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Widow testifies against Kaiser
She says husband died because help was slow to arrive

Victoria Colliver, Chronicle Staff Writer
Thursday, December 13, 2001

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 suffering husband.

"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 hospital network.

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 vcolliver@sfchronicle.com.

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