A state investigation found San Dimas Community Hospital forced poor women in labor to pay cash for epidural anesthesia during childbirth, a county health official said Tuesday.
In a continuing inquiry of hospitals, San Dimas becomes the sixth area hospital discovered to have demanded cash for anesthesia from women in labor.
Northridge Hospital Medical Center, where the practice was first discovered, still appears to be the hospital where the majority of cases occurred. The four other hospitals that demanded cash for the anesthesia are Whittier Hospital Medical Center, Providence Holy Cross Hospital in Mission Hills, Queen of Angels-Hollywood Presbyterian Medical Center, and Pomona Valley Hospital, said Ken August, spokesman for the California Department of Health Services.
Two other hospitals--Presbyterian Intercommunity Hospital and Martin Luther King in Orange County--are still under investigation, August said.
State health administrators have stated that physicians and hospitals are prohibited from charging Medi-Cal patients for services that the agency covers.
At San Dimas Community Hospital, Los Angeles county health officials investigating a complaint confirmed that anesthesiologists refused to provide epidurals to Medi-Cal patients until payment was received. In one case in March, a woman in labor was admitted to San Dimas and endured more than four hours of severe pain. Her obstetrician had ordered an epidural for pain relief at 11:45 p.m. But that order was not carried out until 4:30 a.m., after her family had provided cash payment to the anesthesiologist.
Jean Olander, health facilities manager for the Los Angeles County Department of Health Services, said the practice was allowed to continue until June.
Patrick Petre, chief executive officer at San Dimas, conceded there had been a "delay in service."
"The important thing is what happens in the future and I think any hospital still allowing this to happen is very foolish," Petre said.
The investigation stemmed from reports in The Times that Medi-Cal patients at Northridge Hospital Medical Center had been asked to pay $400 in cash.
Ozzie Chavez, a North Hills mother, was denied the spinal anesthesia at Northridge last summer. She never got the epidural and the birth was even more painful because the child became stuck and the obstetrician had to pull the baby out.
Northridge was cited for breaking six state regulations and ordered to refund payments to as many as 300 women.
Outrage over the practice prompted Assemblyman Martin Gallegos (D-Baldwin Park) to sponsor a bill that would forbid doctors from withholding pain relief from women and declare it unethical to deny anesthesia from any patient based on financial resources.
The Legislature passed the bill last month, but Gov. Pete Wilson has not yet taken a position.