Appeal Process Is Slum Owner’s Ally in Legal Conflicts

Dr. Milton Avol made front-page headlines in June when Municipal Judge Veronica Simmons McBeth imposed on him a unique sentence “to convince him to make repairs” on five slum buildings he owns in Central Los Angeles.

The sentence: 30 days in jail and another 30 days in one of his own slum building apartments.

Avol went to jail as ordered--for eight hours. But his attorneys had already filed notice of appeal and Avol was back at his Beverly Hills home by nightfall. It may be six months to a year before his appeals run their course.

The quick release, the closest the 62-year-old physician has ever come to spending a night in jail, is only the most recent example of how Avol has used court and administrative appeals to fight or forestall sanctions in both his vocation as neurosurgeon and his avocation of landlord.

Hundreds of Citations

Since 1977, Avol has been hit with hundreds of health, fire and building code citations. He has been convicted of more than a dozen criminal code violations. He is one of only 15 property owners ever to receive a jail sentence for slum-related violations in Los Angeles.

At the same time, court records show, he also has been accused by some of his own colleagues of questionable medical practices. In 1980, he was excluded for five years from the Medicare system for “gross and flagrant deviations from professionally recognized standards of health care.” He is one of only 26 doctors in four Western states to ever have been so excluded, according to an official of the U.S. Department of Health and Human Services.

Despite such sanctions, Avol has demonstrated that he will go to court rather than change his ways.

“The lesson of Milton Avol,” asserted Legal Aid Foundation attorney Gary Blasi, who has represented some of Avol’s tenants, “is that if you have enough chutzpah and enough lawyers you can get away with a whole lot for a very long time.”

Avol turned down several requests for an interview. Dennis Fischer, the most recent in a series of attorneys who have represented Avol, objected to Blasi’s remarks.

“If we have a legal system that provides adjudicatory rights, is there anything wrong with taking advantage of them?” Fischer said. “Our system is based on the fact that you have a right to your day in court.”

Avol has had many days in court.

Given to Appeals

Since the mid-1970s, records show, Avol has been party to 30 civil lawsuits alone, both as plaintiff and defendant. He often appeals and loses, only to appeal and lose again.

In four separate cases, records show, he has refused to make court-ordered payments, forcing his debtors to place liens against his property or garnishee his holdings. One of them was a Small Claims Court judgment against him over a $250 plumbing bill. Avol appealed the decision to Superior Court, succeeded in getting the bill reduced to $125, but didn’t pay until a marshal’s sale of his property was threatened. During a brief conversation with a reporter, Avol’s wife, Ann, gave only the briefest of insights into her husband.

“My husband has worked extremely diligently on the buildings,” she said. “We come from poor backgrounds ourselves and would not exploit the poor.”

Asked why, then, he had been singled out for prosecution for code violations, she answered: “He’s white. He’s a doctor. And he’s living in Beverly Hills.”

Milton Avol, who was a medic in World War II, received his medical degree from Hahnemann Medical College in Philadelphia and studied neurology at several Los Angeles-area hospitals in the early 1950s.

He began practicing medicine in the South Bay in the mid-1950s as a circuit-rider of sorts, the only neurologist serving several South Bay hospitals.

By all accounts, Avol was a hard worker who never seemed to stop for lunch. His lucrative specialty and his willingness to work paid off.

In 1964, he moved his family to a large home in Beverly Hills. About the same time, assessor’s records show, he began buying real estate in the high desert.

(Today, according to assessor’s records, he owns several desert parcels and a tract of 70 two-bedroom homes in Palmdale. Several tenants interviewed offered relatively minor gripes about the condition of their 30-year-old homes. A source familiar with Avol’s operation said the housing tract now takes in about $20,000 a month in rent.)

Despite his growing wealth, Avol avoided the trappings of successful physicians.

“We used to joke that he bought his shoes second-hand because the heels were always worn down,” said one nurse who worked with him.

Thrifty to a Fault

He had a reputation for being thrifty to a fault. It was a trait, officials would say later, that was largely to blame for problems in his second career as landlord.

The first time Avol’s colleagues are known to have questioned his medical expertise was during a 1970 dispute at Gardena Memorial Hospital. Details of the dispute are contained in court records stemming from lawsuits Avol filed against the hospital in 1977 and 1978.

In a 1970 letter, staff radiologist Dr. Bruce Jacobs wrote a formal letter to the head of radiology, noting that Avol had acquired a “considerable negative reputation,” and adding that he had observed two cases in which Avol exhibited a “lack of competence.”

At a joint meeting, members of the surgery and radiology departments reviewed three “problems with Dr. Avol.” According to court records, those problems were “attitude,” “asepsis” (lack of proper sterilization) and “technique.”

The committees temporarily suspended his right to perform certain disputed techniques on the grounds that he had violated hospital standards. But that suspension was reversed after Avol argued in administrative hearings that the hospital had never formulated such standards.

Five years later, Avol was again accused of “repeated failure . . . to maintain hospital standards,” and his right to use hospital facilities to conduct the same procedures was again suspended.

Risks Alleged

Specifically, it was alleged that he favored certain outdated diagnostic techniques that constituted an unnecessary risk to patients. Avol argued that he had used the same procedures at several South Bay hospitals for nearly two decades and “never encountered any complications or fatalities whatsoever.”

Avol sued the hospital and 15 doctors in 1977, claiming that the hospital had denied him due process, and asking that he be reinstated to the hospital staff. Avol won his case, a judge ruled, because the hospital had failed to keep sufficient records for an adequate review by the court.

He then sued the hospital for damages in 1978, claiming that the suspension had wrongly deprived him of between $50,000 and $75,000 a year. He also asked for several million in punitive damages for “professional embarrassment.”

According to a statement he filed with the court, he earned about $300,000 a year from his medical practice between 1977 and 1979--most of it from Medicare patients. By 1981, he said, his income had dropped to $91,000.

He lost that case in a jury trial in 1983.

Meanwhile, the quality of Avol’s treatment of Medicare patients was being reviewed by the Department of Health and Human Services. Avol argued in a series of hearings that doctors who had reviewed his cases were biased, that administrative procedures had not been adhered to, and that because medicine “is an art and not a science,” legitimate differences of opinion exist in the medical community as to methods of diagnosis and treatment.

Medicare Exclusion

On Jan. 22, 1980, he was officially “excluded” from the Medicare system for five years.

One of the reasons for the rare sanction was because Avol was “convinced that there is no reason to alter (his) pattern of practice,” and therefore would continue to present “potential harm” to his patients, according to a review compiled by Martin L. Kappert, acting director of the Bureau of Quality Control of the Department of Health and Human Services.

Avol appealed, and succeeded in getting his exclusion reduced to about 3 1/2 years.

“The administrative law judge felt that he had been over-disciplined because he had not been given adequate opportunity to mend his ways and re-educate himself,” said James C. Maupin, the attorney who represented him in the lengthy appeal.

That period has now expired. He maintains a medical office in Hawthorne, and his wife said he plans to apply for readmittance to Medicare shortly. He is also appealing the original decision in administrative hearings in an attempt to clear his name.

Two lawsuits have arisen from the Medicare exclusion.

One was brought by Avol’s own lawyer. Maupin charged in an 1984 lawsuit that Avol had failed to pay him $18,000 in legal fees. The attorney won, but had to get a court order levying Avol’s bank account to get his money.

The other was filed by Avol in 1981 against Hawthorne Community Hospital, where he had practiced after leaving Gardena.

Hospital Action

Reacting to the Medicare exclusion, Hawthorne suspended Avol’s staff privileges “in the name of patient care.” Among other things, they charged him with favoring risky diagnostic techniques over safer, updated methods, and “contributing to the death of a patient due to failure to perform appropriate treatment,” according to court records. The patient was not identified.

Dr. Stanley Goodman, a Torrance neurosurgeon asked by the hospital to review certain of Avol’s patient charts, wrote: “Many of Dr. Avol’s patients are older. . . . They are not protecting themselves by interrogating him. I feel that the patients in his care are in danger.”

Although the hospital restored to Avol some restricted staff privileges, he sued in 1981, claiming once again that he had been denied due process.

He lost, but appealed the case to the state Supreme Court, which refused to hear it.

Avol has twice been sued for malpractice, but both cases against him were dismissed before trial.

He has also been referred to the state Board of Medical Quality Assurance for a license review by two agencies.

David Childress, supervisor of the enforcement and surveillance unit of health facilities of the county Department of Health, said that he had referred Avol to the board as the result of a 1982 county investigation into “life-threatening deficiencies” at California Gardena Hospital (formerly Gardena Medical Center), where Avol had also practiced. That hospital later was closed.

Referred to Board

Avol also was referred to the board automatically by the Health Care Financing Administration.

“But as far as I know they never restricted his license,” said Don Balzano, executive director of Western Medical Review, the contract agency that handled Medicare reviews in this area at the time. “So, you’ve got this doctor out there who isn’t allowed to practice on Medicare patients but is allowed to practice on you and me.”

James Watson, regional supervisor of enforcement for the state Board of Medical Quality Assurance, said that Avol’s license has not been suspended or revoked.

He said the board also has the authority to take milder disciplinary procedures that are not public information. But he declined to say if any such actions had been taken against Avol.

Asked to explain why the state board had not limited Avol’s practice even though the federal government considered Avol a possible danger to his patients, Steve Wilford, assistant executive director of the state medical board, responded that the board requires higher standards of proof before disciplining a doctor than does Medicare.

“It is easier for Medicare to suspend people than it is for us,” he said. “Medicare makes their decision based on a simple weighing of the evidence, 50% plus one, so to speak. We have to go by the higher standard of clear and convincing evidence to a reasonable certainty that there is gross negligence, incompetence, or repeated negligent acts.”

Ironically, while one government agency--the U.S. Department of Health and Human Services--was trying to stop Avol from treating patients, another--the Municipal Court of Los Angeles--was compelling him to treat more of them.

The odd circumstance arose after a 1979 jury trial in which Avol was found guilty of fire code violations at three of his buildings. Then-Municipal Judge Jack Newman, noting that Avol was already on probation from a slum-related conviction in 1978, gave him what was deemed at the time to be an unusually stiff sentence: a $3,000 fine and 1,000 hours of medical service to the community.

“For a doctor of his standing, that was a stiff sentence,” said Deputy Dist. Atty. Art Walsh, who worked on the case. “It was probably the largest community service ever given to a slumlord (in Los Angles).”

But records show Avol did not start serving his time immediately, and there are some questions about whether he served the full sentence at all.

He appealed the decision (and lost), filed a habeas corpus motion (and lost), and appealed to the California Supreme Court (and lost). Because of lengthy delays in processing such appeals, the last decision wasn’t handed down until May, 1982.

Says He Split Time

According to a deposition filed by Avol, he split his 1,000 hours of community service between the Los Angeles Office of Recording for the Blind and the Gardena Medical Center (now California Gardena Hospital).

Margaret Johnston, co-chair of the board of Recording for the Blind, said Avol “misused us terribly and was a disgrace as a volunteer.”

“He got a letter out of us saying he had donated time here,” she said. “But he never did the (two-hour reading sessions) specified. He would come in and read for 20 minutes and then use our telephone for 20 minutes on personal business and then read for another 20 minutes and leave.”

Louis Singer, former administrator of the California Gardena Hospital, said in an interview that Avol had treated “six to 12 indigent patients.”

He said he could not estimate how many hours that entailed, except to say that Avol’s designated job in those cases was limited to surgery, not ongoing care.

Since acquiring his five slum buildings between 1975 and 1977, Avol has been sued by the City of Los Angeles for code violations, by his tenants collectively, by several tenants individually, and by workmen. In turn, Avol has proven to be a determined litigant who appeals any negative verdicts to the hilt.

“It’s cheaper for him to go in and fight in court than to make the repairs,” said Oscar Toscano, who represents one of Avol’s tenants.

Suit Follows Escrow

For example, Avol had barely emerged from escrow on his 127-unit complex at 1839 S. Main St. in 1977 when he was sued by the seller, Rutland Property Ltd., for failing to take out sufficient insurance on the property. The lawsuit demanded $5,920, the amount the original owner had to pay to fully insure the building, plus court costs.

Avol lost that case in 1981, but he didn’t give up. He moved for a new trial, claiming that there had been insufficient evidence against him. He lost, filed another motion, and lost again. Still, he refused to make the court-ordered judgment.

It wasn’t until August, 1982--five years after the lawsuit had been filed--that the original owner got partial payment. That took a notice from the Los Angeles County sheriff telling Avol that his $1-million house was “in danger of being sold” to satisfy the debt.

Rutland finally garnisheed one of Avol’s bank accounts. But that netted the company only $3,512--a fraction of its court costs, according to court records.

In 1979, Avol was cited in public hearings held by then-City Atty. Burt Pines as a prime example of the need for a special slum housing task force. Avol, according to testimony by Legal Aid attorney Gary Blasi, a slum housing expert, was on probation for four cases simultaneously.

(The hearings led to the establishment of a slum housing task force in 1980 that began coordinating the prosecution of health, fire and building code violations.)

In 1981, Blasi, representing a group of tenants, filed a civil lawsuit against Avol.

‘Unbelievably Angry’

“I had seen a lot of slums and I was pretty jaded,” said Blasi. “But when I went into those buildings on South Main, I remember being unbelievably angry at what I saw.

“There was no hot water and often no water at all. There were open holes in the walls, and stories of kids being bitten by rats . . . and yet the tenants kept the rooms remarkably clean and orderly, even if their only furniture was cardboard boxes.”

Blasi took the highly unusual step in the civil lawsuit against Avol of alleging that operating apartment buildings as slums constituted an unfair business practice.

When the case came up for trial two years later, Avol agreed to an injunction that required him to fix a myriad of problems that Blasi had documented in 1,500 photographs. Blasi also got a $6,000 settlement for three tenants, but had to get a marshal to threaten to drive away one of Avol’s cars before he could collect.

“I watched heaters go into rooms that had never had heat and screens go on windows that had never had screens,” Blasi recalled. “And I thought, well, here is one success.”

But his victory, like others, was short-lived at best.

In this case, Blasi partly blames himself and Legal Aid for what he called the “fading away of the injunction.” Because Reagan Administration cutbacks had forced the closing of half of Legal Aid’s six offices, including the office in Avol’s area, he said, tenants stopped dropping in to express their complaints and attorneys lost touch.

After the injunction was issued, Armida Rodriguez was sitting on the toilet in her apartment when the ceiling literally fell in on her.

Ceiling Falls In

“There was a bump in the ceiling above the toilet where water was apparently leaking in,” Rodriguez said in an interview. “The manager always said he’d fix it tomorrow. Finally, one day, when I was sitting down, it just fell in on me. About half the ceiling above just caved in.”

Rodriguez sued Avol for back injuries she said she had sustained in the incident. Avol contended among other defenses that Rodriguez was “negligent” because she had not exercised “ordinary care on her own behalf” by notifying the manager of the problem.

The root of Avol’s problem, contend attorneys and others who have watched his operations closely, is a trait noted earlier by Avol’s medical associates: his willingness to work hard, but spend little.

“Dr. Avol simply will not go to the expense of fixing things right,” said Bill Wakeland, a retired city fire inspector who handled many of the complaints at Avol’s buildings.

“He consistently delayed code compliance because he didn’t want to spend the money.”

For example, he said, Avol frequently was cited for fire door violations.

“What happened was people would wedge open fire doors because it was sweltering in there in the summer,” Wakeland explained. “That wasn’t a malicious act by tenants. Avol could have avoided the problem if he had put in a $250 electromagnetic device that would have held his fire doors open until there was smoke in the atmosphere. But he said it was too much money.”

Pattern Detected

Over the past several years, one city prosecutor said, she noticed a pattern with Avol’s buildings.

“His buildings go up and down like yo-yos,” said Deputy City Atty. Susan LeFebvre. “He gets cited, and then does just enough repairs to get himself into technical compliance when we’re about to file on him.”

In 1981, Avol hired the Charles Dunn Co., a large management firm, to oversee his buildings. However, a Dunn property supervisor said in an interview, the company dropped him a year later.

“We finally didn’t want to be associated with him,” he said. The principal problem, he said, was that Avol insisted on having resident handymen fix the buildings in their spare time instead of paying qualified contractors to do the work.

In his own defense, Avol has argued in court that troublesome tenants and vagrants destroy his properties faster than he can repair them.

“Dr. Avol has done everything he can to bring those buildings up to standard,” said Robert Webster, an electrical contractor who has worked for Avol. “I’ve seen the man, I pity the man, dragging pieces of pipe around those buildings. But today he can’t even get into some rooms because boys have gotten together in rooms and barricaded the doors.”

The case that brought Avol headlines in June stems from charges filed against him in December, 1982, for a building at 463 S. Bixel St.

String of Delays

The court docket indicates that proceedings in the case were delayed 10 times. Finally, just before the case was to go to trial nearly a year later, Avol pleaded no contest to four counts of slum-related code violations.

His fine: $250 per count, plus $1,000 to the county Department of Health Services to help defray inspection costs. As is customary in such cases, Avol was given no jail time, although the law allows for up to six months per count. He was given three years’ summary probation.

It was for violations of that probation, ranging from rats in open walls to fleas breeding in a damp carpet, that Avol was brought before Judge McBeth on June 17, 1985.

Avol testified that he was at the buildings “almost daily” and had made more than $100,000 worth of repairs. The remaining problems, he said, were caused by “vandalism that’s just about unimaginable.”

After Avol testified, Deputy City Atty. Stephanie Sautner called inspectors who testified that Avol had put up some screens by merely stapling screen-like mesh to the plaster and had repaired some open walls, but with drywall material that was not up to code. They also showed dozens of photos of stopped-up bathtubs, dangling electrical wiring and other code violations.

The judge accused Avol of showing “a total absence of any empathy for the people who live in his buildings,” and offered him a choice: 60 days in jail, or 30 days in jail and another 30 days under house arrest in his own building. He chose the latter.

But Avol is unlikely to move in soon.

Notice of Appeal

Dennis Fischer, one of Avol’s two new attorneys, has filed a notice of appeal citing six possible grounds upon which he will seek to overturn McBeth’s decision. Among them: that the 30-day stay in his own apartment was not specifically authorized by statute; that McBeth erred by visiting Avol’s building without notifying his attorney; that the judge refused to grant Avol a continuance so he could change attorneys.

Such code violations are misdemeanors, and California law provides that anyone awaiting appeals in such cases may remain free on bail.

Deputy City Atty. Sautner, however, said she is confident that Avol will lose his appeal and be required to fix his buildings.

“This is a success,” she said, echoing the words of other attorneys who have won victories against Avol in the past.

“Avol is one of only 15 slumlords out of 300 we have prosecuted who has been sentenced to jail time. I think this demonstrates that strong sentences are called for and that judges will give strong sentences. Avol will go to jail in this case.”

However, on Aug. 8, after inspectors reported deteriorating conditions at a building not involved in the McBeth hearing, Sautner filed 13 new counts against Avol.

In turn, Avol has now hired yet another attorney, Don Steier, to represent him.

“Dr. Avol is not stupid and he’s not malicious, so you’ve got to wonder why these problems keep arising,” Steier said. “It’s very frustrating for him. The problem is that he just keeps taking on these responsibilities himself (to repair his buildings). He’s not a contractor, he’s a doctor.”

He said Avol has agreed to hire a contractor to repair the buildings once and for all. “With that in mind, I’m confident this matter will be cleared up in a matter of weeks,” Steier said.

“We’ll see,” said Sautner.