Saying that the public's confidence has been shaken by a series of highly publicized problems and irregularities, Los Angeles County Supervisor Yvonne Brathwaite Burke called Friday for an immediate and sweeping reorganization of the county's Martin Luther King Jr./Drew Medical Center.
Burke's announcement was the most important official acknowledgment to date of major troubles at one of the county's most critically important public hospitals and trauma centers.
Built in the wake of the Watts riots in the 1960s to serve the urban poor in South-Central Los Angeles, King/Drew has been plagued with problems for years, and buffeted in recent months by a series of damaging disclosures.
At a hastily called news conference, Burke said "swift and decisive action" is needed to safeguard the safety of patients, and to restore confidence in the Willowbrook hospital.
Burke's calls for reform came in response to a series of Times reports on widespread problems at the hospital, including troubles at the hospital's blood bank that led to a woman receiving HIV-tainted blood last year. Among other disclosures: Doctors convicted of Medi-Cal fraud remained in administrative positions and allegations that some doctors moonlighted at other jobs, abused overtime and diverted patients to their private practices at county expense.
"Due to a series of highly publicized problems, irregularities, illegalities and tragic mistakes that have occurred at [King/Drew] in the past few years . . . the public's confidence in this major county medical facility has been shaken," said Burke, whose district includes the hospital.
"It is unacceptable for anyone who depends on King Hospital--whether they're ill or injured--to fear that they won't get the level of care they expect and deserve."
Burke said she will seek a "major management shake-up" at the hospital when the Board of Supervisors meets Jan. 2.
"We're talking overall action to solve a whole series of problems," she said in an interview. "It is going to take drastic action to take care of some of the problems that have become endemic [at the hospital]. It has not had the kind of review and control that I think it needs."
To achieve such sweeping change, Burke called for an immediate review and restructuring of the hospital's administration by incoming Health Services Director Mark Finucane. She also said a multi-agency "crisis management task force" and separate "oversight team" will be needed to scrutinize the hospital's operations and make changes in administrative and medical management.
Burke said the final straw was a Times report Tuesday about how systemic problems at the blood bank at King/Drew were responsible for tainted blood being given to Aleta J. Clemons last year. The 44-year-old mother of three acquired the AIDS virus during a routine surgical procedure, and has since begun showing symptoms of the deadly disease.
In response, an angry Board of Supervisors castigated health officials at their board meeting this week, saying they never should have allowed such deep-rooted problems to fester at the hospital, including those at the blood bank. It was only after Clemons' transfusion that county and federal investigators swooped in, eventually sharply criticizing the blood bank for being riddled with problems that hospital officials should have known about.
At their board meeting, the supervisors were scheduled to approve an out-of-court settlement of Clemons' medical negligence case for $450,000. But saying the hospital had given Clemons "a death sentence," board Chairman Mike Antonovich and other supervisors postponed the decision, saying they wanted more answers about what happened at the blood bank. Some said they wanted to find ways to better compensate Clemons, perhaps by giving her lifetime medical care.
After that stormy meeting, Burke summoned administrators from the hospital and the Department of Health Services to decide how to respond to what Burke now concedes has become a mounting public relations nightmare that threatens to scare away patients from the hospital.
Because of the stories in The Times, Burke said, she is concerned that "people are afraid to go to the hospital."
Top officials at King/Drew and in the health department had little comment Friday about Burke's announcement, saying that because she is the top elected official in the district, they will defer to her wishes.
"She is the supervisor, and we don't have a problem with the changes she deems necessary to make," said Dr. Tessie Cleveland, a hospital spokeswoman.
On Friday, Burke was clearly angry about the conditions at the hospital, saying she was unaware of the depth of many of the hospital's problems until she read about them in the newspaper. She cited the blood bank case, saying she had been told that Clemons was infected because of one employee's mistake, not because of the widespread problems that employees had been complaining about beforehand.
In a motion that Burke submitted for consideration by the supervisors, she said cases such as the HIV transmission and "issues of physician impropriety" have called into question the entire administrative and medical leadership of the hospital.
Also, she said, seven key management vacancies, including that of the hospital's top administrator, have gone unfilled for too long. Acting administrator Jaron Gammons, who is fighting a serious illness, has been away from the hospital for months. Burke announced Friday that Gammons has decided to leave permanently.
Besides its top administrative spot, Burke said, the hospital also has no nursing director or chairmen of the departments of anesthesia, emergency services, pediatrics, psychiatry and soon, obstetrics and gynecology.
Among the other concerns Burke cited were: lack of compliance with regulations requiring proper safety measures at the blood bank, failure by doctors to abide by county policies intended to prevent moonlighting, and a decrease in the number of patients the hospital treats.
Top Department of Health Services officials promised investigations, more significant punishment for violators and reforms. Many of the inquiries are ongoing and focus on King/Drew, including one about overall quality of care that for years has been of concern to local and federal watchdog agencies that monitor hospitals.
Earlier this year, the county district attorney's office issued a scathing report detailing at least seven deaths that could have been prevented by better medical care. One of those was the handling of Deputy Nelson Yamamoto, who died in March 1992 at the hospital after suffering gunshot wounds.
Antonovich said he also has grown frustrated with the continuing problems at King/Drew, and that the blood bank incident was the final blow.
"I'm very pleased to see this action, and I support this action," Antonovich said of Burke's' motion. "We need ironclad assurances that all blood used in transfusions is certified as to its safety, to restore the public confidence."
Antonovich praised Burke for her effort to bring "a new team of health managers to ensure that we have quality service."
Although details were not yet in place, Burke said the task force will be made up of "a veteran administrator" who will evaluate the staff at King/Drew and recruit new managers, an associate administrator "to institute tactical and strategic direction," and experienced medical and nursing managers to coordinate medical care and "establish a stable heath care environment."
In addition to the crisis task force, Burke called for the separate oversight team to consist of representatives from her office, the health department, Human Resources Department, county counsel, auditor-controller and the Charles R. Drew University, which is affiliated with the hospital.