Inquiry Under Way After Death of Man Nine Hospitals Barred

Medi-Cal officials said Wednesday that they are investigating the treatment of a Westminster man who was injured in a traffic accident and subsequently died after he reportedly was refused admission by nine hospitals in Orange, San Diego and Los Angeles counties.

The family of Juan Jimenez Collado said Wednesday that the 43-year-old former professional boxer probably would have survived if he could have been transferred from a rural Imperial County hospital to a large, urban hospital with sophisticated specialists on staff.

But, saying they were full, were too far away or didn’t take Medi-Cal patients, hospital after hospital declined to accept Jimenez. He died Sunday at the small community hospital that first cared for him--the 80-bed Pioneers Memorial Hospital in Brawley.

“Everybody rejected him and we believe the reason they rejected him was that he had no money,” Jimenez’ stepson, David Carrillo, said bitterly Wednesday.

‘It Was a Crime’

Added Jimenez’ widow, Leticia, who was with her husband when he was struck by a hit-and-run driver on May 30, “Of course it was a crime” that he could not be moved to a bigger hospital. “The medical system is very wrong; what they want is money, when a life would be No. 1 priority.”

Pioneers nurse Nicholas Aguirre, who spent more than two weeks seeking a transfer for Jimenez, said the situation was one of “try to keep him here and lose him--or try to transfer him to maximize care . . . The question remains, why couldn’t we transfer him?”

At Medi-Cal’s regional office in San Diego, administrator Maria Leslie said her investigators want to know if any hospital violated its Medi-Cal contract when it rejected Jimenez.

By law, no hospital can be ordered to accept a patient, but hospitals with Medi-Cal contracts are supposed “to take reasonable steps to assure that a Medi-Cal patient receives appropriate care,” Leslie noted.

Leslie said her staffers on June 8 approved Jimenez’ transfer to a larger hospital. Why he was never moved remained unclear.

“I can’t comment on whether this patient would have survived” if he had been transferred, Leslie said. “That’s what this investigation will probably involve.”

Also studying the Jimenez case were University of California officials. Acting at the request of Assemblyman Steve Peace (D-Chula Vista), they were considering a probe into why three UC hospitals--UCLA, UC San Diego and UC Irvine medical centers--had declined to admit Jimenez.

Peace field representative Charlene Rollbusch said the assemblyman was assured last Thursday that either UCSD or UCI could give Jimenez a bed. The next thing he knew, Jimenez had died in Brawley, she said.

“I want to know why nothing was done while we both received assurances that the situation was being taken care of,” Peace demanded in a letter sent Monday to UC government relations director Stephen A. Arditti.

In addition, a spokesman for the state Attorney General’s office said his office may look into the situation. “There are requirements that emergency rooms must treat people who are brought to them,” said spokesman Alan Ashby.

“This is a case of rejection by telephone,” Ashby said. “He was in hospital where the doctors felt they were unable to provide the quality of medical treatment that was required. In that sense, it’s almost like he was in an ambulance. It’s something we could have jurisdiction over.”

Meanwhile, officials from many of the hospitals that rejected Jimenez maintained that they had no other choice.

At St. Joseph Hospital in Orange, callers Wednesday had complained: “How could you turn away a dying man?” spokesman Dennis Gaschen said. But he said that St. Joseph does not have a Medi-Cal contract, and so, by law, is not allowed to accept the transfer of a Medi-Cal patient.

Gaschen added, “It’s a shame that the man passed away, but it’s our belief the man did not pass away from being refused to be transferred.”

Closer to Home

At UC San Diego Medical Center, spokeswoman Pat Jacoby said officials there had suggested that Pioneers refer Jimenez to the medical center nearest his home--UC Irvine Medical Center in Orange.

However, UC Irvine Medical was full when the call about Jimenez came in, according to medical center spokeswoman Elaine Beno. “He needed a surgical intensive care unit bed-- which we didn’t have at the time of the call,” she said.

Pioneers’ Aguirre also contacted Grossmont Hospital in La Mesa, just east of San Diego, but was told that Grossmont was not a licensed trauma center and did not handle trauma patients such as Jimenez.

At Mercy Hospital in San Diego, spokeswoman Laura Avallone said Pioneers was asked to call a physician with more detail about Jimenez’ case, but she didn’t know what happened after that first call. At Sharp Memorial Hospital in San Diego, spokeswoman Cindy Cohheen said the hospital never refused care. As far as she knew, Cohheen said, no Sharp physician was ever contacted about Jimenez’ case.

And at UCLA, officials there decided Jimenez could be treated at a closer hospital. “We told them there are a lot of hospitals between UCLA and Imperial County that could adequately serve” him, said spokesman Jeff Otten. Otten added that the hospital’s intensive care beds were full at the time Pioneers called.

Aguirre said he also contacted Fountain Valley Regional Hospital and Medical Center in Fountain Valley and Western Medical Center in Santa Ana. Officials from those centers could not be reached for comment Wednesday.

Jimenez was critically injured May 30 at 2:15 a.m. when he stopped beside Highway 111 north of Niland in Imperial County to work on his overheating truck and was struck by a hit-and-run driver.

He suffered major injuries--massive head injuries and “the right side of his body was literally shattered,” California Highway Patrol officer Christina Moore reported.

At the nearest hospital, Pioneers, doctors quickly determined that Jimenez needed more sophisticated care than their small hospital could offer.

“He needed an orthopedic specialist, a cardiovascular specialist, a kidney specialist,” Jimenez’ stepson Carrillo said.

Nurse Aguirre said he began contacting other hospitals soon after Jimenez was admitted. At one point, Sharp Memorial Hospital indicated it would take Jimenez, Aguirre said. But then a snafu involving Jimenez’ Medi-Cal paper work held up the transfer.

“Each time we got into a block fence,” Aguirre said. And all along, Aguirre said, “We knew this patient was going to die if we didn’t transfer him some place” that was “better equipped.”

When Jimenez died Sunday, officials with the Imperial County coroner attributed the cause to gangrene in his legs and a problem with blood clotting.