‘I was handed a death sentence’

Advocates help NAACP stalwart Ora Lomax receive life-saving dialysis after a Henrico center moves to terminate her treatment

Jeremy M. Lazarus | 2/1/2018, 8:55 p.m.
Getting kicked out of a dialysis clinic is the worst thing that can happen to a patient with failing kidneys. ...

Still her case is a prime example of the life-and-death power kidney specialists like Dr. Starkman wield over their patients with little accountability.

About 450,000 people receive dialysis a year, according to Nephrology News and Issues, a trade publication. But a tiny fraction face the same problem as Mrs. Lomax.

In a recent health blog, retired nephrologist Dr. Robert Allan Bear wrote, “It is shocking that 1,000 patients annually are involuntarily discharged from their dialysis clinics. Further, they are often ‘blackballed’ from other local clinics.

“The consequences for such patients, predominately African-American, are dire,” Dr. Bear’s statement continues. “Some travel long distances, and some end up visiting hospital emergency departments, where they can receive only intermittent dialysis when in extremis. Others die. This health care practice — the involuntary removal of substantial numbers of patients each year from the treatment that sustains their lives —  is without parallel in modern medicine.”

Arlene Mullin, who runs a national advocacy group she founded in Washington 20 years ago for dialysis patients, reports that she is bombarded with requests for help from patients. Mrs. Lomax is now among those she is trying to help.

In the case of Mrs. Lomax, Dr. Starkman, with the support of Mr. Schwemer, stated in the Jan. 3 letter that he was booting her from the center because “for some time now you have exhibited behavioral issues which have impacted the clinic’s ability to provide adequate care for you.

“FKC has addressed each behavioral episode, developed two behavioral contracts and offers to transfer you to another clinic have been refused. Accusations, threats and harassment of staff has escalated. (sic) Resulting in numerous grievances filed with a variety of agencies. All grievances were found to be unsubstantiated.”

Mrs. Lomax said that she was never offered any transfers in the past five months and never received any behavioral contracts. She also insists that the description of her behavior is false.

“When I go there, I get in the chair and that’s it,” she said, denying she raises a ruckus or does anything to upset the staff.

The Free Press carried a permission slip from Mrs. Lomax to the center Wednesday in an effort to see her file and find out more about Dr. Starkman’s evidence, but was turned away.

Even a government-supported program in place since 1972 to help dialysis clinics improve care and to look into patient grievances said it has no authority to overrule kidney specialists’ decisions to remove a patient from dialysis.

“I can’t force a nephrologists to treat a patient,” said Brandy Vinson, executive director of the Mid-Atlantic Renal Coalition.

Mrs. Lomax believes the decision to bar her from the center resulted from a complaint she filed against a social worker at the center for trying to halt Medicaid for paying for her transportation.

Mrs. Lomax said her toes have been amputated as a result of her diabetes, which also shut down her kidneys. She said she needs a walker for mobility and needs transportation to get to the center based on her medical condition and her income. Medicaid has paid for her transportation to the clinic for several years.