County-USC Patients Left in Public Halls on Gurneys : Health care: Hours-long overflow into corridors described as shocking example of overcrowding.

Sick patients, some of them naked and in restraints, were left on gurneys in public corridors at Los Angeles County-USC Medical Center on Monday in what some physicians called a shocking new example of the hospital’s acute overcrowding.

One young patient was reduced to slurping food from a tray in his lap because his hands were tied with thick leather restraints. As a reporter watched, another patient was spoon-fed by two people who appeared to be family members.

“I was shocked when I saw this,” said a senior County-USC physician who requested anonymity. Another physician described the scene as “disgusting” and “degrading” to the patients and demoralizing to the medical staff.

All of the patients, who were in the main public route into the emergency room, were sick enough to have been admitted as inpatients at the medical center’s General Hospital and were awaiting beds in internal medicine units. The overflow into the corridor had been under way for at least six hours, but it was unknown how long any individual had been left in the public area.

A hospital spokesman, Harvey Kern, said Monday the situation, “should not have occurred,” and was corrected as soon as top administrators learned of it. Doctors said the patients were moved into a private, unused room off the main emergency room at about 2 p.m. Monday.

“It was an inappropriate situation, handled by individuals who were not aware of hospital policy,” said Kern.

Most administrators and medical department chiefs were off Monday for the Martin Luther King Jr. holiday, Kern said. He added that Edward Martinez, General Hospital’s chief administrator, came in from home after noon to deal with the situation.

A week ago, County-USC administrators assured state inspectors that staffing deficiencies blamed for overcrowding and deficient patient care were being corrected. Two inspectors for the state Department of Health Services toured the emergency department Dec. 23, citing the facility for several lapses in procedure and quality of care.

The inspectors’ report, obtained by The Times Monday, documented the case of an 82-year-old man with an irregular heartbeat whose vital signs were insufficiently monitored. The report also cited cases where a psychiatric patient in restraints was improperly left unattended and patients waited up to 50 hours on emergency room gurneys for a bed in the critical care unit.

The inspectors also alleged there were too few nurses on duty, and found an instance where three patients were crammed into an emergency room examining cubicle designed for two. The report cited the hospital for violating regulations protecting patients’ rights to “considerate and respectful care.”

“There was no provision for privacy,” wrote the state inspectors. “The three patients were in such close proximity that case discussion, examination and treatment could not be provided with discretion.”

Hospital administrators responded Jan. 13 that they had taken corrective action, among them reminding medical staff of monitoring standards and patients’ rights, according to the report from the licensing and certification division of the state Department of Health Services.

In addition, the hospital has hired 12 nurses, who are expected to be fully trained by May 1, and has requested additional funds from county health officials to hire more. Six of 32 new intensive care beds in the hospital can’t be used because there are not enough nurses to staff them, according to Kern.

Hospital officials also had assured state inspectors that all patients in restraints would be held in areas where they could be closely watched by nursing staff.

However, at least three of the patients observed by a Times reporter in the hallway Monday were in restraints, without a nurse in sight. Restraints are sometimes used when patients are abusive or under the influence of drugs.

At 12:45 p.m., there were 20 patients lined up along the corridor wall, in full view of visitors to the hospital.

“The situation should not have occurred,” Kern, the hospital’s spokesman, said. “We make every effort to treat the patients with privacy and with dignity.”

County-USC is one of six public hospitals in Los Angeles County, all of which are being squeezed by reductions in state and federal funding for health care even as more people appeal to them for care. The emergency department at General Hospital is the busiest in the country.

The overflow Monday came as the Los Angeles County Board of Supervisors and county Health Department are pursuing several investigations into the causes of overcrowding at County-USC and possible solutions.

Since September, physicians at the hospital have been documenting dangerously long delays in moving patients from the emergency department to intensive care units or other treatment areas. Several have died because operating rooms were full, these doctors contend.