5 Leaders at King/Drew Being Fired

Los Angeles County officials are in the process of firing five top leaders at Martin Luther King Jr./Drew Medical Center -- including the hospital’s administrator -- in response to mounting troubles at the public hospital in Willowbrook, according to people familiar with the dismissals.

The termination notices follow a series of disclosures about lapses in care at King/Drew that have endangered patients and, according to government inspectors, contributed to at least five deaths in the last year.

Supervisor Don Knabe said that the terminations represented an unusually large purge of a county institution.

“Usually you lose a CEO or one or two of the top people,” he said. “But King/Drew has significant issues. It just can’t go on like it has been. If you look at the history of some of the investigations and lawsuits, it was the same ol’, same ol’, and nothing was changing.”

The county is sending termination notices to Willie T. May, King/Drew’s chief executive; associate medical director Dr. Alfred Forrest; nursing director Rosemary Haggins; and one of her top assistants, said those familiar with the firings, speaking on the condition of anonymity.

County officials also have sent a letter of termination to Dr. Arthur Fleming, who presided over the training of aspiring surgeons last year when a national body stripped the program of its accreditation.

Fred Leaf, chief operating officer of the county health department, informed the Board of Supervisors in writing Friday that the department had started notifying “a number of senior managers at King/Drew” that they would be fired.

Neither he nor his boss, health director Dr. Thomas Garthwaite, would comment further on who was terminated or why, citing confidentiality restrictions.

But the actions were applauded by some of the facility’s supporters.

“Something has to be done to save the hospital,” said state Assemblyman Mervyn Dymally (D-Compton), who heads the Assembly special committee looking into King/Drew. “Obviously some drastic action has to be taken, and some people are going to be very unhappy. They’re moving in the right direction.”

The hospital, which serves a largely minority population with few choices for care, has faced increasingly severe sanctions in recent months from accreditation agencies and healthcare regulators. Just last week, the federal government threatened to cut off funds to King/Drew unless the hospital corrected serious flaws in the way it handled prescription drugs by March 23.

The threat followed an incident last month in which a patient with meningitis was mistakenly given a potent anti-cancer drug for four days.

In January, inspectors issued a graphic accounting of patient deaths at King/Drew, including one in March 2003 in which nurses had virtually ignored a 20-year-old man suffering from intestinal gangrene. He was found 18 hours after admission on the floor of his room -- where he had fallen unnoticed -- in a pool of his own vomit, according to the federal report and an autopsy summary. He could not be revived.

Four days later, another patient suffering from gangrene and other problems died after being neglected for almost a day, the report stated.

Also last year, three patients died when nurses did not notice their conditions were deteriorating, even though they were connected to cardiac monitors, inspectors found.

County officials said Monday that the terminated employees, who are covered by civil service protections, would have several opportunities to appeal the firings before they become final.

But they stressed that they had gone to great lengths to ensure they had adequately documented the reasons for the decisions.

“The bulk of the employees at King are doing a great job,” Leaf said. “However, a number of individuals are not performing, and we’re holding those individuals accountable.”

Garthwaite said he had been concerned about a lack of accountability at the hospital, and recent findings by federal investigators that nurses had lied or been ordered to lie on patients’ charts.

At most hospitals, he said, such problems would have been caught by administrators and corrected.

Leaf said more discipline would be forthcoming, but he could not say how many employees were involved.

“The reality is we need to take very assertive actions at this point in time,” said Supervisor Gloria Molina. “Even if we’re sued, everybody needs to know that we mean business at MLK.”

Supervisor Zev Yaroslavsky agreed, saying the firings are necessary to turn the hospital around.

“The director of health has to clean house and reformulate the staff at Martin Luther King hospital ... to provide the quality of service that the people of our county are entitled to,” he said.

But Supervisor Yvonne Brathwaite Burke, whose district includes King/Drew, downplayed the significance of the dismissals. They were formalizing the departures of staff who had not worked at the hospital for months, she said.

“I was there this morning,” she said. “I went to pharmacy, the ER. I talked to the nurses, they seemed to feel that they had new procedures in step, and I do feel there’s progress.”

The dismissals come after a round of discipline and the dispatching of crisis management teams to the hospital. In October, the county moved in a management team of top health department officials to run the hospital. A private nursing firm took charge of nursing in December, and a new medical director started in February.

May could not be reached for comment, and messages left for Forrest and Fleming were not returned.

Fleming, the former surgery chairman, was suspended in December after the Accreditation Council for Graduate Medical Education withdrew its approval for King/Drew’s surgery program.

The council said that after repeated warnings, Fleming had allowed two more residents in the program’s graduating class than the six it was allowed.

At an Assembly hearing in September, Fleming said the loss of the residency program was not his fault, and that the council’s action was based on misinformation.

The firings of Haggins and assistant nursing director Barbara Bundage came after government inspectors found a host of problems with the nursing care at King/Drew. A second assistant nursing director, Margaret Latham, remains on suspension.

According to the inspectors, King/Drew nurses were ordered to lie about patients’ conditions, failed to give crucial medications prescribed by doctors and left seriously ill patients unattended for hours.

A report issued Jan. 13 noted that hospital officials had failed to fix dangerous lapses in care after promising to do so.

Bundage declined to comment on the disciplinary action.

Haggins’ attorney said she did not know Haggins had been fired. A message left for Haggins was not returned.

But at a Jan. 9 hearing by an Assembly panel probing King/Drew, Haggins defended her record.

“Unlike my depiction as being careless in the performance of my duties by other departments, I take very seriously the provision of patient care,” she testified. “I, as the nursing director, reported to my superiors -- locally and to corporate -- the critical issues as I assessed them. And nothing -- well, I didn’t get a response.”

On Monday, however, the county released a draft report by a consulting group hired to fix a number of critical nursing problems at the hospital.

The consultants found “major deficiencies” in the way King/Drew was staffed, including a computerized staffing system that worked poorly and a “long-standing problem with employee attendance and tardiness.”

Knabe said the firings could only benefit the largely poor and minority communities that rely on King/Drew.

“This is people’s healthcare,” he said. “King Drew is a vital part of our health safety net -- it can’t be a place where people go and their life is put in jeopardy because of a simple treatment.”