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ABU DHABI // Less than two months after opening, the new Al Mafraq Dialysis Centre is already treating 100 patients a week.

The centre, which opened in May and has the capacity to treat 360 patients, has helped to relieve overcrowding in other dialysis units in the emirate - some of which had only been able to offer patients two dialysis sessions a week instead of the recommended three because of space issues.

"One of the reasons this unit was built is that patients in the Mafraq, Bani Yas or Mussaffah area were having to travel to either Sheikh Khalifa Medical City [SKMC] or Al Rahba for their treatment," said Nick Richards, the chief executive and CMO of Seha, Abu Dhabi's health services company.

Dialysis is prescribed for patients with poorly functioning kidneys, and works to remove harmful waste from the body.

Diabetes is a common cause of kidney failure and, with the growing number of diabetics in the UAE, there has been increasing demand for dialysis treatment, said Mr Richards.

"I don't think the problem is about to go away, and this was understood as a problem some years ago, when Seha and the government decided to do something about it."

To further ease pressure on the strained nephrological health system, new dialysis centres are also planned for SKMC and Tawam Hospital in Al Ain.

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Leamington District Memorial Hospital laid out ambitious plans Tuesday to improve the services it provides to more than 100,000 people.

By fall more babies can be born at the hospital with the addition of a new obstetrician in October. The six-unit dialysis centre that opened six months ago is already at capacity and has enough patients to support a third shift. And once the hospital has raised the money needed, it will open a newly renovated diagnostic imaging centre that will include a stateof-the-art digital mammogram machine and private screening rooms.

The hospital's plans were laid out for MPP Rick Nicholls (PC - Chatham-Kent-Essex), who toured the facility Tuesday.

"We intend to bring (births) back to Leamington," said Roberta Jarecsni, vice-president of patient services and chief nursing officer. "Ninety per cent of births are normal. We can handle them in Leamington."

Nicholls toured the dialysis unit run by staff from Hotel-Dieu Grace Hospital that opened in January after 12 years of lobbying the government. The facility cost about $4 million for construction and equipment, which was raised through donations. Hotel-Dieu provides the staff for the department because Leamington does not have the specialty expertise, said Cheryl Deter, director of patient services.

The unit can accommodate 12 people a day with a maximum of 24 patients Monday to Saturday from 7 a.m. to 5 p.m. Previously patients were travelling to Windsor, so the local service saves patients driving two hours a day three days a week. Patients come from as far east as Amherstburg, although most are from the Leamington area, said Theresa Campeau, a nurse at the dialysis unit. There are enough dialysis patients to support a third shift, Jarecsni said.

In the emergency room, Deter said more front-line staff were hired, including a clinical resource nurse, to improve service. The hospital has 65 beds, down from 88 in 1989, Jarecsni said.

Dr. Martha Leadman, a radiologist, told Nicholls her department is financially squeezed. The imaging department offers the gamut of technology available at big hospitals including mammograms, CT scans, ultrasound and X-rays. In September, the hospital's foundation will start raising $1.1 million to renovate the department and provide a digital mammogram machine.

"We need to have appropriate screening for breast cancer," Leadman said.

Nicholls said he was impressed with how the hospital stretches a dollar and teams up with other organizations like Hotel-Dieu to provide dialysis services.

"It sounds like the community is really behind this hospital," he said. "It's unfortunate there isn't more funding available."

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Kidney dialysis giant DaVita Inc. has settled a whistleblower lawsuit for the first time, agreeing to pay $55 million over allegations of drug overuse while denying any wrongdoing.

Denver-based DaVita settled fraud claims in a Texas lawsuit challenging the dialysis chain's past use of Epogen, an anemia drug whose high cost and dangers helped change how the government pays for kidney care.

DaVita said the $55 million settlement with Ivey Woodard, a former employee of Epogen-maker Amgen, would impact its second-quarter earnings. Attorneys fees will add to the total.

The federal government, which pays for most dialysis through Medicare, will get more than 70 percent of the settlement, the whistleblower's attorney said.

Wall Street shrugged off the news, with company stock rising nine cents Tuesday to $97.71, up more than $28 since the beginning of 2011. The company has predicted a rise in operating income up to $1.3 billion this year.

DaVita still faces ongoing legal action over its drug use in other states, as well as a federal grand jury investigation in Denver over its financial arrangements with kidney doctors.

DaVita said it was the first time it was settling a claim over federal anti-fraud laws, but noted the government had declined to join the whistleblower' s lawsuit.

"DaVita and its affiliated physicians did nothing wrong and stand by their anemia management practices, which were always consistent with their mission of providing the best possible care for each patient," a company statement said. The suit was first filed in 2002.

Most kidney dialysis patients are anemic. Epogen, made by Amgen, is commonly used in dialysis clinics to boost patients' red blood cell counts back to healthy levels. Medicare pays the bills of long-term dialysis patients.

The Texas whistleblower lawsuit accused DaVita of using more Epogen than was medically necessary, and for double-billing the government for Epogen left over in vials and reused. For the period covered by the lawsuit, the payment system rewarded dialysis companies by reimbursing for the amount of drugs used, critics have said.

Woodard and attorneys thought they could prove "DaVita was pushing the envelope and pushing the boundary of what would be good medical practice" by using more Epogen than patients needed in order to boost profits, Caddell said last year in commenting on the suit.

Whistleblowers can win percentages of judgments if courts agree health care companies defrauded the government. Government investigators can formally join the lawsuits to recover Medicare and Medicaid money, and judgments may reach into the hundreds of millions of dollars. In the Woodard case, the government had not joined the action.

In responding in the past to questions about lawsuits and other challenges, DaVita had said that physicians are the ones who make Epogen decisions and prescribe treatment. DaVita has also said in court responses that the government was aware of how dialysis companies used "overfill" in Epogen vials.

Since the years when doctors and other critics raised questions about overuse of Epogen, Medicare has reversed the way it pays dialysis companies. It now bundles dialysis-related services and drugs into one set payment, with targets for red blood cell counts and other measures. The incentive is now to use less of the drugs, analysts have said.

Patient advocates are still mistrustful of how the large dialysis chains make a profit.

"We should worry now about under use" of drugs "because the incentives have flipped 180 degrees," said Bill Peckham, a dialysis patient who runs an advocacy newsletter from Washington state.

In November, Kent Thiry, the chief executive of DaVita, said a federal grand jury in Denver was looking into partnerships between DaVita and a group of kidney doctors. At that time, he was responding to questions from stock analysts about an article in The Denver Post about the kidney dialysis firm's relationship with Denver Nephrology Inc.

Jeff Dorschner, a spokesman for the U.S. Attorney's Office in Colorado, declined comment Tuesday when asked about the status of that grand jury investigation. DaVita said it was ongoing.

In 2008, DaVita sold 49 percent ownership in seven dialysis clinics to Denver Nephrology for $1.89 million. Those clinics generated estimated annual revenues of more than $28 million.

That sale took place 17 months after DaVita offered the 40 percent ownership in the clinics to another group of Denver doctors for eight times the eventual purchase price. DaVita has said the value of the clinics plunged because a major dialysis competitor was coming to Denver.

Federal law says dialysis companies must sell part-ownership of clinics at market value.

Michael Booth: 303-954-1686 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Twitter: @MBoothdp

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