Best Nephrologist In Tucson

Best Nephrologist In Tucson – Sachi Kohara, 39, was born with a condition known as focal segmental glomerulosclerosis and underwent years of dialysis before receiving a double kidney transplant. She is pursuing a career as a social worker at a dialysis clinic after her treatment experience. Alberto Mariani, for the Arizona Center for Investigative Reporting

Dried blood, dust and dirt were found in 21 of the 25 dialysis stations at the Fresenius Kidney Care East dialysis clinic.

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Improperly disinfected dialysis stations and catheter centers that provide access to patient blood are frequently identified at DaVita Desert Mountain Dialysis Center in Scottsdale.

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Failure to follow physician orders for two separate patients, causing potential for “increased mortality” at Fresenius Kidney Care Central Phoenix.

As of 2019, nearly a quarter of Arizona’s 130 outpatient clinics were cited for gaps in protocols designed to keep patients safe, according to an AZCIR analysis of state inspection data. Some structures are repetitive, with frequent infection control and old security breaches from years ago.

Such deficiencies are a concern for dialysis clinics because the treatment requires a port with direct access to a person’s blood, leaving patients vulnerable to serious infections as they often visit the clinic three times a week for four hours at a time.

End-stage kidney disease, usually caused by chronic kidney disease caused by diabetes, congenital kidney problems or high blood pressure, means that a person’s kidneys no longer work well enough to filter dirty blood and fluids. one. For these patients, treatment is a matter of life and death: a kidney transplant or continuous dialysis treatment is necessary to survive.

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“Your life changes in an instant, and I think that can be very painful,” Sachi Kuhara, a former dialysis patient, said of the transition to treatment. He said this pressure makes it difficult for patients to deal with the problems they may see in the clinic.

The Arizona Department of Health Services, the agency responsible for inspecting dialysis clinics, says it has done its part to continue to inspect and issue citations, sometimes with fines of up to $30,000 for repeated problems. But records obtained by AZCIR show that dialysis firms can negotiate these large sums, sometimes in the hundreds of thousands of dollars.

The reports also reveal that the size of the fine does not always correspond to the seriousness of the summons. Fees range from $250 to $1, with clinics fined $250 in seven cases after “actual harm” to patients.

A nationwide shortage of medical staff and supplies due to COVID-19 has also hit dialysis clinics, exacerbating risks to patients. Experts describe the resource shortage as critical as the two-year-old epidemic continues to strain the country’s outpatient dialysis system.

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“The lack of dialysis care in the state right now during this pandemic is a huge problem,” said Colby Power, former director of Health Licensing Services for the Arizona Department of Health Services, who left the center earlier this year 2022. Hospitals have to keep patients for a long time because they can’t put them in the dialysis clinic because they don’t have staff.

Mark Canavan, a 48-year-old man from Surprise who has been in Arizona since 2019, said he has seen a change in his care since the outbreak began.

He said the process of going to clinics for patients to receive dialysis even before the epidemic caused “deep stress”, mental stress and serious medical risks. Now, things have gotten worse.

“There’s no question it had a negative impact on me and my fellow patients,” Canavan said. Despite the “intense” efforts of the dialysis staff at his clinic, he said he fears “the level of care we once received can never come back”.

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Chronic kidney disease affects about 37 million people in the United States, or about 15 percent of the population. Nationally, about 500,000 people need dialysis several times a week.

People aged 65 and over make up the largest proportion of people with kidney disease, and research shows that the condition disproportionately affects people of color: Black people are four times more likely to have kidney failure than whites in the United States and about 14% of blacks. – leather people. Hispanics in the United States suffer from a form of chronic kidney disease.

In Arizona, there are more than 17,000 people with end-stage kidney disease, and about 60 percent of them seek treatment among the state’s 130 Medicare-certified clinics. While dialysis patients tend to follow the state’s demographic breakdown, Native American patients are disproportionately represented compared to their share of the state’s population.

Kohara, a former dialysis patient who moved to Arizona in 2017 for a better chance at a kidney transplant, has encountered the challenges patients can face in Arizona clinics.

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The risks and stress of dialysis is something I dealt with from a young age. Kohara was born with a kidney disease called focal sectional glomerular sclerosis, which damages the kidneys’ ability to filter waste from the blood and can cause the kidneys to not work properly.

When I was born, one of my kidneys really wasn’t working, and then the other one wasn’t working very hard. And when I was six years old, my kidneys completely failed.” He underwent his first cadaver transplant at the age of nine, but needed another transplant 23 years later.

Kohara said she immediately noticed the difference in treatment protocols at the Phoenix clinics after moving here from California.

He said, first, a doctor at the clinic gave him medicine that helped him. After switching services, she said the tech at the clinic “wasn’t really following safety protocols” after realizing she was letting the needle tip touch other areas — which she felt were also at risk of infection.

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However, his next clinic made 2018 “the most difficult year of my life in terms of dialysis.”

At the Kidney Care Center, northeast of Phoenix in the US, Kohara says he has problems with staff not changing gloves between patients and ignoring device safety warnings during treatment. He said the workers berated him and verbally abused him.

Kohara said one of the workers was “laughing at me while they were putting the needles” because he was looking away. He referred complaints to the director of the end-stage nephrology clinic and network, which coordinates between the services and the federal government.

A representative from US Renal Care said in an email that officials “cannot comment directly on this individual’s alleged experience in 2018” and are committed to protecting patients and providing quality care.

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According to ADHS records, a kidney care company in northeast Phoenix, AZ, received citations for infection control, among other things, during government inspections in December 2019 and February 2021.

Dialysis centers must be approved by the state and the Centers for Medicare and Medicaid Services. ADHS conducts appropriate testing in Arizona.

If deficiencies are found, ADHS requires a corrective action plan from the agency. Violations may also result in a recommended fine, with a maximum penalty of $500 per day that the violation occurs.

AZCIR’s review of operating procedures found that sanctions were recommended at 31 facilities from January 2019 to January 2022. Four separate cases related to DaVita Kidney Care Clinics and Fresenius Medical Care, multibillion-dollar companies that cooperate in proportion of over 85%. of dialysis clinics in Arizona External Affairs, the fines were negotiated for a much lower amount than originally recommended by auditors.

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At Fresenius Kidney Care Arcadia in Phoenix, for example, auditors recommended charges totaling $219, $500 in March 2020, or $500 per day for 439 days, for catheter infection control violations. The same violation was found during inspections in 2016, 2017, 2018 and again in 2020.

In a letter obtained by AZCIR, attorneys representing Arcadia Clinic opposed the fee recommended in a 12-page letter to ADHS. The case was settled in March 2021, when the company agreed to pay a $30,000 fine, according to the state licensing database. A recent government audit of the facility found no violations.

Tubes filled with blood follow the length of a patient’s arm during a 4-hour dialysis treatment Fresenius Medical Care in. Greg Bryan, Arizona Daily Star

DaVita East dialysis fee for infection control reduced to $20,000 from $193,000 in 2021. In Scottsdale, DaVita Desert Mountain Dialysis Center posted a $217,050 fee reduced to $6,000 for infection control and other violations in 2022. DaVita Power was also recommended. Road dialysis fee of $83 and $750 to $5,000 this year after inspectors found contaminated catheters.

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Arizona Department of Health spokesman Steve Elliott did not provide specific answers to frequently asked questions about how and why the fines will be reduced, instead writing in an emailed statement that “Discussions are ongoing, and the number of referrals may decrease. ” and back.”

Some dialysis clinics are charged small dollars for problems that may be serious but not directly related to patient harm or involve frequent violations, according to former license administrator ADHS Power. .

But AZCIR’s review of the operation’s transmission over the past three years shows that patients have suffered health consequences from violations that include penalties such as.

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