County Plans New Surgeon Program

Los Angeles County officials vowed Monday to try starting a new surgical training program from scratch at Martin Luther King Jr./Drew Medical Center, less than one week after learning that the accreditation of the hospital’s existing program had been revoked.

“We’re committed to going back and submitting a new program” for approval, said Dr. Thomas Garthwaite, director of the county Department of Health Services. “We think that having a surgery program at King/Drew, with all the trauma and all the needs in that area, is important.”

It was unclear how long re-creating the surgery program would take, or whether the Compton-area hospital would be able to gain the necessary approval for the new program from the Accreditation Council for Graduate Medical Education.

County officials said the program’s woes did not stem from a lack of money. What the program needs, they said, is new leadership with no ties to the hospital or its medical school.

It requires someone “with a very distinguished reputation ... who can look at it with a fresh approach,” said Supervisor Yvonne Brathwaite Burke, whose district includes King/Drew.

In a rare move, the accreditation council this month withdrew approval of the existing program after determining that it had enrolled too many students. It had been placed on probation last year because residents were not provided with enough surgical experience, faculty research was inadequate and curriculum did not follow recommended guidelines.

While plans for the new program proceed, Garthwaite said, his department will make every effort to place two dozen current surgical residents at King/Drew in training programs at other hospitals. County officials hope the accrediting group will give them up to one year to find new placements, although accrediting officials will probably require much quicker action.

Officials at King/Drew said they didn’t know yet how the loss of the residents would affect their ability to handle the great numbers of surgical patients they typically see. But surgeons at other teaching hospitals were not optimistic.

Dr. Christian deVirgilio, director of the surgery residency program at the county-run Harbor-UCLA Medical Center in Torrance, said the loss of King/Drew’s program could have “negative implications not only for the indigent patients, but for trauma in general.”

The spillover could have a “potentially devastating” effect on other hospitals, including Harbor and County-USC Medical Center, he said.

Dr. James B. Atkinson, chief of surgery at UCLA Medical Center in Westwood, agreed. “It would have a huge impact,” he said. “At an institution like Martin Luther King, the surgical house staff are a major part of the work staff.”

Without residents, the hospital would have to hire experienced surgeons, who may be unwilling to work for the below-market wages paid by the county, he said.

But Dr. M. Alfred Haynes, chairman of Drew’s board, said trauma services would remain a top priority regardless of the future of the residency program. Before the hospital opened in 1972, studies showed that trauma care was what the community felt was most needed. “Everything is being done to protect that,” Haynes said

The accrediting council had initially set last June 30 as the effective date for the program’s revocation, but a spokeswoman said Monday that the date would be set in the near future.

On Monday, the county and the Charles R. Drew University of Medicine and Science, which runs the physician training programs at King/Drew, announced they had interim leaders to assume the responsibilities of former surgery department Chairman Dr. Arthur Fleming, who was ousted after the program’s revocation.

Dr. Nand Datta, 68, a professor of urology, was named acting chairman. He joined the Drew staff nearly three decades ago.

Taking over as interim head of residency training is Dr. Rosalyn Sterling-Scott, a 52-year-old thoracic surgeon.

In 1995, the Los Angeles County district attorney’s office blamed Scott and another surgeon for mistakes that led to the death of Sheriff’s Deputy Nelson Yamamoto three years earlier. Yamamoto, a 26-year-old rookie, was shot multiple times. He was conscious when he entered King/Drew but died two days later.

The county restricted Scott’s clinical responsibilities, and the state medical board sought to pull her license but dropped accusations against her in 1997 after other experts spoke up in her defense.

Scott said that Yamamoto died as a result of his injuries and respiratory complications. Two outside physician panels reviewed medical records in the case and concluded that the deputy’s treatment was proper.

Garthwaite said he is comfortable with the decision to appoint Scott temporarily. He said she will not be in charge of clinical affairs, but rather administrative tasks. “Her academic record is quite good,” he said.

Scott said in an interview that she is still assessing the program and meeting with residents. As yet, she said, “no resident has said to me, ‘Will you place me elsewhere?’ ”

Organizers at the residents union, the Joint Council of Interns and Residents, said they expect the county to fulfill its contractual obligation to provide residents with training in their specialty.

“Their first choice obviously is to stay here and keep working with this group of patients,” said union organizer Joshua Rutkoff. The union wants to be sure, though, that “people’s careers aren’t totally derailed,” he said.

King/Drew plans to make a final written plea to the accrediting council detailing its progress so far in changing leadership, in hopes of a reprieve, but county officials are not hopeful.

The revocation comes at a difficult time for the hospital, which lost approval last year for its radiology training program. Four other residency programs at the hospital -- internal medicine, family medicine, anesthesiology and neonatal-perinatal -- have been placed on probation or received warnings.

Next month, the accrediting council will undertake an overall inspection of King/Drew’s teaching programs. The last time the full program was reviewed by the council, it received an unfavorable rating. A second such appraisal could result in the shutdown of all training programs.