Staffers Retrained After CPR Probe

Nearly 500 nurses and other staff members at Martin Luther King Jr./Drew Medical Center had to be retrained in cardiopulmonary resuscitation after Los Angeles County auditors found that one of the hospital’s primary instructors falsified paperwork, gave away answers on at least one test and improperly sold certification cards.

According to the auditors’ confidential report, a copy of which was obtained by The Times, 482 employees supposedly had been taught life-saving skills by nurse manager Virginia A. Williams.

But auditors working for the health department could not verify whether any had received proper training. And in some cases, auditors determined, the training was not provided even though records suggested it had been.

“We started retraining people immediately after it was determined that there had been improprieties with that particular instructor,” said King/Drew chief executive Antionette Smith Epps, who took over in October.

All have been recertified except those who are on leave or have stopped working at the troubled public hospital, she said.

Williams was escorted off the hospital grounds in November after health officials conducted a sting in which an employee working with authorities pretended to need certification.

On Wednesday, Williams declined to comment on the audit’s findings. Previously, she has said that she never sold CPR cards or allowed King/Drew staffers to obtain them without passing a test.

The county is taking steps to fire Williams, a 23-year county employee, health department spokesman Michael Wilson said. No other employees have been disciplined, officials said.

The Public Integrity Division of the district attorney’s office is also reviewing the matter for possible prosecution, said spokeswoman Jane Robison.

The nurse intends to contest her discharge, said Fred Williams, a labor relations consultant who is representing Virginia Williams. “I suggest you let Ms. Williams have her due process rights,” said the consultant, who is not related to Virginia Williams.

The CPR problems are only the latest trouble for King/Drew, which in the last two years has lost its national accreditation and been threatened with a loss of federal funding after a series of sometimes deadly patient-care lapses.

The county has spent tens of millions of dollars attempting to fix the hospital and has disciplined hundreds of problem employees.

Officials acknowledged that the overhaul cannot be considered complete.

“Was I surprised? Quite frankly, no,” Smith Epps said of the auditors’ findings. “It’s to me quite simply another symptom of the need for leadership -- what my team and myself have begun to do and we’re doing a good job of it.”

Fred Williams would not allow his client to answer auditors’ questions, and many details of her alleged wrongdoing remain murky.

The audit, for instance, does not address Virginia Williams’ motive or whether any King/Drew patients were harmed as a result of the questionable CPR training.

Many of the employees had previously received CPR training and had come to Williams for recertification, which is recommended every two years to maintain proficiency.

Even so, experts said, the training was critically important and required by state law.

“It’s not an exercise,” said Jim Lott, executive vice president of the Hospital Assn. of Southern California and a member of the now-disbanded King/Drew advisory board. “It is a serious matter, a very serious matter, to have people trained and certified.”

CPR consists of mouth-to-mouth resuscitation and chest compression and can keep a person alive until more advanced care is available. If CPR is started quickly after a person has a heart attack, it can double the chances of survival.

Recertification courses, which take three to four hours, require participants to pass a written exam and demonstrate skills on a mannequin.

The audit, which was finalized in early February, examined King/Drew nursing education records, including course rosters, answer sheets, check lists and CPR cards from 2003-2005 and found that Williams was the instructor for 482 workers, about one in every five King/Drew employees.

Auditors interviewed 34 of those employees to look for irregularities. Thirteen of the 34 said they paid Williams personally between $2 and $35 to renew their CPR cards. One employee said she paid about $25 and took the class at Williams’ home, although her card says she was trained at King/Drew.

The audit said Williams was not allowed to accept any money personally to provide the course or change the curriculum. A $15 fee should have been paid directly to the King/Drew nursing education office.

The document does not say how much money Williams collected overall and whether that was turned over to King/Drew.

The CPR cards of four employees bore their names typed over other names that had been whited out, the audit said. Other workers said they were never trained by Williams even though she was listed as the instructor on their cards, the audit said. It is unclear if they were trained by others.

Overall, the health department auditors also found that no one was checking to ensure that employees had proper certifications. Of 744 nursing files reviewed by auditors, 36 did not contain a CPR card as required, and 81 had cards that were expired. According to county policy, all direct patient-care staff, except for senior doctors, are required to receive and maintain CPR certification.

The audit also recounted the November sting operation that substantiated the allegations made against Williams.

During the sting, an employee working with a law enforcement task force approached Williams and requested recertification. Williams described changes in CPR, gave a demonstration on a baby mannequin and “provided approximately nine minutes of instruction,” the audit said.

Williams handed the employee the examination and, without being asked, gave the first five answers. She did not accept any money but allowed the employee to finish the test at home and return it before the end of the week.

Before the employee left the office, “Ms. Williams typed up a letter of completion at that time, indicating that the ... employee successfully completed the CPR course,” the audit said.