King/Drew’s Trauma Unit Gets a Reprieve

Faced with the wrath of a hostile crowd and the pleas of local and state officials, Los Angeles County supervisors took a halting step Tuesday on the path to closing the trauma unit at King/Drew Medical Center.

Several hours into a tumultuous, emotion-packed meeting, the supervisors agreed to soften a motion that would have ordered the county health director to “take the steps necessary” to close the trauma unit, the second-busiest in the county. In place of that, the supervisors agreed only to hold a public hearing to consider the closure.

The change was largely semantic, because the original proposal would also have required a public hearing and a second vote by the board. But it reflected the political hurricane into which the board has navigated by calling for the closure of the unit.

“The Salem witch trials don’t have anything on us,” Supervisor Gloria Molina said at one point as she struggled to maintain order amid angry recriminations.

The vote to hold the public hearing passed 3 to 1, with Supervisor Yvonne Brathwaite Burke opposed. Burke, who represents the district in which the hospital is located, had wanted to postpone any decision on the trauma unit. Board Chairman Don Knabe, attending a meeting in Washington, was absent.

In a separate vote, the board agreed unanimously to sign a contract with the U.S. Centers for Medicare and Medicaid Services that requires the county to hire an outside management firm to run the hospital for a year.

Faced with the possible loss of accreditation and federal funding, Thomas Garthwaite, the county’s health director, proposed closing the trauma unit as a way of removing the most taxing medical cases from King/Drew. Although it was not demanded by Medicare officials, Garthwaite argued that it might be the only way to achieve the overall changes that the federal agency was demanding.

Troubled for decades, the county-owned hospital has been reeling in the past year from a series of lapses in patient care, including several that contributed to patient deaths, according to regulators.

Adding to the problems, the private university that trains doctors at King/Drew has been forced by accreditors to close three of its programs, including surgery.

Although county officials have not cited the trauma unit as the source of the most serious problems, Garthwaite has argued that it puts too much of a strain on the rest of the hospital’s resources.

Garthwaite repeated his arguments at the supervisors’ regular Tuesday meeting, saying the county could not afford the risks of keeping the trauma unit open.

“It’s like driving your car on the edge of a cliff,” he said. “Anything can just push it over.”

But in more than two hours of testimony that ran overwhelmingly against the closure, state legislators, City Council members, doctors and members of the community insisted that the proposed shift of trauma care to neighboring hospitals would cost lives.

Although many speakers acknowledged that King/Drew was a troubled hospital, they demanded that the supervisors find another way to fix it.

“Let’s step back and really evaluate this thing,” said state Sen. Gil Cedillo (D-Los Angeles). “Let’s not move forward. We’re not compelled.”

Two speakers, state Sen. Richard Alarcon (D-Sun Valley) and Assemblyman Herb Wesson (D-Culver City), recounted personal experiences with trauma centers. Wesson, a former aide to Burke, credited King/Drew’s trauma unit with saving his two sons’ lives when they were seriously injured in a car accident. Alarcon recounted how his son, also hurt in a car crash, died after being airlifted from the San Fernando Valley to Childrens Hospital Los Angeles.

As murmurs rippled through the audience, Alarcon said he didn’t know whether his son would have survived had there been a closer trauma unit.

“I choose to believe that he didn’t have a chance,” he said. “But I wonder how many parents would suffer the same consequences under this decision.”

Other speakers included Assembly Speaker Fabian Nunez (D-Los Angeles), Assembly members Jackie Goldberg (D-Los Angeles) and Mervyn Dymally (D-Compton), and Los Angeles City Councilwoman Janice Hahn.

All offered their help to the supervisors, with Nunez saying he intended to solicit the help of Gov. Arnold Schwarzenegger.

King/Drew, located in Willowbrook, just south of Watts, serves the poorest sections of Los Angeles County, an area with high rates of violent crime. It treated 2,150 patients last year in its trauma unit, which is designed to handle violent injuries such as those incurred in shootings, stabbings and car accidents.

The hospital also sees about 47,000 patients a year in its emergency room, which treats a wide range of illnesses and less serious injuries. There are no plans to close the emergency room.

At Tuesday’s meeting, the crowd of several hundred, a mix of community activists, hospital patients and union members, salted with the white jackets of doctors and nurses, was repeatedly admonished to be quiet, and sheriff’s deputies escorted several people out when they continued to berate the board.

Almost every speaker denounced the proposed closure of the trauma center.

Rev. Frederick O. Murph of Brookins Community AME Church elicited cheers and sign-waving when he told the supervisors that the community felt under siege. He played off the repeated assertion by county health officials that the closure would “decompress” the hospital.

“Let me tell you, supervisors, if you close the trauma center, you are going to decompress the community, and it’s going to explode,” Murph said.

County health officials say the hearing would likely take place in November, though a date has not been set.

The Board of Supervisors first proposed the trauma closure at a news conference Sept. 13, after discussions at two closed meetings. Two days later, a national accrediting group, the Joint Commission on Accreditation of Healthcare Organizations, announced that it was recommending the revocation of its seal of approval from King/Drew.

Without accreditation, county health officials said, the hospital would be hard-pressed to keep the trauma unit running regardless of how the supervisors voted.

The supervisors initially were united behind the idea of closing the trauma center. But on Friday, Burke announced that she had changed her mind and would propose delaying the decision. Her motion died Tuesday when no other supervisor backed it.

The board’s vote ran counter to a long-standing tradition of abiding by the wishes of the supervisor in whose district an institution is located.

“As we would say in the Capitol, this is a ‘district bill’ for Supervisor Burke,” Cedillo told the supervisors. “Step back, give her the due respect as the representative of her district.”

But supervisors said the issue had grown too large for that.

Molina challenged Burke to come up with an alternative to closing the trauma unit.

“Anytime she is ready to take a leadership role in fixing it, anytime, I’m ready to follow her lead,” she said.

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Times staff writers Steve Hymon and Charles Ornstein contributed to this report.