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Surprise Inspections Planned at County-USC : Medicine: State announcement follows reports of patients in public corridors.


State hospital inspectors said Tuesday they plan new surprise visits to overcrowded Los Angeles County-USC Medical Center following reports that partially clad patients were parked on gurneys in a public corridor for as long as six hours.

"We will be back out there," said Jacqueline A. Linzer, a district administrator for the state Department of Health Services. She said the new inspections, unlike one triggered by reports last month of overcrowding and substandard medical care, would not be announced to hospital administrators.

After the last inspection, the medical center's administrators assured the state that conditions were improving at the huge hospital. But some physicians said the patient mishandling observed Monday was the worst they had seen.

County health officials were grilled Tuesday by the Board of Supervisors about the latest episode. At their scheduled meeting, the supervisors delayed other county business to demand an explanation from hospital officials about how patients were in corridors without even a screen to protect them from the stares of passersby.

Carl Williams, the county's chief of hospitals, acknowledged that having the patients in the hallway violated state regulations that insure patients "appropriate privacy and staffing" which, he said, "was available in a different area" of the hospital.

State inspectors on Dec. 23 had cited the hospital for violating these regulations after finding three patients crammed into an examining cubicle designed for two.

Williams, however, characterized Monday's incident as a "setup," staged for The Times by disgruntled medical personnel trying to dramatize staff shortages and patient overload.

The explanation, however, failed to satisfy Supervisor Gloria Molina.

"Besides trying to bring in the head of who did this, let's also find out what is going on out there and confront some of the realities," Molina said.

The Times had reported in December that chronic overcrowding at General Hospital led to substandard medical care and several patient deaths. Reports were received Friday that the patient backlog was worsening, and on Monday a reporter observed 20 patients--some of them in restraints--left in the corridor.

The Board of Supervisors ordered an investigation into the Monday incident. Supervisor Deane Dana asked that officials focus on whether the incident was staged, while Molina repeated her assertion that the incident was symptomatic of a severely overtaxed hospital.

Meanwhile, administrators at General Hospital--the largest of four hospitals at the East Side medical center--held high-level meetings Tuesday trying to determine how the patients were left in the hallway between the emergency room and the internal medicine admitting area.

The patients had been admitted through the emergency department and were under the jurisdiction of the department of medicine when they were found in the hallway.

"There was a concurrence with everyone that that it (was) an intolerable situation and that will not be repeated," said Edward Martinez, who chaired the meeting with Dr. Sol Bernstein, the hospital's medical director.

The hospital also took several steps Tuesday to reduce the patient overload.

Area police agencies were told not to bring in psychiatric patients unless they have medical or surgical problems requiring emergency room treatment. Martinez said Monday's overflow was partly attributable to psychiatric patients being dumped by police at General Hospital.

For the second day in a row, General Hospital asked the county's Emergency Medical Services agency to divert ambulance traffic. The rationale was to give the hospital a chance to clear the backlog of patients in the emergency room and in holding areas awaiting beds.

One emergency room doctor, who requested anonymity, said 25 patients--some of whom had earlier been in the hallway--spent Monday night on gurneys in a spare area off the emergency room waiting for hospital beds.

The supervisors also had already requested from county officials a detailed plan for relieving the pressure on emergency rooms at County-USC and other public hospitals.

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