Lawsuit Accuses Amazon Online Health Clinic of ‘Reckless and Negligent’ Care After 45-Year-Old Man Dies

Philip Tong died in an emergency room hours after a One Medical telehealth provider advised him to buy an inhaler to treat symptoms, including shortness of breath and coughing up blood.

by Michael Nevradakis, Ph.D.

A California family sued Amazon-owned telehealth provider One Medical and a local hospital and physician, alleging they were “reckless and negligent” in their care of a 45-year-old man who died after seeking help via an online appointment.

According to the complaint, 45-year-old Philip Tong scheduled an online appointment with Amazon One Medical on Dec. 18, 2023. Tong complained of shortness of breath and said he was coughing up blood and that his feet had turned blue. One Medical advised him to purchase an inhaler.

Hours later, Tong visited the emergency room at Alta Bates Summit Medical Center, where he collapsed and died.

Tong’s wife, Suzanne, and his two daughters filed suit Oct. 1 in Alameda County Superior Court. The lawsuit accuses Amazon One Medical, Alta Bates Summit and Dr. Aurelia A. Cheng of medical malpractice and wrongful death.

The plaintiffs allege One Medical lacked “adequately trained and qualified staff” and was “careless, reckless and negligent” in its treatment of Tong, by “failing to appropriately undertake to care for or recommend care, order testing and providing proper treatment for the plaintiff.”

At the time of his appointment, Tong had been sick with flu-like symptoms for about a week and was suffering from “uncontrolled diabetes, stage 3 chronic kidney disease, infection and sepsis,” according to the lawsuit.

The case remained under the media’s radar until The Washington Post reported the story Wednesday. According to the Post, this “appears to be the first wrongful-death suit to be brought against One Medical, which Amazon acquired in February 2023.”

The Post cited Suzanne’s remarks from her husband’s Dec. 28, 2023, funeral: “No one expected a 45-year-old man who had the flu to suddenly be dead … And to have him taken so quickly, so unexpectedly — there are no words.”

The lawsuit seeks unspecified damages to be determined at trial. A hearing in the case is scheduled for March 2025.

Training of telehealth providers ‘in its infancy’

In a statement cited by the Post, Amazon One Medical spokesperson Samantha Kruse said the company is “prohibited by law from discussing patient records.”

“We care deeply about every patient we serve, and the quality and safety of our care are our highest priorities,” Kruse said. “We’re proud of our extensive quality and safety measures, and of the health outcomes we help our patients achieve. We take concerns about our care extremely seriously, and we’re committed to continuous improvement.”

Legal experts told The Defender the case will come down to what the evidence will demonstrate about causation.

“The timing and delay will be a factual issue and will impact causation and harm,” California-based healthcare attorney Rick Jaffe told The Defender. “The medical records, including the recording of the intake call, could sink or save both facilities.”

Jaffe added:

“Once a patient presents with symptoms of shortness of breath and recent splitting-up blood, and a diagnosis of sepsis, there’s no role for online medical care other than to say to go immediately to the ER, which is what the patient did apparently.”

Pediatrician Dr. Michelle Perro told The Defender that while telehealth provides certain benefits to patients, it can’t replace physical examinations in cases like Tong’s. She said:

“While clearly telehealth has many advantages in terms of increasing patient access to care, a foundational tenet of the practice of medicine is doing a thorough physical exam … Although practitioners may not be trained in telehealth, any provider should be able to realize the gravity of Mr. Tong’s reported symptoms.

“Upon reviewing the health history of Mr. Tong and establishing the seriousness of his complaints, there should have been an immediate prompt to have him come in for an in-person assessment directly to an urgent care or emergency setting.”

Noting the increased prevalence of telehealth during and after the COVID-19 pandemic, Ray Flores, senior outside counsel for Children’s Health Defense, told The Defender, “The ‘pandemic’ continues to degrade our quality of life.”

Flores said he doesn’t oppose telehealth for routine issues. In California, physicians are still held to the same standard of care, he said. “But, in instances when, as alleged in the complaint, the deceased was simply told to take an inhaler even though he was coughing up blood, was short of breath and had blue feet, this practice of medicine becomes a travesty.”

Jaffe, who suggested that telehealth is “all about triage and screening,” said there “have to be systems in place where even the telephone operators have to be trained to make quick and accurate screening of patients and moving them to an ER or urgent care center.”

He said the discovery process for the lawsuit should focus on that training and those systems. “The recorded call will be very important, and perhaps the critical piece of evidence,” he said.

Simon Rowland, a researcher with consumer health company Haleon and expert in telehealth and malpractice, told the Post that few telehealth providers receive special training in issuing remote diagnoses to patients.

“Training in that area is in its infancy,” Rowland said. “It’s a clinical scenario that people need to understand better in terms of the risks and benefits.”

For Patrick M. Wood, author of “Technocracy Rising: The Trojan Horse Of Global Transformation,” telehealth’s reliance on standardized protocols will hurt patient care.

“Standardized protocols and ‘best practices’ will always marginalize human judgment in those cases that fall outside their scope, often with devastating consequences,” Wood told The Defender.

‘Profit motive can lead to grave errors’

According to the Post, Amazon has pushed to expand its presence in telehealth since it finalized its $3.9 billion acquisition of One Medical in 2023. This includes efforts to combine One Medical’s services with those offered by its own telehealth service, previously known as Amazon Clinic, the Daily Mail reported.

Amazon also operates an online pharmacy, Amazon Pharmacy, which arose out of its acquisition of PillPack in 2018 for $750 million, according to the Daily Mail.

At a recent Amazon media event, One Medical CEO Trent Green said the company plans to increase online primary care services, including making telehealth appointments available on nights, weekends and holidays, the Post reported.

“By building, testing, and scaling new models of care delivery we can help reduce costs, improve outcomes, and fundamentally transform health care,” Green said.

According to the Daily Mail, One Medical has more than 800,000 members and operates over 200 medical offices in more than 20 markets.

Amazon’s foray into healthcare previously encountered obstacles. According to the Daily Mail, Haven — a joint venture between Amazon, Berkshire Hathaway and JPMorgan Chase — aimed at lowering employee healthcare costs, was discontinued in 2021.

That year, Amazon also shut down its previous telehealth service, Amazon Care.

According to the Post, “As One Medical has grown under Amazon’s ownership, it has sometimes struggled to adequately care for its more vulnerable patients.”

In February, Amazon One Medical announced layoffs, including of some of its clinical staff, and moved more of its patient care and communication online. The layoffs included clinical reception staff who were replaced by an Arizona-based call center. According to the Post, One Medical employees said this “put patients at risk.”

In June, leaked documents revealed that Amazon One Medical staff repeatedly mishandled urgent calls from patients experiencing life-threatening symptoms.

The Post reported that current and former employees have alleged “pressure to improve productivity” increased after Amazon’s purchase of One Medicine.

“Virtual providers’ schedules were so tightly packed, one former employee said, that two different patients reported having telehealth visits with health-care providers who were clearly calling from their cars,” the Post reported.

Jaffe said he expects “more of these cases to be filed against online companies as the telehealth model expands and more players come into the market.”

Perro voiced concerns about the encroachment of non-medical organizations into healthcare. “The constant push for medical providers to see more patients and quickly make assessments driven by the profit motive can lead to grave errors.”

Wood suggested that “so-called ‘evidence-based medicine’ paved the way for the technocratic takeover” of healthcare starting in the 1990s, forcing out human-based medicine. “Bad outcomes like this case are a marker of evidence-based medicine, which empowers technocrats to overuse technology at the expense of common sense.”