Chula Vista Hospital Cleared in Inquiry of Patient Dumping

A young man’s broken jaw and his subsequent treatment did not constitute an emergency medical condition that under a new state law would have prevented his transfer from one hospital to another, the state Department of Health Services said Thursday.

The case was the first investigated under the new law, which prohibits “dumping” of seriously injured poor patients by hospitals.

But, although Community Hospital of Chula Vista was cleared of wrongdoing in the inquiry, the case apparently has left a legacy of bad feelings over how it was handled.

Officials of the Chula Vista hospital are upset that UC San Diego Medical Center failed to check with them about the facts of the case before filing the complaint. Had UCSD done so, it would have found that the patient voluntarily left the hospital because of a delay in locating an oral surgeon to repair his jaw, said Imozelle McVeigh, director of community relations for the Chula Vista hospital.

‘A Whole Lot of Time and Aggravation’

“It would have been a nice courtesy,” McVeigh said. “It probably could have saved everyone a whole lot of time and aggravation. Certainly, it would have made our life easier. It would have saved the health department a whole lot of time.”

UCSD officials would not specifically react to the charge, but issued a short statement saying they believed the new state law, which took effect Jan. 1, required them to file a complaint.

“Based upon information we received when the patient in question presented at the UCSD Medical Center emergency department, the medical center’s legal counsel advised that we were obligated to file a report on the case in accordance with Senate Bill 12,” said the statement by Sumiyo E. Kastelic, associate director.

The law provides fines not only for hospitals that dump patients but also for hospitals that suspect a patient was dumped but fail to report it to state authorities.

Ernest A. Trujillo, district administrator of licensing and certification for the county Health Services Department, said UCSD Medical Center filed its report based on information provided by the patient. Neither he nor UCSD officials would provide details.

“The hospital is not in violation of the law. The patient presented himself, was treated, triaged and determined not to be an emergency case. And the situation wasn’t a violation of SB 12,” Trujillo said.

The Patient Was Given Painkillers

McVeigh gave this version of the incident, which apparently was sufficient to clear the Chula Vista hospital:

A 24-year-old man arrived at the Chula Vista emergency room about 2 a.m. Jan. 23 with a broken jaw he had received in a fight. He was examined and X-rayed, put on intravenous antibiotics and given painkillers.

The emergency room staff tried but failed to find an oral surgeon who was willing to come to the hospital to set his jaw at that hour. They suggested the man’s family leave him at the hospital and return about 7 a.m., after which an oral surgeon might be found.

Patient Was Voluntarily Discharged

“The family then insisted, no, they’d rather go somewhere else. So it was a voluntary discharge at the request of the family,” McVeigh said. He then apparently went to UCSD Medical Center.

McVeigh added that, at the time of the incident, the man was believed to be covered by the Medi-Cal program for indigents. In any case, she added, the hospital cares for indigents regularly and does not turn them away.

Trujillo said the investigation involved reviewing records of the case at UCSD and reviewing all 54 emergency cases at the Chula Vista hospital during the last three months. He declined comment on whether the patient himself was interviewed.

The inquiry did find, however, that the Chula Vista hospital needed to keep better records on its emergency cases. “All transfers were appropriate; however improved documentation was required, including records/X-rays sent with the patient,” the report by Trujillo’s office says.

The hospital promised Wednesday to correct the problem.