Hospitals Hold Up, but Services Shut Down : Response: Buildings withstand shaking, but vital interior systems for water and oxygen fail. Three key facilities in the Valley were evacuated.

This time, the calamity for quake-stricken hospitals was not buckling walls and falling roofs as it was in 1971 when 50 people died in the Sylmar earthquake in the collapse of two medical facilities.

But in terms of lost hospital beds, Monday’s earthquake was just as devastating: The county’s hospitals lost as many as 2,500 beds, at least temporarily, at a time of critical need.

Instead of filling up with injured people, key hospitals in the hardest-hit areas were being emptied. Seriously ill patients who had been admitted before the earthquake--many of them elderly, frail people struck down in the flu epidemic--were sent by helicopter, bus or ambulance to hospitals miles away, adding to the stress of an already thinly stretched rescue system.

Other hospitals were able to absorb the evacuated patients, but not without sorely testing Los Angeles County’s hospital system.

Unlike 1971, when the major problem was the collapse of hospitals, the problem this time was that while the buildings held structurally, their mechanical systems went into meltdown. Water mains burst, lines carrying oxygen into hospitals broke, elevators went out along with power supplies, auxiliary generators failed or were able to provide only limited benefit.

At three major hospitals, nearly 1,000 beds were lost when problems developed and hospital administrators were forced to move all their patients to other medical facilities. The three are the 439-bed Veterans Affairs Medical Center in Sepulveda, 257-bed Holy Cross Medical Center in Mission Hills and the county’s Olive View-UCLA Medical Center, with 377 beds.

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As of Wednesday, only Olive View had reopened and was accepting patients, although on a limited scale.

The Hospital Council of Southern California said Wednesday that only 300 critical care beds are available in the county. “If we have any significant number of new injuries, those beds will quickly fill up and we will have to begin transferring patients out of the county,” said David Langness, a spokesman for the hospital association.

Eighteen hospitals in the county had problems serious enough to force the closing of floors, wings or entire buildings. In all, hospital failures caused 719 patients to be transferred out of affected hospitals and into safer ones. No injuries were reported.

“We pulled off a major evacuation with hundreds of people in such serious condition that they could not get out of bed,” said Langness.

Experts say that if the earthquake had happened later in the day, when parking structures and freeways were filled with shoppers and commuters, injuries would have soared and the failure of the hospitals would have been critical.

“One can say we were extremely fortunate,” said Bill Iwan, a professor of engineering at Caltech and president of the California Seismic Safety Commission.

Iwan said seismic safety experts are happy that there was not a replay of 1971, when 47 people died as a result of the collapse of the Veterans Administration Hospital in San Fernando and three more died at the county’s Olive View Medical Center when structures fell.

But he said the failure of mechanical systems that led to the complete or partial evacuations of many hospitals was alarming.

“A number of hospitals didn’t remain functional. That is a serious concern,” Iwan said. “A hospital has to be able to function, to be able to take the injured. Those are critically important facilities in the community, as important as police and fire stations.”

Assemblyman Burt Margolin (D-Los Angeles), chairman of the Assembly Health Committee and a longtime resident of the San Fernando Valley added: “We managed to handle it this time, but we can’t afford to have our hospital system contract at a time of crisis.

“Clearly, current earthquake standards are too weak,” Margolin said after getting reports on the hospital situation.

State laws imposing stricter earthquake standards on hospitals began being passed in California after the 1971 Sylmar quake.

Margolin complained that they are too focused on the structural integrity of the buildings. “You want hospitals intact, but you also want their mechanical systems working so they can stay open,” he said.

But about 20 years ago hospitals contended they could not afford to meet the newer, tougher standards. One estimate was that it would cost $21 billion to earthquake-proof all of the state’s hospitals. So hospital lobbyists persuaded the Legislature to exclude older hospitals and include only new hospitals or new construction in the law.

The Office of Statewide Health Planning and Development, which is in charge of enforcing earthquake codes on hospitals, estimates that only about 20% of the state’s hospitals are substantially in compliance with the tougher standards of the 1973 Hospital Facilities Seismic Safety Act and subsequent laws.

Inspectors for the state regulation agency said they believe that the tougher standards make a difference.

Bob Van Mourik, an area construction adviser for the state agency, said he could tell by the extent of damage which hospital buildings had been allowed to operate under the old laws and which had to conform to the stricter standards. The older buildings suffered much greater damage, he said.

Van Mourik was a member of one of 12 teams of safety inspectors who fanned out through Los Angeles County on Wednesday to inspect hospitals to determine their readiness. At one point he passed under heavy pipes feeding into Valley Presbyterian Hospital and pointed up to them with pride, noted that they had held up.

“That’s one of ours. It stood up,” said Van Mourick, referring to the fact that he and other inspectors for the state agency had overseen the construction. “Now, if we could only get them to all do it this way, we would be in good shape.”

Even so, Van Mourick and two other inspectors who worked with him decided that only two of three wings at Valley Presbyterian could accept patients. A third wing, built in 1958, was given a temporary restriction, pending further engineering studies of possible structural damage.

Olive View, the veterans hospital and Holy Cross each suffered major structural damage in 1971. Holy Cross and Veterans Affairs had to be completely rebuilt, while Olive View was forced to rebuild a major part of its hospital.

At Olive View, administrators said, the current problems were caused by water damage, temporary disruption of the lines that pipe oxygen into the hospital, and a malfunction with the auxiliary generator.