Kaiser Foundation Hospital Sunset, Los Angeles, agreed to pay $20,000 to settle allegations that it violated the 1986 Emergency Medical Treatment and Active Labor Act. In October 2001, an 83-year-old man in critical condition arrived at 153-bed Sherman Oaks (Calif.) Hospital and Health Center. After the man was stabilized, Sherman Oaks requested a transfer for emergency bypass surgery to 384-bed Kaiser Sunset. A cardiac surgeon at Kaiser Sunset allegedly refused to accept the patient on the grounds that he was too unstable for transfer and would "die anyway." The man was transferred to another hospital, successful bypass surgery was performed, and he was discharged in good health.
Under EMTALA, which prohibits so-called "patient dumping," the physician faces no charges, but the hospital is liable. HHS' inspector general's office said that while the physician was the primary wrongdoer, the hospital was liable because it didn't have an effective procedure for reviewing physician decisions. Kaiser spokeswoman Pamela Dean said the hospital has reviewed and improved its transfer policy because of the incident. "We've put in procedures that kick up a doctor's decision to deny a transfer or refuse to accept a patient to a higher level of review and bring in another physician to make a final decision," Dean said. The case is the 12th EMTALA settlement in federal fiscal 2003, which began last October. -- by Mark Taylor