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String of Errors Put Florida Hospital on the Critical List


TAMPA — Diabetic and disabled, 51-year-old Willie King seems an unlikely figurehead for a national uprising over patients' rights. Two months ago, the retired heavy-equipment operator checked into University Community Hospital here to have his diseased right leg amputated. A doctor cut off his left leg instead.

"When I came to and discovered I lost my good one, it was a shock, a real shock," King said in a press conference three weeks after the Feb. 20 operation. "I told him: 'Doctor, that's the wrong leg.' "

Days later, King went across town to another hospital to get the surgery he needed. He is learning to walk now on a pair of donated prosthetic limbs and, after a quick and confidential deal with insurance companies, is financially set.

But King has also become a poignant symbol of a burgeoning consumer movement that its leaders say represents the last unconquered American frontier: patients' rights. King has lent his name to a proposed bill, now before the Florida Legislature, which would force hospitals to make public patient injury rates and better inform patients about their surgeon's qualifications.

King, who lives alone in a trailer, is doing fine. "I've kind of taken it in stride," he said.

But University Community Hospital is not. Reeling from a series of medical blunders, including King's wrong-leg amputation and the death 11 days later of a man whose breathing tube was mistakenly removed, the hospital was stripped of accreditation Thursday, an action that could mean it no longer qualifies for federal Medicare or Medicaid money.

Although the hospital has 20 days to appeal the ruling and remains open, the decision by the Chicago-based Joint Commission on Accreditation of Healthcare Organizations could be a fatal blow to the 420-bed institution on the city's north side. Last year, University Community took in $52 million in Medicaid and Medicare payments, nearly a third of the hospital's net patient revenues of $158 million.

The hospital board's chairman called the commission's decision unwarranted. "We do not treat these incidents lightly," Ken Lightfoot said in a statement released late Thursday. "However, by singling out UCH, the industry regulators are refusing to accept the fact that all--repeat, all--hospitals have similar patient incidents."

In addition to facing lawsuits from several former patients, the hospital is also under investigation by state and federal agencies. A ban on all elective surgeries was imposed last Friday by the Florida Agency for Healthcare Administration, which cited sloppy operating room procedures. That restriction has meant the loss of at least 60 surgeries each day, the hospital said.

On Wednesday the American Medical Assn. called on the accreditation committee to make an example of the Tampa hospital.

"Although human errors are inevitable, . . . systems are supposed to be in place to make the kind of mistakes which apparently occurred virtually impossible," wrote AMA Executive Vice President James S. Todd. "We know the Tampa hospital may be extraordinary, but we cannot take any chance."

Although stripping a hospital of its accreditation is extremely rare, the mistakes that occurred there may not be, according to many doctors and malpractice lawyers. "Tampa is not the hotbed of medical malpractice, and patient care is probably no worse at University Community Hospital than anywhere else," said veteran malpractice attorney Tony Cunningham, who has sued the hospital--as well as this city's two larger hospitals--many times.

As horrible as King's wrong-leg amputation is, that is not the only or even the worst medical outrage to take place at the hospital during a nightmarish 26-day spell that threatens to wipe out a reputation for quality patient care that took 26 years to build:

* On March 3, 11 days after a surgeon mistakenly sawed off King's left leg, Leo Alfonso, a 77-year-old retired electrician, died when a technician mistook him for another patient and pulled a breathing tube from a tracheotomy hole in his throat. With one arm paralyzed and the other held down by restraints, Alfonso slowly suffocated, unable to call for help. Cunningham now represents the Alfonso family.

* On Feb. 15, a doctor performed arthroscopic surgery on the wrong knee of a female patient. After discovering the mistake, the surgeon operated on the other knee.

* On March 16, a woman who gave birth by Cesarean section was partly sterilized before doctors realized that she had not requested or authorized the procedure. Asked immediately by the doctor if she wanted the tubal ligation repaired, the woman consulted with her physician and declined after being assured that she could conceive more children with only one working Fallopian tube.

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