Signaling that the medical center has failed to correct severe lapses in patient care, the national Joint Commission on Accreditation of Healthcare Organizations voted to begin the process of revoking King/Drew's accreditation.
The proposed move is primarily a huge public relations blow for the Los Angeles County-owned hospital. But it also could have crippling practical effects, including the potential loss of physician-training programs and $14.8 million in private insurance contracts. Another less likely possibility is losing $200 million in annual federal funding if the hospital cannot assure government regulators that it meets their safety standards.
Los Angeles County supervisors vowed to appeal the decision. If the appeal were not successful -- as few are in these cases -- at least one supervisor said he feared that the loss of accreditation would ultimately lead to the hospital's closure.
"How could we face the community in running a hospital if its accreditation had been pulled?" said Supervisor Zev Yaroslavsky. "How could the county or anybody take the risk?"
If King/Drew did lose its accreditation, it could reapply to get it back as one Washington, D.C., hospital did last year.
The deluge of bad news at King/Drew amounted to a "meltdown" that could imperil the large number of poor people in South Los Angeles who depend on its services, said Los Angeles City Councilman Martin Ludlow. "I don't think people are grasping at how massive and catastrophic this is."
In itself, losing approval from the Joint Commission would not force King/Drew to close because hospitals are licensed by state and federal regulators.
But it would add to tremendous pressures on the Willowbrook hospital, south of Watts.
The threat came in the same week that county supervisors announced a controversial proposal to close King/Drew's trauma center, and federal regulators demanded new, outside management at the hospital. Supervisors said they had to shut down the costly trauma service to save the rest of the hospital.
Opposition has been mounting to the plan. On Wednesday, the Los Angeles City Council voted to oppose the closure of the trauma center, which treated 2,150 gunshot wounds and other life-threatening injuries last year.
"We were all shocked and surprised by the sudden decision of the supervisors to close the trauma center," Councilwoman Janice Hahn said in a statement. "Let's not forget the history of this hospital. It rose out of the ashes of the 1965 [Watts] riots."
Council members said closing the trauma center would cost lives.
But several county supervisors and Dr. Thomas Garthwaite, director of the county Department of Health Services, said the Joint Commission's recommendation reinforced their decision to close the trauma unit.
It is one of the most prestigious units of the hospital, but is expensive to run and requires a lot of staff. The resources, they said, were needed elsewhere.
"This shows that we have a hospital in crisis and we have to do whatever is necessary to save it," said Supervisor Don Knabe.
Garthwaite said the accumulation of problems at King/Drew naturally raised the question of whether patients were safe there and whether it should be closed altogether. "None of the choices are ideal," he said. "Certainly no one will rush to the front at other hospitals to take those patients in."
For months, disclosures and sanctions against the hospital have been mounting. Several times, the federal government has threatened to cut off funding for lapses, including giving the wrong patients potentially toxic medications and using stun guns on mental patients.
They also have found that neglect by King/Drew's staff contributed to the death of at least five patients last year.