Mixed Reports About Hospital Given

A week after moving his office to Martin Luther King Jr./Drew Medical Center, Los Angeles County’s health department chief on Tuesday touted improvements at the troubled hospital, citing enhanced supervision of trainee doctors and better nurses.

The assessment came as a consulting firm hired to turn around the hospital reported that a psychiatric patient, who was supposed to be under constant watch, disappeared from the emergency room last week.

The Board of Supervisors received both reports with restraint, in contrast with last week’s rancorous debate in which Supervisor Gloria Molina ordered Dr. Thomas Garthwaite to work out of the Willowbrook medical center, near Watts, until its problems are fixed.

Federal regulators have renewed their scrutiny of King/Drew following revelations in recent weeks of five more problematic patient deaths. The county Department of Health Services has cited mistakes by medical staff members in each case.

Nevertheless, Garthwaite told supervisors he was encouraged after spending the last week checking patients’ medical charts and talking to physicians and nurses. “I think there’s no question that we’ve seen a dramatic improvement,” Garthwaite said. “I’ve always found staff there actively engaged, not only in supervising residents, but caring for patients.”

In reviewing charts, Garthwaite said he found doctors were now doing a better job supervising doctor trainees. County officials have linked many of the persistent shortcomings in care at King/Drew to poor oversight of trainees.

Physicians, he said, also reported that the nursing staff had improved significantly. Six patients have died at the hospital in 21 months after nurses failed to heed monitors signaling deteriorating vital signs.

“I think to a person, they say they’ve seen improvements,” Garthwaite told the board, adding, “There are still issues. I do not minimize the number of issues still involved.”

Two recent deaths under investigation -- both of which the Board of Supervisors learned about from The Times -- involved patients so severely ill they would have probably died even without the medical lapses that occurred, he said.

Garthwaite said the cases were still under investigation.

Kae Robertson, a director with Navigant Consulting Inc., which has a $13.2-million contract to run the hospital for the county, told the supervisors that health officials were pushing ahead with reforms proposed last week by the Hospital Assn. of Southern California.

The hospital, she said, plans to hire enough nurses after May 1 to walk the halls of King/Drew day and night, and to recruit intensive-care doctors to monitor the treatment of patients.

Robertson also revealed that hospital staff members lost a psychiatric patient from the emergency room the same day Garthwaite moved to the hospital. The patient was brought to the hospital’s psychiatric unit by police who decided he was a danger either to himself or to others, she said. Hospital staff members then took the patient to the emergency room April 13 for unspecified medical treatment, but he disappeared the same day, she said.

“We should have figured out not to allow him to elope,” Robertson said. “He should have had one-to-one observation.” Hospital staff asked police to contact the patient at his home, but he has not been found, she said.

Also Tuesday, Supervisor Don Knabe asked county administrators to explore whether they should split the health department into two agencies: one to run the county’s public healthcare programs, the other to manage its clinics and hospitals.

The board approved his motion.