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Reader Stands by Her Assertions About Alameda Hospital

Dear Editor,

In her open letter, the Alameda Healthcare District’s board director Jordan Battani calls my recent op-ed rumor and innuendo. She wants facts.

Regarding my personal experience at the hospital this summer:

Fact One: The Alameda ER written report that details the very real physician and nurse failures that nearly killed me…and the doctor’s documentation errors…he listed me as a child brought in by her parent! I assure you, I am not a child!

Fact Two: The Alameda Hospital bill of $10,000+ for the ER visit and for imaging later that same month; all was comped; I did not pay one dime.

Regarding new hospital strategies:

Fact Three: The Alameda Hospital’s CEO Deborah Stebbins’ presentation at City Hall outlining a. the new revenues they are getting from receiving emergency cardiac patients and funneling them over to Alta Bates, and b. the new revenues they intend to get with a new stroke program that will funnel emergency stroke victims to Eden (a trauma center).

Fact Four: Alameda County EMS (emergency medical services) Manual dated March 11, 2010 (bolded font is from the document): “Certified Stroke Centers: The following hospital have been designated as certified stroke centers. Patients should be transported to one of the facilities if possible. Exception: patients in the City of Alameda should be transported to Alameda Hospital”. Every city in Alameda County is compliant with the California State Master Plan for stroke care which “requires identification of eligible stroke patients in the field [paramedics] and preferential transport to stroke centers”… except the City of Alameda.

Fact Five: Delivery into a certified stroke center is to enable accurate diagnosis in the shortest time possible in order to “identify CVA [stroke] patients who may be candidates for thrombolysis and specialized care at a certified stroke center.” Any delay in delivering a stroke patient directly into a certified stroke center increases the probabilities for permanent damage and death.

Fact Six: Even when a stroke victim is delivered directly into a certified stroke center, these highly adept systems achieve their treatment goals less than 50% of the time. Extrapolated Fact #1: stroke victims being routed through Alameda Hospital and over to Eden (not a certified stroke center) stand even less of a chance of getting the right treatment within the critical therapeutic window of time. Extrapolated Fact #2: stroke victims transported directly into Summit’s certified stroke center (3 to 5 miles away) stand the best chance of getting the right treatment on time.

Fact Seven: Time is Brain. Stroke is the 3rd leading cause of death in California and the #1 cause of serious, long-term adult disability in the United States. Each year, stroke kills more than twice as many American women as breast cancer. Among women over age 45, stroke is more common than heart attack. African-Americans not only have a higher incidence of strokes than Caucasians and Hispanics, but they also suffer more extensive physical impairments that last longer than those of other racial groups in the U.S.

Fact Eight: Every 45 seconds someone in the U.S. will experience a stroke. If you suffer a stroke in the City of Alameda, paramedic must take you to Alameda Hospital. where they do not have the resources (technology, disease expertise) to deliver comprehensive stroke care but can only reroute you to a facility that does.

Fact Nine: The major benefit of administering IV tPA (clotbuster drugs) occurs within 90 minutes of stroke onset. That’s why current medical standards call for field (paramedic) diagnosis and preferential (direct) transport to a certified stroke center so that treatment can begin within 90 minutes. Every second the brain is deprived of oxygen, 32,000 brain cells die.

Certified stroke centers, like the one at Summit, only 3 miles away, can best assess and treat stroke, and meet the 90-minute therapeutic window. Tell me again, why do we get routed through Alameda Hospital for a stroke? Follow the money.

I don’t think sounding the alarm about the hospital’s new strategies, and the corollary board members’ failures to represent our best interests, is out of line, do you?

Again, we need to fix this. And we can start next week on November 2nd: vote Chen and Gorelick onto the hospital board and do not vote Bonta onto city council!

— Denise Lai, Alameda

7 comments to Reader Stands by Her Assertions About Alameda Hospital

  • Trish Herrera Spencer

    As a 3-year breast cancer survivor, I go to Alameda Hospital for follow-up visits (no tests/lab work) with my oncologist, however, I do my mammograms at Carol Ann Read Breast Health Center (Alta Bates Summit) in Oakland. Per their website, “Our new General Electric Senographe DS digital mammography system, in conjunction with state-of-the-art ultrasound equipment, offers clearer imaging, faster processing, greater accuracy, and improved patient convenience. This new technology also allows for lower dose radiation exposures than the traditional film mammography. Radiologists can easily see through dense breast tissue that may hide suspicious masses or calcifications. Digital mammography takes seconds for the images to be viewed, reducing the patient’s exam time. Images can be stored in the hospital’s computer, and even burned to a disc allowing the patient and physicians to easily view and share information.”

    “A study performed by the National Cancer Institute found that digital mammography was a much better screening device for younger women under age 50 and any woman that has very dense breasts, which made film mammograms difficult to read.”

    Unfortunately, Alameda Hospital only offers analog mammograms. When I checked with them in Sept., I was told they’re “in the process of installing digital mammo and renovating/digitizing much of the Imaging department, but this most likely won’t be completed for several months.”

    I was 47 when diagnosed. When I became suspicious of a lump, my girlfriend (a doctor) told me to get a “digital” mammogram. Early detection is critical for survival. I don’t think analog mammograms should be offered. As a patient, I want “state-of-the art” equipment.

  • DHL

    Trish: There’s a statistically significant increase in the risk of stroke seen among women with a history of breast cancer. Hopefully, you’ll never have a stroke, but because some of us are at higher risk for having a stroke, these hospital programs and EMS protocols should give us serious pause. We all want and deserve optimum care in an emergency. For a CVA, that means paramedics take us directly into Alta Bates Summits’ highly qualified stroke center. Or Eden; Eden just got their certification for being a stroke center in August 2010; so I imagine that going directly to Eden might be the better choice from Bay Farm Island and maybe even the most eastern parts of the East End; I don’t know. The EMTs would know. We should ask them. There are statistics that show a significant increase in survival and reduced brain damage when the CVA victim is taken directly to a certified stroke center. For subarachnoid hemorrhagic strokes (3% of all stroke victims), the likelihood of survival is increased by 25%. In Alameda, we’ve got just under 600 strokes per year (extrapolating from US stroke statistics), which means around 18 of these kinds of strokes per year! that 18 people who would not get the care they need and would probably die. These are the 18 people that Dr. Deutsch apparently thinks don’t matter when he, defending the new hospital strategies, told me:” the percent of people that require that [a certified stroke center] is so small.”

  • Dr. Deutsch has not responded to repeated requests, one directly to him, and the other via Hospital spokespersons who provided the Battani letter, to clarify statements attributed to him by Ms. Lai about the EMS Field Manual directing paramedics to take stroke victims to Alameda Hospital instead of a regional stroke center.

  • DHL

    Correction to my Letter: Someone told me that Eden received their stroke center certification in August 2010. Eden was not, and still isn’t, listed as a certified stroke center in the list of stroke centers in California:
    And I can’t find the listing at the Joint Commission.
    On the landing page of their website, Eden says they are certified by the Joint Commission as a stroke center; so we can assume this is true. I have not been able to find confirmation of this fact elsewhere. URL anyone?

  • As I have written elsewhere, I worked in healthcare marketing for many years, and sat in a lot of meetings where physicians discussed openly various ways to game the system. Billing Medicare, oberbilling patients, ordering unnecessary tests they profit from, the woiks!

    Consequently, I question everything my docs and hospitals do, and often catch them at irregularities. I worked at a University for 20 years, and trust me, PhDs are a lot smarter than M.D.s! I was recently prescribed heavy doses of a diuretic called Lasix, because I’m on dialysis, but was experiencing a common side-effect, “Severe Drowsiness.” I was often comatose, housebound, even bedridden. I stopped tailing it, and immediate improved. Telling everyone I know taking Lasix to try going without it.

    The moral of this story is that you have to be your own front line caregiver and advocate. And if Alameda Hospital is putting patients at risk, those patients need to notify the JCAH, Joint Certifers Association of Hospitals, so they can do a surprise inspection.

  • Trish Herrera Spencer

    Thanks, DHL! I appreciate the additional info. I wasn’t aware of the increase in stroke risk. Thank you!

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