Surgeon Criticizes Hospital Leaders

Dr. Debi Thomas, a world champion figure skater turned orthopedic surgeon, lent her considerable prestige to Martin Luther King Jr./Drew Medical Center in its most turbulent days.

“We are under siege,” she told the county Board of Supervisors, which oversees the public hospital near Watts, as allegations of shoddy patient care multiplied nearly two years ago. “The media has basically painted a picture that I think is very untrue.... There are thousands of people that are helped by this hospital and trauma center.”

Now, as King/Drew scrambles to finish reforms in time for a critical federal inspection, Thomas has dramatically pulled her support from the hospital’s leaders. Indeed, she faulted King/Drew’s top administrators at an informational meeting for physicians last month with the very regulators who will decide the medical center’s fate.

“I just said we have policies in place that cause us to have to deliver bad care, and that’s wrong,” said Thomas, 39, of the June 23 meeting at King/Drew. “I just told them I’m ticked off at the way things are running.”

She added, “I know they’ll try to spin it and make it look like I’m crazy or whatever, but when I got up and said that, everybody in the room was thinking the same thing.”

The surgeon’s words carry an extra sting -- and not just because she was an athletic celebrity with an impressive triple toe loop who in 1988 became the first African American to medal in the Winter Olympics. She is also a paid spokeswoman for the federal government’s health quality agency, a featured authority in public service announcements.

Thomas finished her orthopedic surgery training at King/Drew last year and left the hospital as planned at the end of last month to prepare for her certification examination and begin a fellowship at another Southern California hospital.

At the meeting and in an interview, she contended that administrators have created a dangerous backlog of cases by closing all but two of King/Drew’s operating rooms during a $12.5-million renovation. Adding to the delays, the hospital temporarily cut the number of anesthesiologists working overnight from two to one.

As a result, Thomas said, many patients with serious fractures, and in some cases open wounds, have had to wait days for surgery after being bumped by emergencies and elective surgeries, such as cataract removals and hernia repairs.

Thomas said she resorted to advising her patients and their relatives to contact administrators and demand more timely treatment. She also started writing notes in patients’ charts detailing how administrative policies had delayed surgeries.

At the June 23 meeting, Thomas said, she reminded hospital administrator Antionette Smith Epps and other top leaders that she had given them a four-page memo, complete with patient names and medical record numbers, detailing the problems. But she told them she had seen little progress.

Thomas said Epps, in turn, questioned Thomas’ commitment and said she was glad the doctor would be leaving.

Epps said in an interview Thursday that she believed it “counterproductive to go into this tit for tat in what Debi said or didn’t say or whatever.”

“At that meeting, there were many other surgical subspecialties, and nobody else voiced the concern that she said she had,” Epps said. “Any time anybody decides that they want to blame the system, what I do is ask them what have they done to improve the system, because we are all part of this system, whether we want to accept it or not.”

Epps said The Times’ decision to write about Thomas’ concerns “sounds like a gossip column. My God, I think that is so childish.”

The hospital’s medical director, Dr. Roger Peeks, acknowledged that reducing the number of operating rooms has been a “major inconvenience.” But he added, “It’s the necessary pain that you have to go through to get to the ultimate goal of having the state-of-the-art operating rooms so we can deliver quality care to everybody.”

The renovations were recommended by outside consultants after the reports of widespread problems at King/Drew.

A Thomas colleague, Dr. Clarence Woods, said her concerns are legitimate, though he added that he might not have voiced them in a forum with regulators.

The two operating rooms “are not sufficient for orthopedics,” said Woods, the former department head. “The numbers are just too great. I’ve said this to all the people involved before.”

Calling herself a late bloomer and a poor test taker, Thomas said she came to King/Drew in January 2001 for her residency because the hospital, which serves a largely minority community, gave her a chance when others wouldn’t. Since then, the Stanford University graduate said, many patients have praised her care and some cried when they learned of her departure.

She said she remains loyal to the institution and its patients, despite her differences with its leaders. She said critical reports in The Times have done a “disservice to this population of people that most of these physicians have worked very hard to take care of.”

Thomas’ complaints about administrators, however, come at a pivotal time. The U.S. Centers for Medicare and Medicaid Services is poised to conduct a top-to-bottom review of the hospital by the end of August that could determine if King/Drew survives in its present form. If the hospital fails any part of the review, it stands to lose $200 million, about half its budget.

Just last week Dr. Roberta Bruni, president-elect of the hospital’s physician organization, quit her post, accusing administrators of conducting a “witch hunt” to remove outspoken doctors who are seen as “enemies of progress.”

And Thursday, three federal reports were released detailing patient care lapses last year. The Medicare agency documents, based on inspections in June and August 2005, had been inexplicably delayed for months.

Among other things, the reports detail failures by the emergency room staff to properly screen patients. In a January 2005 case, inspectors say, a patient with kidney pain, elevated blood pressure and, later, severe chest pain was not evaluated by a physician for about 15 hours. Less than two hours later, the patient died of an aneurysm.

The report also detailed the inspectors’ findings in two cases reported in The Times last summer. In one, a surgeon brought his son into a surgery in June 2005 without the patient’s permission, falsely telling staffers the son was a medical student. In a second case, a dialysis patient who was supposed to be under a nurse’s observation was forced to rouse the staffer from sleep, the report said. The nurse fell back asleep until awakened by an alarm as blood spurted from the patient’s dislodged catheter needle, inspectors said.

The hospital says those issues have been resolved.

Dr. Bruce Chernof, county health director, said change has been hard on some King/Drew doctors and some have left. “The fact that physicians are able to talk about what their concerns are is actually progress,” he said.

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Times staff writer Tracy Weber contributed to this report.