first to you and then to their health care system.  We now have  a new ethics in American medicine, yet this new ethics has not in the least relieved MD's, nurses and even health care systems of the medical legal obligations forged under the old ethics.

Do not tolerate substandard care.

Peter Laird, MD