Doctor ‘Dumped’ Indigent Patient, State Panel Told

A former emergency room physician at Panorama Community Hospital sent an indigent man to a county hospital for treatment even though the man was going into shock and could have died in transit, a physician testified Wednesday during a hearing before a state medical panel.

Dr. Stephen C. Acosta could lose his medical license if the four-member Medical Board of California panel upholds a claim that he illegally “dumped” patient Felix Talag because the man could not pay for treatment. Talag, who was 67 at the time, went to the Panorama City hospital on April 11, 1987, because he had been vomiting blood and felt dizzy.

The medical board, represented by the state attorney general’s office, has accused Acosta of gross negligence, incompetence and general unprofessional conduct, charges that Acosta denies. The board’s complaint states that Acosta sent Talag away because he was concerned that the patient “could not pay for the required hospitalization.”

“The patient was going into shock,” testified Dr. Lawrence Yeager, a consultant for the medical board. “He had to be put in much better condition before being transported. He could have bled to death in the car.”

The panel’s recommendations are subject to approval by the full board. It could take three to four months before a final decision is reached, authorities said.

Talag, a Philippine national who was visiting relatives in Los Angeles, was taken from Panorama to Olive View in the family car, admitted to the intensive care unit and eventually recovered. He was suffering from two ulcers that may have been made worse by aspirin, testified Dr. Robert Galli, the attending emergency physician at Olive View who helped treat Talag.

Yeager and Galli were among three physicians to testify during the first day of the two-day hearing in downtown Los Angeles. Acosta’s attorneys, David Kalifon and John D. Harwell, said they plan to call Acosta to the witness stand today. They also intend to question members of Talag’s family who accompanied him to the hospital, as well as others who are familiar with Acosta’s work.

Harwell said outside of the hearing room Wednesday that it was Talag, not Acosta, who insisted that the patient not be treated.

“The mistake the state has made is that they believe Dr. Acosta refused to treat the patient,” Harwell said. “In fact, it was Dr. Acosta’s recommendation that the patient be admitted immediately to Panorama and that he promptly be given proper treatment. The family were concerned about the cost and asked if there was a cheaper place.”

Acosta, who no longer works at Panorama hospital but is still practicing, examined Talag and determined that he was suffering from an “acute episode of gastrointestinal bleeding,” the board’s complaint states. Tests taken at Panorama hospital showed that Talag had substantially lower than normal blood-cell counts and exhibited potentially serious drops in blood pressure when he would sit up, the complaint alleges.

Galli testified that physicians at Olive View were unable to obtain a pulse by feeling the patient’s wrists and could not detect his diastolic blood pressure.

“It would appear . . . that he was already critically ill” at Panorama hospital “and was more critical when he arrived” at Olive View, he said.

The case is the second of its kind to come to light recently involving alleged “dumping” at Panorama Community Hospital. In December, the Los Angeles city attorney’s office filed a misdemeanor charge against an emergency room nurse at the hospital who allegedly denied care to a seriously ill baby girl in December, 1988. The girl survived after being treated at Olive View, but she lost a foot to gangrene.