County Supervisors Vow to Examine Medical Malpractice Cases

Felipe Ortega Sotelo alleges that the treatment he received at a county hospital left him partially paralyzed, partially blind and unable to speak.

Sandra Lee Williams says that after a surgical procedure at a county hospital she could not walk well enough to return to work, while Robert Christman alleges that his care left him with spinal problems, no motor strength from his chest down and total incontinence.

And Marco Vallejo’s family says he died because county medical staff failed to treat him properly.

In all of those cases--set to go before the county Claims Board today--county lawyers have acknowledged that the county stands a high risk of losing the lawsuits brought by the former patients and their families.

So instead of risking jury awards that could exceed the total of $6.1 million sought in the various lawsuits, the county counsel’s office has recommended settling the claims for more than $2.4 million, plus lifetime medical care for the surviving victims.

The Claims Board, a three-member panel of county lawyers, analysts and auditors, is expected to approve the settlements.

But the agreements then must go to the Board of Supervisors, some of whose members have grown increasingly uncomfortable with the continuing stream of medical malpractice cases coming from the county Department of Health Services.

“We need to get into the details of each of these cases and determine whether it was [caused by] an aberration or part of a chronic problem at a particular institution, and find out what we need to do to prevent these kinds of problems in the future,” said Supervisor Zev Yaroslavsky.

Yaroslavsky and, through aides, Supervisors Mike Antonovich and Gloria Molina said they planned to personally review the cases in depth before the settlements come to the board. That usually occurs several weeks after the Claims Board signs off on them.

“The people who are ultimately held accountable for the operation of the Health Department are the supervisors, and we need to involve ourselves in the risk management of these cases,” Yaroslavsky said.

Sotelo was shot in the chest and stomach while being robbed Sept. 16, 1994, and taken to Martin Luther King Jr./Drew Medical Center.

According to county legal documents, medical personnel delayed performing exploratory surgery that was needed to locate the source of his postoperative internal bleeding. “The almost four-hour delay is believed to be the major contributor to the anoxic brain damage” that Sotelo suffered when his brain was deprived of oxygen, county lawyers concluded.

That injury led to Sotelo’s partial blindness, inability to speak and partial paralysis, the lawyers said in recommending a $998,000 settlement plus payment of $120,000 in medical bills. Sotelo, they said, “requires a wheelchair to move about. It is believed that his condition is permanent.”

Christman was admitted to the emergency room at Olive View/UCLA Medical Center in Sylmar on July 23, 1995, complaining of numbness and back and shoulder pain.

According to legal records, medical personnel failed to promptly perform a diagnostic imaging procedure, ultimately delaying surgery to relieve Christman’s “spinal epidural abscess” by more than 10 hours.

County lawyers concluded that the diagnostic procedure “could have substantially enhanced his potential for recovery,” and have recommended a $909,277 settlement.

Williams was admitted to County-USC Medical Center with a broken thigh bone in August 1995. Doctors placed a metal rod in her leg, but months later it had to be replaced after she had trouble walking and her leg became infected. Lawyers have concluded that the rod “was too small to accommodate and support her height and weight.”

Williams, who will require further surgery and walks “with a pronounced limp,” should get $225,000, the county lawyers say.

Vallejo also went to the County-USC emergency room, in March 1995. There, medical staff found that he had a high fever and other “classic signs of diabetes” and a potentially deadly symptom known as ketoacidosis--too much acid in the blood--that required immediate treatment, county lawyers have concluded.

Yet Vallego remained in the emergency room eight hours without being seen by a physician, and then was allowed to leave the hospital, the documents show.

Vallejo died the next day of ketoacidosis. “Experts will be critical that there was an inadequate nursing assessment . . . [and] critical of the lack of physician care,” said the county lawyers in urging settlement of the case for $230,000.

County health Director Mark Finucane was off Thursday and unavailable for comment. But he has said his department has made much progress in addressing malpractice cases since 1995.

Yaroslavsky and a top aide to Molina agreed, saying Finucane has attempted to set up a system in which malpractice cases are reported and reviewed quickly.

Even so, Molina remains “enormously concerned with the growing number of medical malpractice cases,” said her chief deputy, Alma Martinez. The Eastside supervisor has been meeting regularly with county health and legal officials to draft a set of “protocols” in which problems found at one hospital will be addressed, and fixed, throughout the vast county health system.

“They’d have an incident at one particular emergency room and they would reprimand that person and it would stay in their file,” Martinez said. “This will make sure problems are corrected immediately, and institutionally. We are looking at the amount of money the county spends, and how to prevent that.”

Martinez said Molina will unveil the protocols within the next two months.