April 08, 2004, 8:49 a.m.
Life & Death in South L.A.
A hospital in chaos.

LOS ANGELES — When a local story here in southern California tickles the antennae of the exalted ones at the New York Times, you can be sure things have come to a pretty pass. And indeed they have at Martin Luther King Jr./Charles R. Drew Medical Center, in the Willowbrook area of South Los Angeles. The Times reported on Sunday that the hospital has descended into a state of chaos, marked by infighting, racial tension, accusations of corruption, and many, many millions of dollars in malpractice payouts. "King/Drew consistently ranks at the bottom of American teaching hospitals," the article reads. "A report in January by federal health officials said that at least five of the hospital's patients died needlessly last year, and the county authorities are investigating accusations that hospital officials ordered nurses to lie about the abysmal state of things."

The decline of King/Drew Hospital should serve as a cautionary tale to anyone who clings to the notion that health care should be dispensed by the government. Imagine a hospital that makes even the Department of Motor Vehicles look like a marvel of efficiency by comparison. It's one thing to be sent the wrong license plates, it's quite another to be given the wrong medicine, or no medicine at all, both of which have occurred at the hospital with alarming regularity, sometimes with deadly consequences (King/Drew has long been known to cops in the area as "Killer King") The federal government has told the hospital it will begin withholding Medicaid and Medicare payments if conditions don't improve, a move that could cost the facility half its budget, some $200 million per year. The county of Los Angeles is already strapped for cash, and it would have little choice but to close the hospital if these federal dollars are cut off. This would shut down the only trauma center in an area where, sadly, people seem to inflict trauma on one another with an almost casual alacrity: The hospital handled 40 percent of the county's gunshot patients last year.

Built on land where once stood a public-housing project, King/Drew Hospital opened its doors in 1972, seven years after the Watts riot scorched a wide swath of South Los Angeles. (The hospital's website euphemizes the riot as a "social disturbance.") The McCone Commission, impaneled by Governor Pat Brown to investigate the riots, identified the lack of health-care facilities in the area as having contributed to the unrest, and from its inception the hospital was intended to be run by blacks for the benefit of the surrounding black community. This may have made some sense in 1972, when South Los Angeles was still predominantly black, but today the area is about 60-percent Hispanic, yet only 17 percent of the hospital's employees are Latinos. The hospital's administration is almost exclusively black.

Speaking to the New York Times, Connie Rice, a black civil-rights attorney here in Los Angeles, described the situation at the hospital this way: "The hospital is run like a tribal fiefdom, and it's appalling. You can't ask questions because it's a black institution. If you ask questions, they scream racism. But it's not a question of race, it's a question of competence." I'm guessing Rice has never voted for a Republican in her life, but surely that comment had her telephone ringing with accusations of selling out to The Man.

Adhering more to the party line is County Supervisor Yvonne Brathwaite Burke, a black woman whose district includes the hospital. "It's not a matter that you go there and die," Burke told the New York Times, "it's that the press picks up on every little mistake."

Here are some of those "little mistakes," as reported by the Los Angeles Times on March 17:

A woman with respiratory failure and ovarian cancer received the wrong dosage of an antibiotic on Feb. 28; did not receive an ordered dose of a blood thinner on March 1; and was given only three of 12 ordered doses of respiratory drugs from Feb. 28 to March 2.

A stroke patient had to wait nearly five hours for a drug to help prevent heart attacks and recurrent stroke. At one point, pharmacists wouldn't fill the order because a doctor had spelled the drug's name wrong. Later an inspector watched as two pharmacists within half an hour picked up the pill bag and looked at it but did not approve its use.

In the case of a tuberculosis patient, an inspector found a missing dose of intravenous antibiotics on a pharmacy counter more than two hours after it had been ordered, with a sticker that read "missing dose." The inspector noted errors in three of six medications given to the patient.

A paraplegic with a pressure sore and bone infection was not given a laxative suppository that had been ordered and reordered by a physician over at least five days.

It's odd that Supervisor Burke should today be defending the management at King/Drew, for she was once one of the hospital's harshest critics. A Los Angeles Times article from December 1995 described the comparably sorry state of affairs at the hospital at that time, and quoted Burke as demanding change. "Due to a series of highly publicized problems, irregularities, illegalities and tragic mistakes that have occurred at [King/Drew] in the past few years...the public's confidence in this major county medical facility has been shaken," Burke told the paper. "It is unacceptable for anyone who depends on King Hospital — whether they're ill or injured — to fear that they won't get the level of care they expect and deserve."

Whatever steps Burke might have taken to fix things at the hospital since then, conditions have only gotten worse. I know as much about medicine as I do about fixing cars, which is to say not much. But I can walk into a garage or an emergency room and tell fairly quickly if the people working there are competent. Having visited the ER at King/Drew Hospital many times in my career, I can say it's the last place in Los Angeles I'd want to be taken if I were hurt on the job. In fact, I've instructed coworkers that even if I get shot in the waiting room at King/Drew, they're to call an ambulance and have me taken somewhere else.

I'll close with an anecdote: When police officers respond to shootings in Los Angeles, they must advise their watch commanders of the victim's condition so the appropriate detectives can be notified. I was once on the phone with my watch commander as I watched paramedics load a shooting victim into an ambulance. "How's he look?" asked the lieutenant.

"Not that bad," I said, "but they're taking him to King."

"Okay," he said. "I'll call Homicide."

— Jack Dunphy is an officer in the Los Angeles Police Department. "Jack Dunphy" is the author's nom de cyber. The opinions expressed are his own and almost certainly do not reflect those of the LAPD management.

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