County Paying Millions to Settle Claims

When the Los Angeles County Claims Board met Tuesday, it recommended that more than $1 million be paid in the case of Juan Arellano, an infant who survived choking on a pinto bean only to receive negligent care and suffer irreparable brain damage at a county hospital, according to court officials and documents.

The board also recommended paying more than $1.6 million in the case of a 2-year-old girl who suffered severe brain damage while in the custody of foster parents, the documents show.

And the board’s work didn’t end there.

In all, its three members spent much of the past two days deliberating on 15 legal claims filed against the county. Based on the advice of county lawyers, they eventually voted to urge the Board of Supervisors to settle each of them at a cost to taxpayers of $5.4 million. The supervisors, who traditionally have approved most such recommendations from the board, are expected to take up the cases in the next few weeks.

County lawyers have decided that going to trial could end in far higher settlement costs because of the nature of the cases, which involve serious and at times preventable injuries, mistakes or misjudgments by county doctors, sheriff’s deputies and other county employees.

One county employee who endured continued sexual harassment should get $450,000, and a “mentally disturbed” man who was shot five times by sheriff’s deputies deserves $400,000, the Claims Board concluded.

Juan, now 20 months old, is deaf and blind, suffers from cerebral palsy and must be fed through a tube as a result of the Jan. 28, 1995, incident at County-USC Medical Center. The 2-year-old girl has been in a vegetative state since her 1990 incident. Neither is expected to live another 10 years. In addition to the suggested settlements, county lawyers have proposed paying for past and future medical bills in both cases.

“This was the worst agenda in my 12 years on the Claims Board,” said Chairwoman Nancy Singer.

Worst, maybe. But not unusual. County officials estimate the cost at tens of millions of dollars a year, with no signs of abating. In each of the last three years, the amounts of settlements recommended by the board have increased, jumping from $22.7 million in 1993 to $31.5 million in 1995.

Now, as the county enters another budget season amid its continuing fiscal crisis, some top county officials concede that they need to take a hard look at the root causes of so many expensive legal settlements.

The fact that no one seems to keep track of how many claims are settled each year or whether problems are recurring disturbs a number of officials.

Some, including Supervisor Gloria Molina, say they want to know why the county’s five elected supervisors are asked to approve millions of dollars in claims with only the barest of details about the cases and after the settlement negotiations are over. Often, such settlement proposals are sent to the board many years after the claims were filed.

By waiting so long, some corrective actions that could have prevented similar problems were never put in place, and the people responsible were never disciplined, according to documents and interviews with county lawyers and administrators.

Molina said some county departments--especially the massive Health Services Department--never seem to learn the right lessons from expensive legal settlements and the underlying problems that caused them. “You don’t just go out there and do the same thing again,” Molina said. “We have to pay with taxpayer dollars.”

Molina recently has held up some settlements, demanding more details about the cases before giving her final approval. She said that health officials in the past 18 months promised to institute reforms prompted by legal settlements, but that when her staff members checked, they found that many reforms ultimately were ignored.

New health director Mark Finucane said in an interview that he has begun a wholesale reappraisal of the way his department disciplines workers and tracks malpractice cases. He said he is looking at past and present legal claims to learn from the mistakes that caused them. He also said he will inform the supervisors of all disciplinary and corrective actions before they vote to settle future claims.

Several supervisors have expressed interest in getting more involved in the claims process before settlements come to them for approval, according to Chief Administrative Officer Sally Reed. “They want to know what the cases involve and how they are being handled, which is very legitimate. But they need a process [by which to do that],” Reed said. “They also need to have some way of monitoring the litigation overall, so they know how it is being handled.”

Like some supervisors, Reed said she was concerned that the issues of lawsuits and those responsible for them aren’t linked together as well as they should be. “Are we holding employees accountable for their failure to perform or for improper performance?” she asked. “There are times when we don’t.”

On a broader scale, Reed said, “you have to be concerned both about the amount of the claims and some of the terrible things that have happened, and the consequences for the people involved. It does seem to me that we need to be looking at the problems that cause us to be vulnerable in this way. I think we have to learn from every one of them, and I’m not sure we’re doing that.”

Claims Board member Bill Pellman, a senior assistant county counsel, said the sheriff’s and health departments are involved in the vast majority of the claims. At times, he calls the department officials himself after serious liability cases, “asking what they have done to make sure these kinds of situations are corrected or minimized,” Pellman said.

“That is not the charge of the Claims Board. But we don’t live in a vacuum,” Pellman said. “We have an interest in making sure the taxpayer’s outlay of funds is minimized.”

That won’t happen in the 15 cases handled by the board this week.

In the case of Juan Arellano, county lawyers concluded that medical personnel at County-USC were negligent because they did not monitor the infant closely enough after the bean was extracted from his windpipe during surgery.

Some operating room personnel failed to notice that the breathing tube ensuring that oxygen reached his brain had come loose, and by the time it was put back in place, documents show, the infant was so severely brain-damaged that he will need acute hospital care the rest of his life. In addition, the anesthetist “left before Juan awoke from anesthesia, which is contrary to hospital policy,” documents show.

Ultimately, lawyers for the county concluded that “the county is liable for failure of its hospital and medical staff to provide services consistent with the appropriate standard of care..”

In the case of the girl in the foster home, county lawyers recommended paying her guardians $825,547 and repaying the state at least $776,000 for medical care provided since the March 14, 1990, incident.

The girl was in good medical and emotional condition when sent to a licensed foster care home in 1989, legal documents show. Soon she began eating her own feces and engaging in other bizarre behavior, according to a deposition of a social worker, who never mentioned such activity in her case notes, the documents show.

The child later was transferred to another foster home, where she remained even though a doctor and social workers expressed concerns that she was being molested.

In the incident involved in the claim, the girl was left to sit on a toilet unattended and began vomiting, the documents show. The foster mother checked on the child but left the room. When she returned, the child had fallen to the floor, suffered an apparent seizure and was in full cardiac and respiratory arrest by the time an ambulance took her to a hospital, the records show.

County lawyers concluded that although the cause of her brain damage was uncertain, a jury could decide that her injuries resulted “from abuse by the foster parent or from her significant negligence.”

The Claims Board recommended paying $400,000 to settle the case of the man who was shot five times by a sheriff’s deputy in Santa Clarita in 1991.

Then 19, the man “mistakenly” entered someone’s home, the documents showed. Because the first deputy on the scene knew about the man’s mental problems, county lawyers concluded, a jury might find in his favor.

The man had been attending college, but since has been confined to residential care facilities after suffering injuries to his face, arm and other parts of his body, legal documents show.

The Claims Board also recommended $440,000 to settle a case involving a firefighter.

Gilbert Case’s car was struck by a county fire truck that went through a red light at a Marina del Rey intersection in 1993--with its lights on and siren blaring--even though it was not responding to an emergency, the documents show.

Cates, who was studying to be a doctor, suffered brain damage, four broken bones in his face and other serious injuries, documents show.