Desperate to find medical attention for her husband, a widow described
in court yesterday how she had to slip into a restricted part of Kaiser's
Woodland Hills emergency department to find a doctor or nurse to attend to her
"I was just frantic to find some help," said Edith Spunbarg, describing how
her husband, Wolfgang, failed to receive immediate care in the emergency room
the night of April 25, 2000.
According to her testimony in Oakland before state Administrative Law Judge
Judge Michael C. Cohn, help did not arrive in time to save her husband, who
died of a ruptured aortic aneurysm.
The testimony came on the fourth day of a hearing on the appeal of a $1.1
million fine issued against Kaiser by the state Department of Managed Health
Care, which regulates the state's health maintenance organizations, for
"systemic" problems in the HMO's emergency care system.
The state contends these problems in access to emergency care led to the
death of three patients from abdominal aortic aneurysms, the 13th-leading
cause of death in the United States.
According to the state, the Woodland Hills emergency system did not attend
quickly to Spunbarg because it routinely operated over capacity. The physician
who attended to Spunbarg testified yesterday the Woodland Hills department
refuses to accept patients brought in by ambulances about 30 hours a week.
Kaiser, meanwhile, argues the state overstepped its regulatory boundaries
by asserting its authority over Kaiser doctors rather than limiting it to the
Kaiser Foundation Health Plan, which contracts with doctors and provides the
Attorneys for the state Department of Managed Health Care have argued that
the line between Kaiser's medical group and health plan is blurred and that it
relies on information from medical groups to regulate health plans.
"This is not the first time we have held a health plan accountable for
access and continuity of care at the medical group level," said James Novello,
an attorney for the department.
Yesterday, the department called Dr. Robert Pearl, head of the Permanente
Medical Group. Pearl testified that while the system is not perfect, Kaiser is
a leader in urgent and emergency care, citing Kaiser's high ratings in several
performance and member satisfaction surveys.
The hearing is scheduled to resume Jan. 8.
E-mail Victoria Colliver at email@example.com.