Vast cache of Kaiser patient details was kept in private home

Federal and state officials are investigating whether healthcare giant Kaiser Permanente violated patient privacy in its work with an Indio couple who stored nearly 300,000 confidential hospital records for the company.

The California Department of Public Health has already determined that Kaiser "failed to safeguard all patients' medical records" at one Southern California hospital by giving files to Stephan and Liza Dean for about seven months without a contract. The couple's document storage firm kept those patient records at a warehouse in Indio that they shared with another man's party rental business and his Ford Mustang until 2010.

Until this week, the Deans also had emails from Kaiser and other files listing thousands of patients' names, Social Security numbers, dates of birth and treatment information stored on their home computers.

The state agency said it was awaiting more information from Kaiser on its "plan of correction" before considering any penalties.

Officials at the U.S. Department of Health and Human Services began looking into Kaiser's conduct last year after receiving a complaint from the Deans about the healthcare provider's handling of patient data, letters from the agency show. Kaiser said it hadn't been contacted by federal regulators, and a Health and Human Services spokesman declined to comment.

Kaiser said it remained confident that this patient information was never disclosed or accessed inappropriately. It said that some employees were disciplined because company policies were not followed and that it had informed regulators of the steps it had taken to ensure this type of incident didn't happen again.

"Kaiser Permanente is committed to protecting the medical and personal privacy of its patients," spokesman John Nelson said. "In retrospect, we certainly wish we'd never done business with Mr. Dean."

Even with tougher government oversight of medical privacy in recent years, this case underscores how confidential patient information remains vulnerable in the hands of big healthcare institutions and legions of outside contractors.

"Kaiser has shown extraordinary recklessness in this situation," said Beth Givens, director of the Privacy Rights Clearinghouse in San Diego. "Healthcare companies have to make sure their contractors adhere to ironclad security practices."

Federal and state laws impose strict standards on anyone dealing with patient information. The privacy rule of the federal Health Insurance Portability and Accountability Act, known as HIPAA, bans the unauthorized disclosure of individuals' medical records and requires healthcare providers and vendors, such as billing and storage companies, to protect the information.

Despite those rules, personal medical information of 21 million people nationwide has been improperly exposed since 2009, according to federal data. Last year, Blue Cross Blue Shield of Tennessee agreed to pay $1.5 million to resolve allegations it violated federal law after 57 computer hard drives with patient information were stolen from an outside facility.

In October, Kaiser sued the Deans in Riverside County Superior Court, accusing them of violating their contract by not returning all of its patient information two years ago when Kaiser picked up the paper records.

In court filings, Kaiser said the Deans put patient data at risk by leaving two computer hard drives in their garage with the door open. In response, Stephan Dean moved them to a spare room. On a recent day they sat next to a red recliner where Ziggy, the family's black-and-white cat, curled up for a nap. Dean said those hard drives contained spreadsheets on thousands of Kaiser patients, prepared at the company's request.

At one point, Dean told Kaiser he was planning to contact patients about the whereabouts of their medical information because he felt Kaiser hadn't taken proper precautions. The company sought a temporary restraining order against Dean, barring him from disclosing any confidential information. A Superior Court judge granted Kaiser's request until Thursday, when another hearing is scheduled.

Dean, 47, got his foot in the door at Kaiser from his previous work labeling paper folders for courthouses, hospitals and doctors.

But the demand for folders was slipping as hospitals and doctors used computers more. Kaiser was at the forefront of this as it invested billions of dollars in its HealthConnect system, which it bills as the largest private-sector electronic health record in the world. Kaiser, with more than 9 million customers, is the nation's largest nonprofit insurer and hospital system.

Dean said his small business, Sure File Filing Systems, got a big break when Kaiser acquired the Moreno Valley Community Hospital in 2008. The company needed to organize and clear out thousands of old patient files and it gave the job to the Deans, Kaiser records show.

In August 2008, the Deans started packing up thousands of files from Moreno Valley and moving them to the warehouse in Indio.

Hospital clerks routinely messaged Dean asking him to pull records on specific patients, emails sent by Kaiser to Sure File show. Dean said some Kaiser employees would put the patient's full name in the subject line of the email, and other messages listed the patient's Social Security number, date of birth, doctors' names and treatment dates. One message started, "Good Morning Sure File," and requested adoption records for a child.

Dean said Kaiser showed little concern for patient privacy in handling those requests. Only one out of more than 600 emails from Kaiser was password-protected with encryption, he said. Many medical providers use such technology so information isn't visible to others.

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EU says its Google case not affected by U.S. ruling

BRUSSELS (Reuters) – A decision by U.S. regulators to end a probe into whether Google Inc hurt rivals by manipulating internet searches will not affect the European Union‘s examination of the company.

“We have taken note of the FTC (Federal Trade Commission) decision, but we don’t see that it has any direct implications for our investigation, for our discussions with Google, which are ongoing,” said Michael Jennings, a spokesman for the European Commission, the EU executive.

U.S. regulators on Thursday ended their investigation into the giant internet company, which runs the world’s most popular search engine.

Other internet companies, such as Microsoft Corp, had complained about Google tweaking its search results to give prominence to its own products. But the FTC said there was not enough evidence to pursue a big search-bias case.

The European Commission has for the past two years been investigating complaints against Google, including claims that it unfairly favored its own services in its search results.

Google presented informal settlement proposals to the Commission in July. On December 18 the Commission gave the company a month to come up with detailed proposals to resolve the investigation.

If it fails to address the complaints and is found guilty, Google could eventually be fined up to 10 percent of its revenue – a fine of up to $ 4 billion.

(Reporting By Ethan Bilby; Editing by Sebastian Moffett and David Goodman)

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House approves $9.7 billion in Sandy disaster aid

WASHINGTON — Responding to the political storm over delays in disaster aid to the Northeast, the House on Friday approved a $9.7-billion flood insurance bill, the first segment of a possible $60-billion Superstorm Sandy recovery package.

The measure’s approval comes after New Jersey Gov. Chris Christie and Rep. Pete King of New York, among others, publicly slammed House Speaker John Boehner, a fellow Republican, for putting off a vote on a relief measure in the closing days of the 112^thCongress.

The 354-67 vote sent the bill to the Senate, where it could be approved by the end of the day. 

But Democrats were still fuming that it has taken 68 days for the House to act – and that a  broader relief bill still must be approved.

"Talk about fiddling while New York City burns,’’ said Rep. Nydia Velazquez (D-N.Y.), calling the delay an "embarrassment’’ to the House. 

"How dare you come to this floor and make people think everything is OK,’’ Rep. Bill Pascrell Jr. (D-N.J.) told Republicans.

Rep. Frank LoBiondo (R-N.J.), among the Northeast lawmakers who complained earlier this week about congressional inaction on a relief bill, called the vote a "key step in getting critical federal assistance to the residents, businesses and communities devastated by Hurricane Sandy.

“This week’s events make it clear that the need for help is real and that any additional delays in providing federal aid will be met with fierce resistance from myself, members of the delegation, and Gov. Christie,’’ he added.

The larger aid package, due to come before the House on Jan. 15, would fund such things as repairing roads, the electric grid, transportation system and Liberty Island, where the Statue of Liberty has been closed since the storm hit, and shoring up defenses against future storms.

That measure, expected to cost $51 billion, could still run into resistance from conservative lawmakers, some of whom have sought to offset the new spending with budget cuts elsewhere.

The conservative Club for Growth urged a no vote on the flood insurance measure, saying, "Congress should not allow the federal government to be involved in the flood insurance industry in the first place, let alone expand the national flood insurance program's authority."

The measure approved Friday  would increase the borrowing authority for the national flood insurance program to cover insurance claims for flood damage.

The Federal Emergency Management Agency has warned that without congressional action, funds available to pay claims would be exhausted next week.   

Sandy, which was a hurricane before the center of the storm made landfall  Oct. 29 in New Jersey, caused more than 125 deaths in the United States.

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Richard.simon@latimes.com

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'McDreamy' says he beat Starbucks for coffee chain

SEATTLE (AP) — "Grey's Anatomy" star Patrick Dempsey may be the real "McSteamy."

The actor, who was dubbed "McDreamy" as a star of the hospital drama while his co-star affectionately was called "McSteamy," won a bankruptcy auction to buy Tully's Coffee, a small coffee chain based in Seattle.

Among those Dempsey beat out is Tully's much bigger Seattle neighbor, Starbucks Corp., which wanted to convert the cafes to its own brand.

Dempsey, whose company Global Baristas LLC plans to keep the Tully's name, declared victory on the social media site Twitter with the message: "We met the green monster, looked her in the eye, and...SHE BLINKED! We got it! Thank you Seattle!

Then, in an interview on Friday, Dempsey said that as the underdog in Seattle, Tully's would need to find its identity.

"It's a much smaller chain that has a lot of potential that hasn't been given the proper care," he said.

But Starbucks is saying not so fast. The chain, which has 18,000 cafes worldwide, said in a statement that a final determination on the winning bid won't be made until a court hearing on Jan. 11. Starbucks said it's in a "back-up" position" to buy 25 of the 47 Tully's cafes, with another undisclosed bidder making an offer for the remainder.

The combined bids of Starbucks and the undisclosed bidder come to $10.6 million, above the $9.2 million Dempsey's company is offering to pay through his company. The other investors in Global Baristas aren't being disclosed.

Tully's Coffee, which has more than 500 employees and locations in Washington and California, filed for Chapter 11 bankruptcy protection in October, citing lease obligations and underperforming stores. TC Global Inc., its parent company, said in a release Friday that it was "encouraged and excited" about Dempsey's commitment to the chain.

Tully's President and CEO Scott Pearson called the deal a "great match" and that the goal is to make sure creditors get paid and to keep as many people employed as possible.

Dempsey said he planned to be very involved in the running of the company, adding that the immediate challenges were to address bookkeeping issues, staff morale and sprucing up the coffee shops. Once the business is stabilized, Dempsey said the long-term goal would be to take the chain national.

"We can pull this off. We just have to take steps that are slow and smart," he said. "I'm going to get behind the counter. I'm going to serve coffee...I'm going to give the company a boost of energy."

Although Dempsey lives in Los Angeles, he plans to spend more time in Seattle, the city where "Grey's Anatomy" is set in. Dempsey said he believed there is room in the city for Tully's and the much larger Starbucks; he noted there might be people who are rooting for the underdog.

"In a society where there are so many big corporations that swallow the little guy, we thought, let's not let this happen to this company," he said.

Dempsey made an appearance Friday morning at a Tully's near Pike Place Market, shaking hands with workers and greeting customers before visiting other stores. Several dozen people, mostly women, came into the store.

Patrease Estelle, 45, works nearby, and came in with a small group from her office.

"I will take whatever I can get. A photo, a hug, a 'hey, how you doing,' a wink," said Estelle, who got a picture and handshake with the actor.

___

Blankinship reported from Seattle and Choi from New York.

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Scant Proof Is Found to Back Up Claims by Energy Drinks

Energy drinks are the fastest-growing part of the beverage industry, with sales in the United States reaching more than $10 billion in 2012 — more than Americans spent on iced tea or sports beverages like Gatorade.

Their rising popularity represents a generational shift in what people drink, and reflects a successful campaign to convince consumers, particularly teenagers, that the drinks provide a mental and physical edge.

The drinks are now under scrutiny by the Food and Drug Administration after reports of deaths and serious injuries that may be linked to their high caffeine levels. But however that review ends, one thing is clear, interviews with researchers and a review of scientific studies show: the energy drink industry is based on a brew of ingredients that, apart from caffeine, have little, if any benefit for consumers.

“If you had a cup of coffee you are going to affect metabolism in the same way,” said Dr. Robert W. Pettitt, an associate professor at Minnesota State University in Mankato, who has studied the drinks.

Energy drink companies have promoted their products not as caffeine-fueled concoctions but as specially engineered blends that provide something more. For example, producers claim that “Red Bull gives you wings,” that Rockstar Energy is “scientifically formulated” and Monster Energy is a “killer energy brew.” Representative Edward J. Markey of Massachusetts, a Democrat, has asked the government to investigate the industry’s marketing claims.

Promoting a message beyond caffeine has enabled the beverage makers to charge premium prices. A 16-ounce energy drink that sells for $2.99 a can contains about the same amount of caffeine as a tablet of NoDoz that costs 30 cents. Even Starbucks coffee is cheap by comparison; a 12-ounce cup that costs $1.85 has even more caffeine.

As with earlier elixirs, a dearth of evidence underlies such claims. Only a few human studies of energy drinks or the ingredients in them have been performed and they point to a similar conclusion, researchers say — that the beverages are mainly about caffeine.

Caffeine is called the world’s most widely used drug. A stimulant, it increases alertness, awareness and, if taken at the right time, improves athletic performance, studies show. Energy drink users feel its kick faster because the beverages are typically swallowed quickly or are sold as concentrates.

“These are caffeine delivery systems,” said Dr. Roland Griffiths, a researcher at Johns Hopkins University who has studied energy drinks. “They don’t want to say this is equivalent to a NoDoz because that is not a very sexy sales message.”

A scientist at the University of Wisconsin became puzzled as he researched an ingredient used in energy drinks like Red Bull, 5-Hour Energy and Monster Energy. The researcher, Dr. Craig A. Goodman, could not find any trials in humans of the additive, a substance with the tongue-twisting name of glucuronolactone that is related to glucose, a sugar. But Dr. Goodman, who had studied other energy drink ingredients, eventually found two 40-year-old studies from Japan that had examined it.

In the experiments, scientists injected large doses of the substance into laboratory rats. Afterward, the rats swam better. “I have no idea what it does in energy drinks,” Dr. Goodman said.

Energy drink manufacturers say it is their proprietary formulas, rather than specific ingredients, that provide users with physical and mental benefits. But that has not prevented them from implying otherwise.

Consider the case of taurine, an additive used in most energy products.

On its Web site, the producer of Red Bull, for example, states that “more than 2,500 reports have been published about taurine and its physiological effects,” including acting as a “detoxifying agent.” In addition, that company, Red Bull of Austria, points to a 2009 safety study by a European regulatory group that gave it a clean bill of health.

But Red Bull’s Web site does not mention reports by that same group, the European Food Safety Authority, which concluded that claims about the benefits in energy drinks lacked scientific support. Based on those findings, the European Commission has refused to approve claims that taurine helps maintain mental function and heart health and reduces muscle fatigue.

Taurine, an amino acidlike substance that got its name because it was first found in the bile of bulls, does play a role in bodily functions, and recent research suggests it might help prevent heart attacks in women with high cholesterol. However, most people get more than adequate amounts from foods like meat, experts said. And researchers added that those with heart problems who may need supplements would find far better sources than energy drinks.

Hiroko Tabuchi contributed reporting from Tokyo and Poypiti Amatatham from Bangkok.

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Stocks head for big weekly gain after jobs report

NEW YORK — Stocks edged higher after a report showed that hiring held up in December, keeping the Dow on track for its best week in more than six months.

The Dow Jones industrial average was up 16 points to 13,407 as of 1:22 p.m. EST Friday. It's up 3.6% for the week, putting it on track for its biggest weekly advance since June. The Standard & Poor's 500 index rose four points to 1,464 and is up 4.4% in the week, its biggest gain in more than a year. The Nasdaq was up less than a point at 3,101.

Stocks have surged this week after lawmakers passed a bill to avoid a combination of government spending cuts and tax increases that have come to be known as the "fiscal cliff." The law passed late Tuesday night averted that outcome, which could have pushed the economy back into recession.

The Labor Department said U.S. employers added 155,000 jobs in December, showing that hiring held up during the tense fiscal negotiations in Washington. It also said hiring was stronger in November than first thought. The unemployment rate held steady at 7.8%.

The jobs report failed to give stocks more of a boost because the number of jobs was exactly in line with analysts' forecasts, said JJ Kinahan, chief derivatives trader for TD Ameritrade.

"The jobs report couldn't have been more in line," said Kinahan. "The market had more to lose than to gain from it."

Among stocks making big moves, Eli Lilly and Co. jumped $1.87 to $51.59 after saying that its earnings will grow more than Wall Street expects, even though the drugmaker will lose U.S. patent protection for two more product types this year.

Walgreen Co., the nation's largest drugstore chain, fell 30 cents to $37.49 after the company said that a measure of revenue fell more than analysts had expected in December, even as prescription counts continued to recover.

Stocks may also be benefiting as investors adjust their portfolios to favor stocks over bonds, said TD Ameritrade's Kinahan. A multi-year rally in bonds has pushed up prices for the securities and reduced the yield that they offer, in many cases to levels below company dividends.

Goldman Sachs today reiterated its view that stocks "can be an attractive source of income," and warned that there is a risk that bonds may fall. In a note to clients, the investment bank said that an index of AAA rated corporate bonds offers a yield of 1.6%, that's less than the S&P 500's dividend yield of 2.2%.

The 10-year Treasury note fell, pushing its yield higher. The yield on the 10-year note rose 2 basis points to 1.93%. The note's yield has now climbed 54 basis points since falling to its lowest in at least 20 years in July.

Other notable stock moves;

-- Accuray Inc. plunged $1.36 to $5.42 after the radiation oncology equipment company reported weak sales and said it would cut 13% of its staff.

-- Lululemon, a yoga apparel maker, dropped $3.64 to $71.45 after Credit Suisse predicted slowing momentum and downgraded its stock.

-- Finish Line, an athletic footwear and clothing company, fell $1.12 to $17.92 after it reported a small loss after sneaker trends changed and customers didn't take to its new web site launched in November. Analysts had forecast a profit.

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Can the Government Really Ban Twitter Parody Accounts?

Arizona is entertaining a law that will make it a felony to use another person’s real name to make an  Internet profile intended to “harm, defraud, intimidate or threaten,” which to some sounds like a law against parody Twitter accounts. The legislation, if passed, would make Arizona one of a few states, including New York, California, Washington and Texas, to enact anti-online-impersonation laws. If these regulations seek to put a stop to fake representations online, that does sound like the end of fake celebrity baby accounts and Twitter death hoaxes. Then again, these laws have existed in these other places for years, and that hasn’t stopped the faux accounts from coming in. So what then does this mean?

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What kind of stuff is the law intended to prosecute?

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The law does not say that all uses of another person’s real name can be charged as a felony, but only profiles made for the more nefarious purposes fall into that territory. The legislation is  targeted at more serious forms of impersonation, like cyber bullying. Two Texas teens were arrested and charged under this law for creating a fake Facebook page to ruin a peer’s reputation, for example. Or, the case of Robert Dale Esparza Jr. who created a fake profile of his son’s vice principal on a porn site might fall under this law, suggests The Arizona Republic‘s Alia Beard Rau. Or, in one of the cases brought to court under the Texas version of this law, an Adam Limle created websites that portrayed a woman he used to date as a prostitute. (The case was eventually dropped because of a geographical loophole. Limle lived in Ohio, not Texas.) 

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Okay, the harm and threat in those situation is pretty clear. How can it at all apply to something relatively harmless, like a Twitter parody account? 

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The term “harm” is pretty vague, as this Texas Law blog explains, referring to that state’s version of this legislation, on which Arizona based its own law. “‘Harm’ can be very broadly construed–one person’s joke is another person’s harm,” writes Houston lawyer Stephanie Stradley. 

RELATED: Netanyahu’s Son Demonstrates Another Political Risk of Social Media

So, that could extend to parody accounts then? 

Well, possibly. Stradley suggests that politicians who had parody accounts created to mock them might have a case. Some of the impersonation of Texas lawmakers has gone beyond just the jokey fake Twitter handle. Jeffwentworth.com is not the official site for Texas state senator, but rather redirects to the web site of the anti-tax advocate group Empower Texans which considers the San Antonio politician the “the most liberal Republican senator in Austin.” Wentworth told The New York Times this domain squatting amounted to “identity theft,” and could be the basis for the law’s usage. 

The law could also possibly effect sillier parody accounts, suggest privacy advocates. “The problem with this, and other online impersonation bills, is the potential that they could be used to go after parody or social commentary activities,” senior staff attorney for the Electronic Frontier Foundation Kurt Opsahl told The Arizona Republic’s Alia Beard Rau. ”While this bill is written to limit ‘intent to harm,’ if that is construed broadly, there could be First Amendment problems.”

Ok, but what about precedent? Has the law ever applied to a faux Twitter handle? 

Twitter has its own parody policy that mitigates a lot of the possible damage that could ever lead to a court case. Saint Louis Cardinals manager Anthony La Russa sued Twitter in 2009 because of a made-up account, but the account was removed before the case went anywhere (And that was before these laws went into effect.) 

But it’s not clear that parody would ever be considered harmful enough for the law. When California’s version went into effect, a first amendment lawyer suggested to SF Weekly‘s Joe Eskenazi that jokes could go pretty far without prosecution. “You’re going to have to have room for satire,” he said. The account would have to look fool people, he argued. “A key question is, ‘is it credibile?’” asks Simitian. “Do people who read it think it’s him?” Because of our increasing skepticism of things on Twitter, unless the site has verified checkmark, it’s unlikely that most people believe in a fake account for long. So, unless the imitation tweeter does something extremely harmful to someone’s character, it doesn’t sound like anyone would have a strong case. Alas, parody Twitter accounts, for better or worse (worse, right?) are here to stay. 

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Bieber urges crackdown on paparazzi after photographer's death

Justin Bieber and his collection of exotic cars have been tantalizing targets for celebrity photographers ever since the young singer got his driver's license.

A video captured the paparazzi chasing Bieber through Westside traffic in November. When Bieber's white Ferrari stops at an intersection, the video shows the singer turning to one of the photographers and asking: "How do your parents feel about what you do?"

A few months earlier, he was at the wheel of his Fisker sports car when a California Highway Patrol officer pulled him over for driving at high speeds while trying to outrun a paparazzo.

This pursuit for the perfect shot took a fatal turn Tuesday when a photographer was hit by an SUV on Sepulveda Boulevard after taking photos of Bieber's Ferrari. And the singer now finds himself at the center of the familiar debate about free speech and the aggressive tactics of the paparazzi.

Since Princess Diana's fatal accident in Paris in 1997 while being pursued by photographers, California politicians have tried crafting laws that curb paparazzi behavior. But some of those laws are rarely used, and attorneys have challenged the constitutionality of others.

On Wednesday, Bieber went on the offensive, calling on lawmakers to crack down.

"Hopefully this tragedy will finally inspire meaningful legislation and whatever other necessary steps to protect the lives and safety of celebrities, police officers, innocent public bystanders and the photographers themselves," he said in a statement.

It remained unclear if any legislators would take up his call. But Bieber did get some support from another paparazzi target, singer Miley Cyrus.

She wrote on Twitter that she hoped the accident "brings on some changes in '13 Paparazzi are dangerous!"

Last year, a Los Angeles County Superior Court judge threw out charges related to a first-of-its-kind anti-paparazzi law in a case involving Bieber being chased on the 101 Freeway by photographer Paul Raef. Passed in 2010, the law created punishments for paparazzi who drove dangerously to obtain images.

But the judge said the law violated 1st Amendment protections by overreaching and potentially affecting such people as wedding photographers or photographers speeding to a location where a celebrity was present.

The L.A. city attorney's office is now appealing that decision.

Raef's attorney, Dmitry Gorin, said new anti-paparazzi laws are unnecessary.

"There are plenty of other laws on the books to deal with these issues. There is always a rush to create a new paparazzi law every time something happens," he said. "Any new law on the paparazzi is going to run smack into the 1st Amendment. Truth is, most conduct is covered by existing laws. A lot of this is done for publicity."

Coroner's officials have not identified the photographer because they have not reached the next of kin. However, his girlfriend, Frances Merto, and another photographer identified him as Chris Guerra.

The incident took place on Sepulveda Boulevard near Getty Center Drive shortly before 6 p.m. Tuesday. A friend of Bieber was driving the sports car when it was pulled over on the 405 Freeway by the California Highway Patrol. The photographer arrived near the scene on Sepulveda, left his car and crossed the street to take photos. Sources familiar with the investigation said the CHP told him to leave the area. As he was returning to his vehicle, he was hit by the SUV.

Law enforcement sources said Wednesday that it was unlikely charges would be filed against the driver of the SUV that hit the photographer.

Veteran paparazzo Frank Griffin took issue with the criticism being directed at the photographer as well as other paparazzi.

"What's the difference between our guy who got killed under those circumstances and the war photographer who steps on a land mine in Afghanistan and blows himself to pieces because he wanted the photograph on the other side of road?" said Griffin, who co-owns the photo agency Griffin-Bauer.

"The only difference is the subject matter. One is a celebrity and the other is a battle. Both young men have left behind mothers and fathers grieving and there's no greater sadness in this world than parents who have to bury their children."

Others, however, said the death focuses attention on the safety issues involving paparazzi

"The paparazzi are increasingly reckless and dangerous. The greater the demand, the greater the incentive to do whatever it takes to get the image," said Blair Berk, a Los Angeles attorney who has represented numerous celebrities. "The issue here isn't vanity and nuisance, it's safety."

richard.winton@latimes.com

andrew.blankstein@latimes.com

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Depardieu, in tax fight, gets Russian citizenship

MOSCOW (AP) — The Kremlin has cast Gerard Depardieu in one of the most surprising roles of his life — as a new Russian citizen.

The announcement Thursday that President Vladimir Putin has approved Depardieu's application for citizenship is almost a real-life analogue to the French actor's 1990 comedy "Green Card," in which his character enters into a sham marriage in order to work in the United States.

But in this version, taxes appear to be at the heart of the matter. Depardieu has waged a battle against a proposed super tax on millionaires in his native country.

French President Francois Hollande plans to raise the tax on earned income above €1 million ($1.3 million) to 75 percent from the current 41 percent, while Russia has a flat 13-percent tax rate.

A representative for the former Oscar nominee declined to say whether he had accepted the Russian offer.

Thursday was a holiday in Russia and officials from the Federal Tax Service and Federal Migration Service could not be reached for comment on whether the decision would require Depardieu to have a residence in Russia.

But it's clearly an image buffer for Russia, calling attention to the country's attractive tax regime and boosting Putin's efforts to show that the economic chaos of the early post-Soviet period has passed.

"The distinctiveness of our tax system is poorly known about in the West. When they know about it, we can expect a massive migration of rich Europeans to Russia," Deputy Prime Minister Dmitry Rogozin bragged on Twitter.

Others aren't so sure.

Political analyst Pavel Svyatenkov told the state news agency RIA Novosti that the move was "very good, very high-quality PR for Russia" but he was didn't think it would ignite a flood of new residents.

"I don't expect a massive movement of rich people to here, for the reason that Russia remains a pretty poor country by Western measurements and here there are bigger problems with crime and corruption," he said.

As Depardieu's criticism of the proposed tax roiled his country, French Prime Minister Jean-Marc Ayrault called him "pathetic."

Depardieu responded angrily in an open letter.

"I have never killed anyone, I don't think I've been unworthy, I've paid €145 million ($190 million) in taxes over 45 years," the 64-year-old actor wrote. "I will neither complain nor brag, but I refuse to be called 'pathetic'."

Depardieu said in the letter that he would surrender his passport and French social security card. In October, the mayor of a small Belgian border town announced that Depardieu had bought a house and set up legal residence there, a move that was slammed by Hollande's newly-elected Socialist government.

Najat Vallaud-Belkacem, the French government spokeswoman, didn't comment directly on Depardieu's tax fight. But she drew a clear distinction between people who have personal or professional reasons to live abroad and "French citizens who proclaim loudly and clearly that they they're exiling themselves for fiscal reasons."

She said Putin's offer "is an exclusive prerogative of the Russian chief of state."

Depardieu has had increasingly high-profile ties with Russia.

Last October he visited Grozny, the capital of the Russian province of Chechnya, to celebrate the birthday of Chechen President Ramzan Kadyrov. And in 2011, he was in Russia's Arkhangelsk region to play the lead role in the film "Rasputin."

He is well known in the country, where he appears in an ad for Sovietsky Bank's credit card and is prominently featured on the bank's home page.

"You have to understand that Depardieu is a star in Russia," Vladimir Fedorovski, a Russian writer living in France, told the Europe 1 network on Thursday. "There are crowds around Depardieu. He's a symbol of France. He's a huge ambassador of French culture."

Depardieu has made more than 150 films and was nominated for an Academy Award for his role as Cyrano de Bergerac in the 1990 film of the same name.

The Kremlin statement gave no information on why Putin made the citizenship grant, but the Russian president had expressed sympathy with the actor in December, days after Depardieu reportedly said he was considering Russian citizenship.

"As we say, artists are easily offended and therefore I understand the feelings of Mr. Depardieu," Putin said.

Although France's highest court struck down the new tax on Dec. 29, the government has promised to resubmit the law in a slightly different form. On Wednesday, the French government estimated the court decision to overturn the tax would cost the country €210 million ($275 million) in 2013.

In an interview, Depardieu told the Sunday Parisien the court decision made no difference.

France's debt burden is around 90 percent of national income — not far off levels that have caused problems elsewhere in the 17-country eurozone.

Depardieu is not the only high-profile Frenchman to object to the super tax. Bernard Arnault — chief of the luxury goods and fashion giant LVMH and worth an estimated $41 billion — has said he would leave for Belgium.

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Hinnant contributed from Paris. Silvie Corbet also contributed from Paris.

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Skin Deep: Questions Surround Iris Implant Procedure – Skin Deep

ANITA ADAMS was born with one green eye and one brown eye. While differently colored irises, a condition otherwise known as heterochromia, may look exotic on David Bowie and Kate Bosworth, Ms. Adams did not like them on herself.

“I wanted my irises to match,” said Ms. Adams, 41, who works as a caretaker for at-risk adolescents in Grand Junction, Colo.

In mid-2008, she began looking online to see if there was any solution other than colored contact lenses (which comprised about 20 percent of the $7.8 billion global contact lens market in 2011, according to a January 2012 report published by BCC Market Research). She found a company, New Color Iris, marketing a device invented by a Panamanian ophthalmologist, Dr. Alberto Delray Kahn, that could apparently implant an artificial or prosthetic iris over her natural one.

The device was not approved by the Food and Drug Administration, nor were there any clinical studies or peer-reviewed publications about it. But Ms. Adams found Facebook posts and YouTube testimonials from patients whose eyes had gone from drab brown to an icy blue and were thrilled with the results. On his Web site, Kahnmedical.com, Dr. Kahn wrote that he supported “programs for the prevention of blindness in the Kuma and Embera Indians of Panama,” who have high rates of ocular albinism, which makes them sensitive to light. 

Ms. Adams was impressed. At the company’s request, she went for routine tests to her ophthalmologist, who told her he had never heard of the procedure and advised against it. She didn’t listen. “I went, ‘Oh, whatever,’ ” she said. “I don’t think anything was going to convince me not to do it. At that point my mind was made up.”

Ms. Adams is not alone in her quest for symmetry, whatever the risk.

Dr. Gregory J. Pamel, a corneal and refractive surgeon in Manhattan and a clinical assistant professor of ophthalmology at New York University, said that for the last two years he has received about three inquiries a month from patients who have learned from his Web site that he implants artificial irises for medical reasons. “They’d want to enroll in the clinical trial, and I would say, ‘There’s nothing available in the U.S.,’ ” he said. “There are no approved devices in the U.S. to change the eye color cosmetically. There are no clinical trials to date that are looking into this. There’s nothing on the horizon.”

There are, however, iris implants for patients with serious conditions like aniridia, a rare hereditary absence or partial absence of the iris, that are available under a special “compassionate use” F.D.A. provision. The provision allows patients with serious or life-threatening medical conditions to be treated with devices that have not been approved by the F.D.A., but “we can only use it for people with trauma,” Dr. Pamel said. “I would be very hesitant and skeptical about any technology that purports to change the iris color for cosmetic reasons.” 

Dr. Kenneth Steinsapir, an oculofacial surgeon and ophthalmologist in Los Angeles, also received calls from patients wanting their eye color changed, so he began investigating New Color Iris. He found no positive reports, but he did find a number of studies reporting serious complications. In July 2010, he blogged about it on his Web site, lidlift.com. “The colored disk that is put in the eye has been shown to cause harm,” he wrote.  “If you are not albino and missing iris pigment or have part of the iris missing either from a birth defect or from trauma, then there is no compelling medical reason for this surgery.” 

But Ms. Adams was determined to fix her perceived imperfection. In September 2008, she wired nearly $2,000 to New Color Iris, and a month later flew with her mother (paying their airfare) to Panama. She was told the surgery would present no complications other than a slight risk of glaucoma. She signed a consent form, paid an additional $5,000 and underwent the 15-minute procedure.

For two days, Ms. Adams’s vision was blurry, which she was told was normal. By the third day, she could see well enough to tour around the city. “I was happy with the experience at the time,” she said.

She appeared on “Inside Edition” to talk about how delighted she was, for which she said New Color Iris paid her $500, promising an additional $500 for every future media appearance she did. She also allowed the company to use her likeness on its Web site and on YouTube.

Ms. Adams was pleased with her matching irises for about two years. But in fall 2010, she said, her vision grew “spotty,” and she was “scared to death I was going blind.” She repeatedly tried to contact Dr. Kahn as well as the company in New York, but said she received no response. She started a Facebook page (now dismantled) highlighting her negative experience, noticing that other people had shared similar stories.

And when she returned to the New Color Iris Web site, she was redirected to another site, Brightocular.com, which was marketing another implant to cosmetically change eye color and offering more glowing testimonials.

Ms. Adams said she contacted it using a fake name and was told that the procedure was being offered in Istanbul and soon “in all of Europe” and that the company was not affiliated with New Color Iris. Convinced this was untrue, she contacted Dr. Steinsapir in February 2011, and he began blogging about a possible relationship between the two companies. On Aug. 16, 2011, Dr. Steinsapir received a certified letter from Kevin J. Abruzzese, a lawyer in Mineola, N.Y., representing Stellar Devices, which owns the trademark for Brightocular, that denied that any association existed between the two companies. The letter also asserted that Stellar Devices was working with Minnesota Eye Consultants, in Minneapolis, to obtain “F.D.A. compassionate approval for a patient with aniridia,” and ordered  the doctor to remove “any and all defamatory content” about Brightocular.

Still skeptical, Dr. Steinsapir found a registered trademark for Brightocular, originally filed March 18, 2010 and granted registration on April 19, 2011.

But the company to which the trademark was registered was not Stellar Devices, but New Color Iris. What’s more, New Color Iris and Stellar Devices shared the same Midtown Manhattan address. Dr. Steinsapir later published his findings. He said he also arranged surgery for people who had iris color surgery and needed urgent help.

Alain Delaquérière contributed research.

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