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FOR RESPONDENTS - BINDING ARBITRATION Wrongful death/Survival action - Family practitioner employed by HMO allegedly negligent in failing to properly work up middle- aged man with chronic reflux syndrome.

Los Angeles, California

@TITLEHD = CLAIMANT’S CAUSE The claimant patient brought this binding arbitration action against his HMO, Kaiser Permanente, alleging that the respondent family practitioner deviated from accepted standards of medical practice in failing to properly work him up for "GERD"-like symptoms. The claimant alleged that as a result, cancer was permitted to develop and progress undetected.

The claimant died of esophageal cancer in ________.

The claimants argued that from May 23, ________, through February ________, the patient was treated by Kaiser family practice physicians and, despite having dyspepsia and gastroesophageal reflux disease ("GERD"-like symptoms), no upper endoscopy was performed to determine whether his medical condition was becoming cancerous. The claimant patient died from esophageal cancer on May 2, ________.

@TITLEHD = RESPONDENTS’ CONTENTIONS The respondents claimed that there were no breaches of the standard of care by its physicians, and the patient’s cancer was not caused by any act or omission by the physicians, regarding the treatment of the claimant patient’s gastric symptoms. The respondents conceded that the claimant had presented to Kaiser between ________ and ________, but alleged that his complaints were varied and minor. The respondents maintained that on a few of these occasions, the patient indicated that he had dyspepsia, but that it was relieved by taking Rolaids or other over-the-counter antacids. Throughout this period of time, up until shortly before his death in May of ________, the decedent had no major complaints related to his dyspepsia, as his prescription for Tagamet controlled the his symptoms.

Furthermore, the respondents argued that the patient had no other symptoms potentially indicative of any precancerous condition. He had no weight loss, no dyspepsia, no coughing, no change in his bowel patterns and no change in his eating habits. The respondents contended that good control of the patient’s symptoms was afforded with Tagamet, and therefore, there was no need to increase the dosage, perform an upper endoscopy or otherwise refer him to a specialist. The respondents further argued that even if the patient had been referred for an upper endoscopy in ________, ________, ________, ________, ________ or ________, there is no way to know what the diagnostic studies would have shown. The respondents also argued that nothing the respondents did would have changed the outcome, noting that esophageal cancer is almost always fatal.

The panel found in favor of the respondents.

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