2 Reports Denounce County Hospital

Financial records related to Martin Luther King Jr./Drew Medical Center were in such disarray that Los Angeles County auditors were unable to account for millions of dollars spent annually by the county for physician training and clinical programs there.

In an audit expected to be released today, reviewers could not even determine how many physician trainees worked at the hospital.

In a separate development, a national group of accreditors has accused the hospital’s orthopedic surgery program of intimidating medical residents so they would not raise concerns about the program with superiors.

“This is an extremely serious problem that is of great concern,” said the letter from the Accreditation Council for Graduate Medical Education, which in the last two years has ordered three other physician training programs at King/Drew to close.

Together, the findings represent yet another setback for the hospital, which is owned by Los Angeles County.

Earlier this week, the county Board of Supervisors excoriated health department leaders for their inability to resolve myriad problems at King/Drew, which is in Willowbrook, just south of Watts.

Board members said they had grave concerns about extending the county’s $13.8-million contract with the Charles R. Drew University of Medicine and Science to run physician training at the hospital.

On Thursday, supervisors said the newest disclosures only heightened their skepticism toward Drew University, the only historically black medical school west of the Mississippi.

“Fundamentally, the county has to look at an alternative to its relationship with Drew University,” said Supervisor Zev Yaroslavsky.

Supervisor Yvonne Brathwaite Burke said she was so concerned about activities at King/Drew that she planned to set up a toll-free tip line for public complaints.

“I really should not be doing this, but I feel as though I have to have some mechanism to get information,” said Burke, whose district includes the hospital.

Dr. Thomas Garthwaite, the county’s health director, said he supported signing a new deal with Drew and making any necessary reforms.

“I’m still committed to the mission,” he said.

The fiscal audit, expected to be released today by county Auditor-Controller J. Tyler McCauley, was requested by Garthwaite to see if there were adequate checks and balances in the county’s contract with Drew.

McCauley’s answer was a resounding “No.”

“The absence of the records makes it hard to determine” if the county got what it paid for, McCauley said in an interview. “With better records, we could provide that type of accountability.”

Among the specific findings in the report obtained by The Times:

* Drew has not maintained adequate records indicating how it spent money it received from the county. Despite promising to develop accountability measures in 2001-02, the county and Drew never created them.

* The county was paying Drew to run physician training programs in nephrology and cardiology, even though those residencies were actually under the auspices of UCLA, not Drew.

* King/Drew doctors earned far more proportionally than their peers at Harbor-UCLA, a county hospital near Torrance.

Drew’s interim president, Harry E. Douglas III, said he had not seen the report and could not comment.

Separately, a national group of accreditors determined that the orthopedic surgery program faltered at so many levels that it should be voluntarily closed -- or risk being closed by the accrediting group.

For the moment, the accreditation council proposed putting the orthopedic surgery program on probation.

The report on orthopedic surgery came as a surprise to King/Drew, because officials had said they had turned the corner on oversight of their graduate medical education programs.

The accreditors found that residents did not have enough time to learn orthopedic surgery skills because they were required to perform too many surgeries and work beyond an 80-hour-per-week limit, among other things. In addition, their pass rates on exams certifying them to be specialists was below par, with only 62.5% of them passing during the last five years.

Garthwaite said he and Douglas had agreed to phase out the program and stop accepting new residents. The two also agreed to seek a relationship with another hospital so outside physician trainees could spend some time at King/Drew.

Supervisors and Garthwaite complained that Drew officials apparently had not given them a copy of the critical letter from the accreditation group for as long as two weeks. They received the July 29 letter Wednesday, after The Times alerted health officials about its contents.

“There are people in the hospital who do not recognize how important it is to face problems head on,” Burke said. “People get this impression that if you bury something, it’s going to go away. It does not go away.”

Douglas said he also received the letter only Wednesday.

“I’m appalled at this,” he said, referring to the delay. “We can’t tolerate this.”