Would you undergo surgery at a facility that limited your sedatives and pain medication in order to speed you out of PACU? Or one that downplayed pre-op preparations in order to make sure your case started on time? Or one where a single anesthesiologist managed 4 cases at the same time? According to an Oregon anesthesiologist's whistleblower lawsuit, such patient safety infractions are par for the course at a national healthcare network.

Erik Franck, MD, filed the lawsuit against Northwest Permanente, a division of Kaiser Permanente, earlier this month to call attention to the unsafe practices that he says compromise the network's standard of care and to recoup $9 million for his loss of employment, wages and personal and professional reputation.

Dr. Franck, 55, has been in practice since 1997 and, according to his suit, delivered exemplary outcomes and received high patient satisfaction scores while administering anesthesia at Kaiser clinics in the Portland area between June 2013 and August 2015.

He sees the network's decision to dismiss him, however, as wrongful termination, breach of contract and an act of retaliation for voicing his concerns over management mandates that put surgical patients at risk.

"Dr. Franck reasonably believed that the policies, practices and demands of Kaiser were inconsistent with patient care and safety and with professional standards of care," says the lawsuit, which details his ignored or overruled concerns over the following:

• Ordering "the minimal use of surgical and pre and post surgery pain and anxiety medications" in order to speed patient emergence and discharge.
• Decreased staffing levels which required anesthesiologists to simultaneously supervise 4 CRNAs, up from a 1:2 ratio, even during pediatric procedures.
• Prioritizing 7:30 a.m. start times, regardless of pre-op patients' preparations, medical needs or requests for information. This once led to administering a patient's spinal anesthesia in pre-op and transporting them to the OR unmonitored, says the lawsuit.
• Discouraging anesthesiologists from entering the OR during cesarean sections "unless absolutely necessary."

According to the Oregonian newspaper, Dr. Franck's litigation is the third whistleblower suit filed by a former Northwest Permanente provider over standard of care concerns.

In an e-mailed statement, a Northwest Permanente spokesman emphasized the network's focus on quality care. "We prefer to respond through the appropriate legal process, rather than litigate in the media," wrote Michael Foley. "The claim is meritless and we are confident the facts will readily reflect that."

Dr. Franck's attorney, Judy Snyder of Portland, did not respond to a request for comment.

David Bernard