Politicians and others fighting to save the endangered trauma center at Martin Luther King Jr./Drew Medical Center have called it "a model for the country" and "the crown jewel" of the hospital.
The reality, however, is more complicated, according to confidential reports obtained this week by The Times.
King/Drew's trauma unit saves hundreds of lives annually. About 90% of patients survive, even though many come in with life-threatening injuries, hospital statistics show. The military recently sent doctors there for training in how to treat severe gunshot wounds.
But a March 2003 inspection report by the American College of Surgeons suggests that the prized unit has been afflicted recently by some of the same problems plaguing the hospital as a whole -- especially the failure to identify and correct mistakes.
Shortcomings at the Los Angeles County-run hospital were considered serious enough that the surgeons group refused to give its seal of approval to King/Drew last year.
It initially pulled King/Drew's certification in 1999, a move that was described as rare by a top medical official with the organization, which verifies the quality of trauma units nationally.
In the 2003 report, expert reviewers from the surgeons group concluded that the King/Drew trauma unit failed to properly investigate questionable patient deaths, and that doctors routinely skipped meetings held to discuss treatment problems.
In addition, physician trainees were left unsupervised while resuscitating patients, and the unit closed too often to ambulances, according to the report.
Among the cases found troublesome by reviewers, who are familiar with the demands of busy urban trauma units, was that of a 22-year-old stabbing victim.
The inspectors said the woman could have lived had a surgeon not left the hospital prematurely, under the impression that her injuries were not severe.
"There was a significant delay in diagnosis and treatment," the report states. "This was thought to be a preventable death."
The American College of Surgeons' approval is considered highly desirable for an urban unit of King/Drew's importance, but it is not required.
King/Drew's trauma chief, Jean-Claude Henry, attributed the organization's findings to lapses in documentation, not poor care.
"Unfortunately, we're too busy taking care of patients to really make the record look good," he said, adding that his staff has worked hard to correct the problems.
The reports from 2003 and 1999 came to light days after county health officials proposed closing the labor-intensive unit to focus resources on fixing other parts of the troubled hospital.
On Tuesday, amid boos from a crowd of King/Drew supporters, the county Board of Supervisors voted to consider the matter at a public hearing, which has yet to be scheduled.
Several supervisors, and even the health department director, said they had not seen the reports until this week.
The director, Dr. Thomas Garthwaite, said that the quality of care at the trauma center did not figure into the board's initial proposal to close it.
Garthwaite said he obtained the reports only after checking into assertions that the unit was among the finest.
King/Drew Trauma Unit a 'Jewel' With Big Flaws
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