Hospital’s Discharge of Seriously Ill Inmate Investigated

State health officials have launched an investigation to determine whether an Anaheim hospital that provides care for Orange County Jail inmates violated state and federal laws when it discharged a seriously ill prisoner last month on the eve of open-heart surgery.

A public defender and a municipal judge familiar with the case have raised questions about whether the facility discharged the man prematurely to avoid the costs of doing the operation.

Officials at the hospital, Western Medical Center-Anaheim, declined to comment specifically on the case but balked at the suggestion that a patient would be endangered to save money.

Jesus Perez Espinosa, 48, of Orange says he was abruptly forced out of Western Medical by hospital staff Sept. 5, the day before he was scheduled to undergo heart valve replacement surgery.

The unexpected discharge, according to his family, triggered a frantic effort to find him care until Western Medical agreed the next day to readmit him and perform the operation. But that move came only after Espinosa returned to the hospital threatening to sue, family members said.

At the time, the unemployed laborer, who has no health insurance, had been in the jail hospital 1 1/2 months with a host of major health problems after his arrest on drug charges.

“I think they just wanted to get me out of the hospital to avoid the costs,” Espinosa said in an interview. “My life was at stake here and I was very sick. How would you like to be sent home the day before your operation?”

Espinosa’s release has prompted Municipal Court Judge Gregory Lewis, who is presiding over the drug case, and a supervising attorney in the Orange County public defender’s office to look into the discharge, which they said could have been the result of a simple misunderstanding or--at worst--a callous attempt by the hospital to save thousands of dollars. They said they would try to take steps to prevent a similar situation from occurring in the future.

“I don’t want an inmate released because of a medical problem if he is entitled to care under the county guidelines,” Lewis said.

In addition, officials with the Licensing Division of the state Department of Health Services, after learning about the matter from The Times, said they have begun an investigation to determine whether Western Medical violated laws designed to prevent the improper transfer of critically ill patients to other hospitals. The agency has the authority to impose a wide range of sanctions, from fines to pulling the hospital’s license.

Although prohibited from discussing specifics of Espinosa’s care without his permission, Tim Carda, Western Medical’s top administrator, said he was baffled by the assertion that Espinosa was deliberately ejected from the hospital.

“This is not true. There has never been a time when a patient has been forced to leave for financial reasons,” Carda said. “Many patients released from custody continue to receive treatment here, and we provide hundreds of thousands of dollars in care that the hospital is never compensated for. . . . Why would someone make a statement like that?”

Espinosa was first admitted to Western Medical in late July following his arrest on charges of being under the influence of drugs and possessing $15 worth of cocaine and tar heroin. Unable to post $5,000 bond, he was booked into Orange County Jail. The case is pending.

Shortly after his arrest, Espinosa fell ill and was transferred to the jail ward at the hospital, where it was determined that he needed to have a heart valve replaced. The cost of such an operation with hospitalization can run about $25,000, officials said.

Espinosa says his surgery was scheduled for Sept. 6. However, on Sept. 5, Lewis reduced his bail from $5,000 to own recognizance, in effect no bail.

After Lewis’ decision, Espinosa says, he was discharged from Western Medical by staff members who told him to go on his own to UCI Medical Center in Orange. He asserts that he protested when Western Medical wanted him to sign a release form that stated he was voluntarily leaving the hospital against medical advice.

“Our family was upset and all in tears,” said Gloria Arroyo, Espinosa’s sister, who picked him up at Western Medical. “How could they do this? He looked like he was ready to keel over and they told him, ‘You can go home now.’ How can that be?”

The next morning, the family took him, as a walk-in patient, to the UCI emergency room. Elaine Beno, a UCI spokeswoman, said UCI attended to Espinosa but would not admit him because emergency room doctors thought he was the responsibility of Western Medical.

Espinosa and his sister returned on their own to Western Medical’s emergency room. They said the staff refused to accept him until they threatened to sue the hospital. Espinosa eventually received his heart surgery and was allowed to go home on Oct. 11.

Times staff writer Lanie Jones contributed to this report.