King/Drew Hits Hard at Problem Personnel

More than a fifth of the staff at Martin Luther King Jr./Drew Medical Center has been fired or disciplined since January 2004 in an extraordinary crackdown prompted by revelations of widespread misconduct at the troubled public hospital.

But weeding out misbehavior hasn’t been easy. Indeed, some of the serious lapses in employee performance and judgment identified in recent months are markedly similar to what brought heightened scrutiny to King/Drew in the first place, a Times review of Los Angeles County Civil Service Commission records found.

Under the gaze of regulators, auditors, consultants, county supervisors and the media, King/Drew employees have continued to skip work or doze on the job, neglect patients and engage in heated and sometimes violent altercations, the records show.

Among the allegations by the hospital against employees last year:

* Critical-care nurse Arceli Andrade nodded off at a table in the break room while she was supposed to be on duty. One of her patients faded and eventually died. She was fired, as was her boss, Felix Brown, who had “frequently witnessed” her sleeping on other occasions and had to “shake her to wake her,” according to his discharge letter.

* Nursing attendant Martha Cortez was arrested on her lunch break on suspicion of battery, then had a family member call the hospital to say an “unexpected emergency” would keep her from her shift. She was in jail.

* Several custodians goaded a belligerent patient struggling with a police officer, urging him to “Kick the police’s ass.” Janitor Gregory G. Williams, who had a decade-long history of discipline problems, challenged the officer to “take off your badge and take off your gun and meet me at 120th” Street, his discharge letter said.

Details of these cases and dozens of others emerged from the files of the Civil Service Commission, which handles disciplinary appeals by county employees. Nearly all the King/Drew appeals are pending.

The Times sought to reach the employees named in this story both directly and with the assistance of labor union representatives. However, with one exception, the workers could not be reached. Unless otherwise noted, all of the employees denied the allegations against them in letters to the commission from the union.

In the above cases, Cortez withdrew an appeal of her suspension but still works at King/Drew. The allegations against Andrade were included in her boss’ disciplinary record. The Times could find no record that she appealed her discharge.

In general, the reports show a hospital cracking down as never before.

Since Jan. 26, 2004, the public hospital in Willowbrook just south of Watts has disciplined 524 of its approximately 2,500 employees. The pace of discipline picked up considerably in 2005, accounting for two-thirds of that figure. Over the two years, 199 staffers have been fired or resigned under investigation. The rest have been suspended or received reprimands and warnings. These personnel problems have not only overwhelmed King/Drew, they have also swamped the Civil Service Commission.

One in seven cases filed with the commission last year came from a King/Drew worker. In 2002, the figure was fewer than one in 100. In fact, far more King/Drew staffers challenged their punishments in 2005 than did employees in the entire Probation Department, which is nearly double its size.

Z. Greg Kahwajian, president of the commission, said that given the recent news coverage of King/Drew, the agency had anticipated a jump in employee discipline and appeals. Even so, the caseload is taxing the staff.

“We’ve had some very difficult and lengthy commission meetings as a result,” he said.

Although the alleged misbehavior is dismaying, county officials say they believe that the scores of disciplinary filings are a sign King/Drew is finally righting itself.

“I really think we’re close to being over the hump,” said Michael J. Henry, director of personnel for the county.

Former county health director Dr. Thomas Garthwaite, who resigned last month, agreed, adding that the employees who remain at King/Drew are on notice that wrongdoing won’t be tolerated.

“If the rules are consistently enforced, you would expect more people to behave,” he said.

King/Drew, which serves a largely poor, minority community, has been cited by regulators over the last two years for a series of serious patient-care and management lapses, including several deaths. The hospital has lost its national accreditation and faces possible loss of more than $200 million in federal funding if it does not pass an upcoming inspection.

In December 2004, a series of stories in The Times detailed how decades of inaction by county and hospital officials had allowed personnel problems at King/Drew to take root. Nurses neglected patients while they lay dying. Staffers failed to give patients crucial drugs or gave them the wrong ones by mistake. Employees did little or no work while on the job -- or didn’t show up at all.

“There was a serious lethargy in management at that hospital for years,” said Jim Lott, executive vice president of the Hospital Assn. of Southern California. “People were just not motivated to pursue disciplinary actions.”

Now, King/Drew is not just struggling with recent misbehavior and derelict performance, but it is also finding problems that were overlooked in the past.

Some employees have only recently been suspended or fired for long-standing criminal records, which include burglary, assault and, in one case, the “deposit of human waste” in public. It is unclear why the county didn’t take action sooner, or, in some cases, why the employees were hired in the first place.

In a termination letter to custodian Sean Farris, a King/Drew official said the hospital became aware of his 1991 robbery conviction in December 2004. Farris, first hired by King/Drew in 1998, said in an interview with The Times that he had disclosed his record on two employment applications and was given jobs nevertheless.

“If I was a detriment to the hospital, why did they hire me?” he asked. “I messed up. Hey, I was 23 years old. I’m 38 now. What can you do? How do they expect you to survive if they don’t give you a chance?”

Other employee files detail years of warnings about misconduct before any serious action was taken.

In one effort to corral workers, King/Drew sent some chronically absent staffers what it called “Where Are You?” letters after they didn’t show up for days or weeks at a time.

Surgical technician Charles Dennis was sent four such missives, beginning in November 1996, according to a disciplinary letter in his Civil Service file.

In September 2004, he received a 15-day suspension. Beginning three days after his suspension ended, Dennis missed the equivalent of three months out of the next seven, resulting in his firing, the letter said.

Similarly, nurse Mildred Cureton was fired in October after seven warnings about her absenteeism and failures to clock in. Her discharge letter said she was absent the equivalent of nearly four months between Sept. 1, 2004, and April 30, 2005.

The problems extend well beyond absenteeism. King/Drew employees, despite months of negative publicity and repeated visits from health inspectors, have continued to neglect patients -- at times in the same wards where deadly lapses previously occurred, according to allegations in the Civil Service records.

In April, for example, nursing attendant Danielle Jordan was caught napping in a “hunched-over position” in front of a bank of cardiac monitors in Unit 4B, her disciplinary letter said. That ward had been shut down for four months in December 2003 after nurses failed to notice the dropping vital signs of three patients connected to monitors. The patients all died.

Jordan’s union representative appealed her 30-day suspension while officials investigated. A county Department of Health Services spokesman declined to comment on the findings but said Jordan remains a King/Drew employee.

In another case, after being warned Sept. 19 that a female patient in the emergency waiting room “seemed very ill and possibly ready to faint,” supervising nurse Majoniwasa Utishala allegedly told staffers to put the woman in the triage area to wait for a bed and to keep her family out, her disciplinary letter stated.

“Leave her there. If she is faking it, give her five minutes and I bet you she will get up and walk,” Utishala allegedly said. The patient was moved to a critical-care area later that night and was dead the next morning, the letter said.

Utishala was suspended for 30 days while the incident was investigated, and she retired in December, a health department spokesman said.

Clerk Shannon Salone was fired in July for her allegedly rude treatment of supervisors, patients and even a counter clerk at the McDonald’s across the street from King/Drew, her discharge letter said. (Salone allegedly delivered a profanity-laced demand for “fresh fries,” sparking a dispute that ultimately led a McDonald’s manager to report her to the hospital for “harassment.”)

When Salone’s supervisors attempted to counsel her about her behavior, her discharge letter states, she allegedly said, “I am under stress. Stress pays. You know stress pays. I do not want to be here. Don’t tell me how I need to behave and talk to people.”

Stress is often cited at King/Drew as a reason for claiming workers’ compensation, but it could not be determined whether Salone filed such a claim.

She conceded in an interview with King/Drew officials that she had been frustrated on the job, but denied saying “stress pays,” according to her discharge letter.

Some of the cases now coming before the Civil Service Commission involve employees who were fired for alleged medical lapses that contributed to the deaths of patients.

Critical-care nurse Wilma Walker was suspended for three days in April 2004 after she and other nurses were accused of giving a potent anti-cancer drug to a meningitis patient. Last June, the county fired her for alleged lapses in the care of an AIDS patient who died in October 2004. Walker was accused of ignoring the patient’s vital signs monitor, falsifying patient records and failing to follow medication orders.

In her Civil Service appeal, Walker’s union advocate, D. Tyler Ross, wrote, “She followed policy and procedure in her care of the patient and performed her duties based on her training and the norm of patient care at King/Drew.”

The Civil Service filings suggest that some employees knew they were headed for trouble, long before disciplinary action arrived.

After allegedly using profanity while threatening to slap a fellow employee in March, typist clerk Zanetta Allen left the office saying, “Let me get out of here before I lose my county job.”

Allen was later fired, a county spokesman said.

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(BEGIN TEXT OF INFOBOX)

More appeals

As Martin Luther King Jr./ Drew Medical Center cracks down on employee misbehavior, more appeals of disciplinary actions are reaching the Civil Service Commission.

Number of King/Drew discipline cases appealed:

2002: 4

2003: 6

2004: 33

2005*: 88

King/Drew cases as a percentage of all appeals to the commission:

2002: 0.8%

2003: 1.3%

2004: 7.2%

2005*: 14.5%

* As of Dec. 14

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Source: Los Angeles County Civil Service Commission