A labor union sued DaVita, Fresenius Medical Care and Satellite Healthcare on Tuesday, alleging Latino and Asian patients are more likely to experience adverse symptoms during hemodialysis at the companies' California centers.
The Service Employees International Union-United Healthcare Workers West and the National Health Law Program allege nearly one in five treatments delivered to Asian patients and one in seven treatments given to Latino patients are administered at high speeds above 13 milliliters per hour. That's a higher rate than white patients, according to the groups' analysis of renal data submitted to the Centers for Medicare & Medicaid Services.
Typically, higher ultrafiltration rates are associated with higher hospitalization and mortality rates, longer recovery times and severe symptoms such as permanent heart damage and loss of cognitive function.
Several patients included in the complaint stated that they experienced low blood pressure, dizziness, headaches and cramping as a result of high-speed hemodialysis and high ultrafiltration rates above 10 to 13 milliliters per hour, as well as the death of peers and family members undergoing the same treatment.
"No one should experience high ultrafiltration rates," said Jane Perkins, legal director at the National Health Law Program. "But the fact that the data is showing that Asian American and Latino patients experience it much more frequently than white patients is startling and really unacceptable."
The dialysis providers receive federal funding through Medicaid and Medicare, leading the groups to allege the treatment disparities violate the Civil Rights Act and Affordable Care Act.
These allegations contradict Fresenius' strong record of improved quality and outcomes for all patients regardless of race or ethnicity, said Brad Puffer, spokesperson for Fresenius Medical Care North America, in a statement.
"Dialysis providers do not prescribe ultrafiltration rates, as each dialysis treatment is based on the physician prescription for each individual patient," Puffer said. "We continue to drive new product innovations to improve fluid management and personalize treatments. We strongly question the motive for this complaint."
California's dialysis industry has been the subject of several fights over regulation and business practices in recent years, including a ballot proposition defeated in 2020 that would have required a trained physician at each of the state's 600 dialysis clinics to improve patient care.
DaVita and Fresenius opposed SEIU-UHW's measure of increased regulations as something that could reduce access to care, particularly for at-risk dialysis patients of color.
Over 65,000 patients in California receive dialysis regularly to remove waste and fluid from the blood once their kidneys stop working, according to the complaint. Approximately 43% of all dialysis patients in California are Latino and 18% are Asian.
Currently, DaVita and Fresenius operate around 83% of dialysis facilities in the U.S., according to the Centers for Disease Control and Prevention, including more than 70% of centers in California.
SEIU-UHW and the National Health Law Program's lawsuit asks for the Health and Human Services Department's Office for Civil Rights to require the dialysis centers to stop delivering dialysis treatment at an ultrafiltration rate above 10 milliliters per hour.
