In summary
An emergency trip to the hospital turned disastrous for a Los Angeles-area family when Joshua Saeta’s condition deteriorated, leaving him permanently incapacitated. In a lawsuit, the family says nurses later told them the hospital was dangerously understaffed.
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As he lay tethered to a hospital bed by tubes and wires, Joshua Saeta told his sister his stomach hurt so badly he would take a knife and cut it open to relieve the pressure if he could.
He had been admitted earlier in the day with severe abdominal pain and was swiftly deteriorating. His words slurred together and he couldn’t count backwards from 10. His left eye wandered, and his belly was badly distended, his family says.
His sister went in search of a nurse or doctor to talk to and found the floor “desolate” of personnel.
“I couldn’t find a nurse anywhere to talk to. I was literally walking the halls,” Jennifer Saeta said, recounting the day in February 2017 that changed everything for the family. “It got worse and worse. His eye wandering, all of that was getting worse but no neurologist ever came. No cardiologist ever came. Nobody came.”
Roughly 16 hours after his arrival, Joshua Saeta’s heart stopped beating. It took 14 minutes and 5 seconds to resuscitate him, according to a recent lawsuit filed in Los Angeles Superior Court. Without his heart pumping blood and oxygen to his brain for so long, Joshua Saeta suffered a disabling brain injury. Now, he can’t walk or talk and he requires around-the-clock care.
Seven years later, his family is still trying to piece together what went wrong. In the lawsuit, they allege Joshua Saeta’s injury was caused by dangerously inadequate staffing. It’s the second lawsuit from the family against West Hills Hospital and Medical Center, which is owned and operated by HCA Healthcare. The first alleges malpractice, and it is also playing out in Los Angeles Superior Court.
The new complaint offers a glimpse into hospital staffing practices that labor groups have long asserted are insufficient. California has laws on the books that dictate hospital staffing minimums, but state records show hospitals are rarely penalized.
Prior to his injury, Saeta worked in visual effects on major movies, including the “Chronicles of Narnia: The Lion The Witch and the Wardrobe” and “Django Unchained.” On Thursday, Joshua’s sister and father wheeled him into a hearing at the state Capitol that included a discussion on the state’s staffing law.
“Let them see what they did to him,” Jennifer Saeta said.
West Hills Hospital has not filed a response in court to the Saeta family’s new claim, but spokesperson Aimee Bennett said in a statement that the hospital will “vigorously defend the care provided in this case.”
“Our top priority remains the safety of our patients and colleagues and West Hills Hospital is proud of our long-standing track record for delivering high-quality care,” Bennett said in the statement.
Union sees ‘unsafe hospital staffing’
The lawsuit says an emergency room doctor ordered Saeta to the intensive care unit two and a half hours after he arrived via ambulance at West Hills Hospital, noting his condition was “very unstable.” According to the lawsuit he had pancreatitis, possible sepsis, electrolyte imbalances and heart abnormalities. Twelve hours later, a second doctor again ordered Saeta be transferred to the ICU, the lawsuit states.
Hospital staff did not transfer him to the ICU. Instead, he remained in a unit that was not equipped or staffed to care for someone as sick as him, the family alleges in the lawsuit.
A nurse found Joshua Saeta at 7:21 a.m. unresponsive and not breathing, the lawsuit states. The alarms on his heart monitor had been turned off, his family said.
West Hills Hospital denied all allegations of malpractice in the family’s initial lawsuit against the company. In a July brief, an attorney for the company wrote that Saeta received “appropriate care” from nurses and doctors.
The attorney wrote that “West Hills disputes the contention that plaintiffs cardiac arrest would have been responded to differently had he been in the ICU, and contends that the response in this case was timely and appropriate.”
Saeta’s family and the union representing nurses at West Hills Hospital say the circumstances of his injury call attention to the consequences of unsafe staffing and ineffective oversight.
California is the only state to limit the number of patients a nurse can be responsible for at any one time in every unit. That number varies based on the severity of care a patient needs. In an intensive care unit — like the one doctors had ordered Saeta be transferred to — nurses are supposed to care for at most two patients and provide almost constant monitoring.
Instead, according to the lawsuit, Saeta’s medical record indicates there were so few staff at the hospital that critical laboratory test results were delayed and he was never transferred despite pleas from overburdened nurses, the lawsuit says. Legal documents show the Saeta family and West Hills Hospital disagree on how frequently medical personnel checked on Joshua Saeta in the hours leading up to his cardiac arrest.
“If the allegations made in this case are true, what happened to Josh Saeta demonstrates the real human cost when unsafe hospital staffing goes unchecked,” said Leo Perez, president of SEIU local 121RN, the union representing nurses and other medical staff at West Hills Hospital.
Perez said Saeta’s story is not an isolated incident and that nurses work with the “constant fear of failing their patients” because of unsafe staffing conditions.
California hospital staffing penalties are rare
California first adopted a nurse staffing law in 1999. In 2020, the state added administrative penalties for hospitals that violate nurse-to-patient staffing standards.
Labor groups often accuse hospitals of purposefully staffing wards with too few or too inexperienced personnel to save money, while hospitals frequently cite California’s ratio regulations as a financial burden that drives up costs and prevents them from responding quickly during emergency situations like the COVID-19 pandemic.
The state granted many hospitals reprieve from staffing requirements during the height of the COVID-19 pandemic, but unions say the California Department of Public Health has never adequately enforced existing laws.
Last year, lawmakers attempted multiple times to address the staffing enforcement issue. They sent a letter to the public health department detailing complaints of patients abandoned for hours and nurses unable to take bathroom breaks at various hospitals. Legislators also passed a union-backed transparency measure requiring the public health department to publish an annual report on its investigations into staffing violations. Gov. Gavin Newsom vetoed the bill, stating much of the information it requires is already available.
Cassie Dunham, deputy director for the Center for Health Care Quality, the division of public health that oversees medical facility regulations, fielded questions from state lawmakers about enforcement at last week’s hearing.
She said the department “takes allegations of staffing non compliance very seriously” but acknowledged under questioning that the department had “possibly” not begun investigating complaints until September.
“We get complaints from constituents who work in hospitals about the fact that they report situations, and nothing seems to happen.”
state sen. richard roth, democrat from riverside
At the hearing, lawmakers accused the Center for Health Care Quality of not being transparent about enforcement and repeatedly not providing data.
“We need to know what’s going on because we get a lot of complaints. We get complaints from our constituents. We get complaints from patients about care issues, and then we get complaints from constituents who work in hospitals about the fact that they report situations, and nothing seems to happen,” Senate health chair Richard Roth, a Democrat from Riverside, said during the hearing. “That may or may not be true (but) we need to be in a position to respond.”
Learn more about legislators mentioned in this story
Richard Roth
State Senate, District 31 (Riverside)
State Senate, District 31 (Riverside)
The department is currently developing a publicly available investigations dashboard in response to Newsom’s veto directives, Dunham said.
According to state data, nine penalties have been levied against California hospitals over staffing violations between 2020 and 2023. West Hills Hospital was not one of them. The public health department has investigated and substantiated 19 incidents of staffing violations at West Hills Hospital in that timeframe without levying penalties, according to a union review of state records.
Joshua Saeta’s career in film
Before the “incident,” as his family refers to it, Joshua Saeta was an accomplished visual effects supervisor, a musician and a charismatic and kind uncle. He recently turned 40 and had just returned from Morocco where he worked on the Hollywood thriller “Beirut” with his father and executive producer Steven Saeta.
In the evenings after filming, Steven Saeta said his son would join him on the hotel balcony overlooking where the Mediterranean Sea and Atlantic Ocean met for a glass of scotch and a chat. Their careers had taken them to six of the world’s seven continents, and they promised to take a father-son trip to the last one, Antarctica.
“I’m still waiting,” Steven Saeta said.
When Joshua Saeta returned from Morocco he received a blunt abdominal blow during a martial arts class that sent him to the hospital. His family did not know how critical his condition was, they said. If she had known, his sister Jennifer Saeta said she never would have left his bedside to go home and rest. It wasn’t until the Saeta family requested his medical record and noticed the ICU transfer orders that were never filled that they started asking questions.
In November, the Saeta family joined a three-day strike held by SEIU RN Local 121, where nurses were protesting unsafe staffing at three Southern California HCA-owned hospitals including West Hills. Some of the nurses on the picket line remembered Joshua Saeta, they said, and that’s when all of the pieces began to fall into place.
The Saetas don’t blame the nurses or other medical staff, they said. They place the blame squarely on hospital administration and believe Joshua Saeta “represents all of the nurses at West Hills,” the family’s lawyer Deborah Chang said.
The family has asked a judge to combine the new case with the ongoing medical malpractice lawsuit against West Hills Hospital and they are aiming for a trial in June.
“He has survived to tell the story,” Jennifer Saeta said. “He’s here right now, not standing, but to tell his story to save the lives of the people ahead of him.”
Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.
