Fiscal Concerns Led to Death, Widower Says : Malpractice suit: David Ching testifies against two Simi doctors. Radiologist supports him. Judge will hear arguments for a mistrial.

In a day punctuated by tears and angry objections by defense lawyers, David Ching testified Thursday that he believes two Simi Valley doctors let his wife Joyce die of colon cancer because they didn’t want to lose money by referring her to a specialist.

“She was in a lot of pain,” Ching said, recalling how his wife lay balled up in agony as he tried to get doctors’ permission to take her to the emergency room. “She wasn’t getting better. Nothing was being done.”

Supporting Ching’s testimony was Dr. Charles J. Aucreman, a Simi Valley radiologist who examined Joyce Ching shortly after her primary care physicians reluctantly sent her to the specialist.

“The first thing I concluded [after the examination] was Mrs. Ching was the victim of a tragic delay in diagnosis,” Aucreman told the Ventura County Superior Court jury. “My second conclusion was she had a very serious problem.”

The defense objected to the doctor’s statement and requested an immediate conference in judge’s chambers that lasted for half an hour and resulted in defense motions for a mistrial. Judge Ken Riley said he would hear arguments for a mistrial Monday and prohibited lawyers from discussing the issue with the media.

Ching is suing his wife’s primary care physicians, Elvin Gaines and Dan Engeberg of Simi Valley Family Practice, alleging the two doctors failed to diagnose his wife’s cancer or send her to a specialist for a crucial 11 weeks as her health steadily deteriorated.

Ching and his lawyer, Mark O. Hiepler, allege the doctors were negligent because of monetary concerns: They belong to an HMO system that generally pays a flat rate for patient care and rewards primary care physicians for cutting down on treatments and referrals.

The defense claims Gaines and Engeberg did everything professionally possible to treat the ailing woman.

An emotional, soft-spoken Ching spoke of his frustrations in dealing with Gaines and Engeberg as his wife lay in pain the weekend before she was finally diagnosed with cancer.

Ching said he called the doctors repeatedly that October weekend in 1992 to ask about his wife, who was in extreme pain “either curled up on the couch in a ball or sitting on the toilet.”

When Ching asked whether he should take her to the emergency room, Gaines, he said, told him “it wasn’t necessary” and recommended applying a hot water bottle to his wife’s abdomen and giving her painkillers.

That Monday, Gaines insisted the couple come in for an appointment, Ching said.

Ching expected bad medical news, but what he got, he said, was a mean-spirited and loud lecture while his wife lay curled in pain on the examination table.

“He said to us, ‘I don’t appreciate the way you were crapping on us all weekend. I don’t appreciate all the telephone calls. A lot of people appreciate us here. We don’t need your crap,’ ” Ching testified. “We were shocked and humiliated.”

Then Gaines told the Chings to find another doctor, Ching said, wiping away tears.

Joyce Ching saw another specialist that afternoon and was diagnosed with cancer the next day. She died at age 35 in April, 1994, leaving David a single parent of their son Justin, now 5.

During a short cross-examination, defense attorney Michael Gonzalez pointed out Ching made no mention of the acrimonious encounter with Gaines a year ago during deposition.

Gonzalez then asked why Ching did not take his wife to the emergency room that weekend. Ching responded that his insurance booklet stated he must first seek the permission of his HMO.

Said Gonzalez: “So you let some policy stand in the way of taking your wife to the emergency room?”

Before Ching could respond, Gonzalez withdrew the question.

A good portion of the day was also spent putting a human face on Joyce Ching and the suffering felt by David Ching and his son.

The couple met while working on an assembly line in Hayward, Calif., and got married years later.

Ching described his wife as an active woman who spent much of her time playing with her infant son in a nearby park.

That life changed as Joyce’s health slowly deteriorated and she spent days resting and giving herself enemas and swallowing painkillers.

Since her death, their son Justin sleeps with a lock of his mother’s hair and watches family videos to remember what his mother looked like.

“He misses their trips to the park,” Ching said.

“Last night Justin asked me if when I die, will he die with me because he doesn’t want to be left alone,” said Ching, whose remarks were followed by a family video of happier times.