Emergency Room

Times are tough enough for Californians; they're even tougher for Californians' teeth. "One-quarter of all adults and 28% of children in California have untreated dental caries [cavities]," says Len Finocchio, a senior program officer at the California Healthcare Foundation, a health advocacy group. "Our research tells us that many people in California have been avoiding routine care that might have cost about $100 for a checkup and cleaning, and then find themselves in the emergency room, where they get only an antibiotic, a bill that can average over $600 and instructions to see a dentist."

Just before 10:45 a.m., Keith Marks called 911 and the Los Angeles County emergency response system sprang into action. A fire engine, a paramedic squad and a private ambulance - eight men in total - rushed to the Martin Luther King Jr. urgent-care center in Willowbrook. When they arrived, Marks, 56, was sitting calmly in a wheelchair just outside the entrance. His complaint: he was having joint pain from gout and wanted his medication refilled. "I can't walk," he said.

Just before 10:45 a.m., Keith Marks called 911 and the Los Angeles County emergency response system sprang into action. A fire engine, a paramedic squad and a private ambulance - eight men in total - rushed to the Martin Luther King Jr. urgent-care center in Willowbrook. When they arrived, Marks, 56, was sitting calmly in a wheelchair just outside the entrance. His complaint: he was having joint pain from gout and wanted his medication refilled. "I can't walk," he said.

Our 7-year-old daughter awoke screaming and could not be comforted or touched. We took her to the emergency room. Now our insurance company is denying the visit, saying that it wasn't medically necessary for her to be seen in the ER. Yet the emergency room physician considered a spinal tap to rule out meningitis. How could this visit not be necessary? The situation you describe certainly seems to qualify as an emergency, and you should fight to have your insurer pay for your daughter's ER visit.

Frustrated emergency room doctors filed a class-action lawsuit against the state Tuesday, saying that California's overstretched emergency healthcare system -- which ranks last in the country for emergency care access -- is on the verge of collapse unless more funding is provided. Across the state, scores of hospitals and emergency rooms have shut their doors in the last decade, leading to long waits, diverted ambulances and, in the most extreme cases, patient deaths.

KANSAS CITY, Mo. -- Anna Brown was homeless and had so much pain in her legs that she couldn't walk. When Brown, 29, refused to leave the emergency room at St. Mary's Health Center in Richmond Heights, Mo., a suburb near inner St. Louis, the police thought she was on drugs and arrested her for trespassing. She'd already been examined, and a doctor said she was healthy enough to go to jail. The police carried her into a jail cell by her arms and ankles, her body slackened.

Debbie Cassettari had outpatient foot surgery to remove a bone spur. She arrived at the surgery center at 8 a.m., left at 12:30 p.m., and the bill came to $37,000, not counting doctor fees. In recovery now from sticker shock, she's waiting for her insurance company to do the tango with the clinic and figure out who owes what to whom. Gary Larson has a $5,000 deductible insurance plan, but has found that his medical bills are cheaper if he claims he's uninsured and pays cash. Using that strategy, an MRI scan of his shoulder cost him $350.

The story of 11-year-old Ella Moser's $5,000 tummy ache begins in October, when her Studio City parents called their pediatrician one night and were advised to go to an emergency room, just to be safe. Ella's father, John Moser, was mindful of the fact that emergency room costs can be sky high. He's the son of a doctor who teaches medicine at Yale and has written several articles about excessive medical testing and overcharging. But Ella was in a lot of pain and as the pediatrician had advised, it might be smart to rule out appendicitis and other serious ailments.

New estimates from the U.S. Centers for Disease Control and Prevention show that emergency room visits rose nearly 10% to 136 million in 2009. The agency reported that: ER visit rates were higher for African Americans than for whites.   More than one-third of the ER patients were under 25.   More than three-quarters were prescribed medication.   Most - 85% - of ER patients had some form of insurance. Only a small number - 8% - came to the emergency room with non-urgent issues.

In Southern California -- where the posting of wait times has yet to be adopted -- wait times are even longer than they are nationally. An unpublished survey of Los Angeles County hospitals by the Hospital Assn. of Southern California found that wait times for non-emergency patients averages seven hours. At county facilities, the wait time is 12 hours, said association spokesman Jim Lott, noting that those statistics aren't exactly something most hospitals want to brag about. One area hospital, San Gabriel Valley Medical Center, launched a billboard campaign last year promising no more than 30-minute waits.

Crackdown on pot Re "Raid on pot college stuns activists," April 3 Oaksterdam University founder Richard Lee's disability notwithstanding, the reason I can't get on board with the indignation everyone else has about the raid on the pot trade school in Oakland is because the medical marijuana debate has been co-opted by just plain old potheads who want to get high and, in a lot of cases, make some money. Instead of getting happy about finding a "doctor" so you can get your card for (pick one)

Debbie Cassettari had outpatient foot surgery to remove a bone spur. She arrived at the surgery center at 8 a.m., left at 12:30 p.m., and the bill came to $37,000, not counting doctor fees. In recovery now from sticker shock, she's waiting for her insurance company to do the tango with the clinic and figure out who owes what to whom. Gary Larson has a $5,000 deductible insurance plan, but has found that his medical bills are cheaper if he claims he's uninsured and pays cash. Using that strategy, an MRI scan of his shoulder cost him $350.

Coliseum games Re " Coliseum probe brings three arrests ," March 23, and " Coliseum case widens; six charged ," March 24 What explains the fact that a newspaper usually is the originating source that produces an investigation into financial irregularities or other illegal activity? Why is it not a city, county or state agency - which, theoretically, employ people whose job it is to prevent or uncover precisely this type of wrongdoing? If our government agencies are so incompetent, why do we bother paying for multiple layers of bureaucracy?

KANSAS CITY, Mo. -- Anna Brown was homeless and had so much pain in her legs that she couldn't walk. When Brown, 29, refused to leave the emergency room at St. Mary's Health Center in Richmond Heights, Mo., a suburb near inner St. Louis, the police thought she was on drugs and arrested her for trespassing. She'd already been examined, and a doctor said she was healthy enough to go to jail. The police carried her into a jail cell by her arms and ankles, her body slackened.

The story of 11-year-old Ella Moser's $5,000 tummy ache begins in October, when her Studio City parents called their pediatrician one night and were advised to go to an emergency room, just to be safe. Ella's father, John Moser, was mindful of the fact that emergency room costs can be sky high. He's the son of a doctor who teaches medicine at Yale and has written several articles about excessive medical testing and overcharging. But Ella was in a lot of pain and as the pediatrician had advised, it might be smart to rule out appendicitis and other serious ailments.

The psychiatric emergency services at two county-run hospitals are so overcrowded that mentally ill patients have to sleep on mattresses on the floor, health officials acknowledged this week. The packed conditions at Olive View-UCLA Medical Center and Harbor-UCLA Medical Center make it more difficult to de-escalate the emotions of patients who arrive at the hospital agitated and anxious, said Christina Ghaly, deputy director of strategic planning for the Los Angeles County Department of Health Services.

Grand Junction is heaven for patients with no health insurance, compared to most places in America, at least according to Michael Ervin. Patients in this Western Slope city pay as little as $7 for a visit to the doctor. They enjoy the benefits of preventive care and ready access to specialists. Ervin was 55 when he left his job as an advertising account executive for a simpler life and shorter work hours in Grand Junction. He soon found himself with a major illness requiring neurosurgery.

His smashed finger wrapped in bandages, Len Balon walked into an emergency room and eyed the flat-screen monitor broadcasting live wait times for Scottsdale Healthcare's area hospitals. Osborn Hospital, where he was standing: two hours and 55 minutes. Thompson Peak hospital, a short distance away: four minutes. Balon sat down to read a long Civil War memoir he'd brought in preparation for a long delay. His dread of an emergency room wait was justified. A study released this month found that wait times nationwide had continued to climb over the last 10 years.

A man with two hearts--one his own, one a donor heart--was resuscitated via a defibrillator when both organs developed irregular heart rhythms, a case study reports. The study, published online recently in the journal Annals of Emergency Medicine , chronicles the life-saving measures used in 2010 to save the 71-year-old, who received the donor heart in 2003. He had also received a pacemaker in 2001. The heart was implanted in a heterotopic procedure, which means the patient keeps his heart and receives a donor heart.

Huntington Hospital is more than halfway done with an expansion of its emergency department as it seeks to keep pace with rising demand for emergency room services. The Pasadena hospital's emergency and trauma center has 21 beds. The new center will add 22,000 square feet and contain 50 beds. The $80-million expansion was fueled by several factors that have increased activity at Huntington's emergency room. The first came in 2002, when Pasadena's St. Luke Medical Center closed, making Huntington the hub for 90% of 911 calls in the area.