Alta Bates Proposal to Close Cardiac Cath Center Alarms Patients

By Riya Bhattacharjee
Thursday April 08, 2010 - 09:04:00 AM
Alta Bates Summit Medical Center is considering closing its cardiac cath lab. The proposal has alarmed patients.
By Riya Bhattacharjee
Alta Bates Summit Medical Center is considering closing its cardiac cath lab. The proposal has alarmed patients.

Alta Bates Summit Medical Center’s proposal to relocate its Cardiac Catheterization Lab from its Ashby Avenue campus to the Summit campus in Oakland has alarmed some longtime patients. 

Considered a lifeline for heart patients in Berkeley, Albany and El Cerrito, the cardiac cath lab program at Alta Bates has been a leader in coronary angioplasty—the process of opening blocked coronary arteries—for more than 20 years. 

But aging facilities and a decision by Kaiser Permanante to not renew its cardiac contract with Alta Bates beyond the 10-year period ending June 30 means that the hospital will have to make some hard choices this month. 

“We are closely examining the possibility of transferring some of the coronary procedures performed in cath lab—less than four a week—to the Summit campus,” said Alta Bates spokesperson Carolyn Kemp. “Regardless, we will maintain cardiac procedures including electrophysiology, ECHO cardiograms and cardiac implant procedures at Alta Bates.” 

Kemp said that without the “Kaiser volume,” Alta Bates will easily be able to relocate services from the “underused” cath lab to Summit. 

Upgrades to the cath lab is estimated to cost at least $2 million, money that Alta Bates parent company, Sutter Health, is not willing to spend. 

The news came as a shock to Berkeley resident Bob Hink, who had an angioplasty performed at the cath lab and is a former member of the Alta Bates Summit Foundation, the hospital’s philanthropic wing. 

“The last meeting I attended in February 2009, we were told that the foundation had $36 million,” Hink said. “And now they are saying they don’t have $2 million to fix the lab? It’s literally a matter of life and death.” 

Hink pointed to the case of a female basketball player at UC Berkeley, who had a heart attack in the middle of the Haas business school courts and was rushed to the Alta Bates cath lab within minutes. 

“She was revived—but would she have had the same outcome if she was taken to Summit?” he asked. “Would she still be walking around?” 

Hink said that Sutter Health was trying to convert Alta Bates into a “baby-making factory.” 

“There’s money in neonatal and ob-gyn, that’s why,” he said. 

Kemp acknowledged there would be changes to Alta Bates’ cardiovascular services because of Kaiser’s decision not to renew their contract. 

“Having said that, before we make any change in a service line, we undergo a thorough and thoughtful process,” she said. “It involves input from physicians, staff and administration—all to ensure appropriate individuals are involved. Excellent patient care has always been our goal.” 

Kemp stressed that the Summit campus is the designated cardiac center for Alameda and Contra Costa counties, with patients being transferred there from hospitals throughout the East Bay, including Eden, Alameda County Medical Center and Alameda Hospital.  

“Just as Kaiser selected our Summit campus as the location for their cardiac program, other medical centers seek the specialized care offered at Summit,” she said. 

Hink said he was worried about losing the amazing group of doctors, nurses and technicians at the cath lab. 

“It’s not going to come back,” he said. “It’s just going to go downhill from now on. We need the cath lab at Berkeley given that we have heart attacks on campus. If someone has a heart attack at the Memorial Stadium at 5 p.m., it will take five minutes to get to Alta Bates but with Summit, you have to go all the way to Oakland. This whole thing is ridiculous.” 

Although Kemp could not specify how many people would be laid off if the lab closed down she said Alta Bates’ goal is “to minimize job losses through attrition, retraining employees for new position, placement services and elimination of registry.” 

Don Goldmacher, who has been visiting the cath lab for the last 20 years, echoed Hink’s concern about how transferring patients to the Summit campus could prove fatal. 

“They are depriving us of an acute hospital facility,” said Goldmacher, a physician who lives nine blocks away from the Ashby campus. “It’s very upsetting.” 

The Philips cath lab at Alta Bates provides more than 200 emergency procedures every year, of which 150 are people who are already admitted in the hospital. The other 40 or 50 show up at the emergency room. 

According to an e-mail from Alta Bates cath lab director Dr. Robert Greene to Hink’s wife, tax attorney Jane Sterzinger, emergency coronary angioplasty has significantly reduced the death rate of the hospital’s heart attack patients. 

Greene said the hospital’s “door-to-balloon times” were consistently better than the national average, with more than 75 percent of the patients having a door-to-balloon time of less than 90 minutes. 

“As you know our cardiac cath lab facilities are failing and are unable to be repaired,” Greene’s e-mail said. “They are in need immediate replacement. Our hospital administrators do not have the funds at this time and will not commit to future funding.” 

Green warned that “if our cath lab is not replaced, all Alta Bates patients with unstable cardiac conditions will have to be transferred to the Oakland campus. All of these patients—including patients having a heart attack—will require summoning an ambulance to transfer them. At the Summit campus they will need to be reassessed by medical specialists using up critical time and resources.” 

Greene pointed out to an analysis by Dr. Ratnaji Nallamothu, which showed that of 4,278 patients transferred from one hospital to the other for emergency angioplasty, only four percent had a door-to-balloon time under 90 minutes. 

“It is well known, the shorter time to treatment—”[also known as] the golden hour”—the better the outcome,” Greene said. “The loss of our cardiac cath lab will lead to longer treatment times and the mortality rate of our patients may increase." 

Greene declined to be interviewed for the story because of ongoing discussions about the issue with hospital administration and staff. 

When asked whether he would visit Summit in the event the cath lab closed down, Goldmacher said, “Where are the other hospitals? Show me the other hospitals.” 

Goldmacher said he was very disturbed that Sutter was consolidating hospitals all over the Bay Area. He said he had complained about the proposed closure of the cath lab to the Berkeley Health Commission and the City Council, but it had been in vain. 

“If people don’t wake up now, no amount of healthcare reform will keep healthcare from being destroyed in our own city,” Hink said.