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News Release: 00-07
GRAY DAVIS, Governor
Date: 05/12/00
WILLIAM KENEFICK, Acting Commissioner
Department of Corporations Takes Enforcement Action Against Kaiser Health Plan
Sacramento, May 12, 2000 — The Department of Corporations today announced it has issued an order against the Hayward, California facility of Kaiser Foundation Health Plan, Inc. for systemic problems that resulted in a death of one of its enrollees in 1996. The enforcement action also includes the imposition of a $1 million administrative penalty against the health plan. The administrative penalty, when collected, will be deposited into the state's General Fund.
The department’s action is the result of an investigation into the death of Kaiser patient Margaret Utterback, a 74-year old plan enrollee, who experienced a ruptured abdominal aortic aneurysm at Kaiser Hospital in Hayward in January 1996. Mrs. Utterback was exhibiting classic symptoms of the life-threatening condition for which her medical history made her a likely candidate. Mrs. Utterback repeatedly sought from Kaiser a same-day medical appointment for persistent back and abdominal pain. She was unable to speak with her doctor, a nurse or other medical professional until she was actually seen eight hours later. Mrs. Utterback died in the Kaiser Hayward Hospital Critical Care Unit a day and a half later.
After its investigation, the department found that Kaiser failed to provide access to basic health care services, including preventive and emergency care, in violation of the law that regulates health plans, the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene Act). The enforcement action comes only after the department’s investigation revealed systemic health care delivery problems.
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