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King/Drew Trauma Unit Faces Closure

County supervisors say that shutting the heavily used center and hiring outside managers could save the rest of the troubled hospital.

September 14, 2004|Tracy Weber, Charles Ornstein and Mitchell Landsberg | Times Staff Writers

The Los Angeles County Board of Supervisors on Monday unexpectedly moved to shut down the trauma unit at Martin Luther King Jr./Drew Medical Center, immediately drawing the ire of physicians, politicians and community activists.

The only public hospital serving a large swath of South Los Angeles, King/Drew treats more trauma patients than any other hospital in the region except County-USC Medical Center.

The proposed trauma closure, expected to take effect in about 90 days, amounts to a last-ditch scramble to save a foundering hospital that repeatedly has been cited by regulators for harming patients and in some cases contributing to their deaths.

Under pressure from federal health officials, the supervisors also agreed to hire outside managers to run the hospital -- replacing the team of county health leaders who have run it for nearly a year.

The reaction from community leaders was swift and mostly negative. Assemblyman Mervyn Dymally (D-Compton), who has led legislative hearings on the future of King/Drew, was outraged.

"I could see if they were going to close some other department, but not the trauma center. My God, this is a crisis," he said.

But Assemblyman Mark Ridley-Thomas (D-Los Angeles), applauded the board's latest actions, saying they were long overdue.

"It's about time that the Board of Supervisors faced up to their responsibility, and has chosen to take appropriate action, albeit unpopular," he said. "There's no expert in the area of public healthcare worth his or her salt who would deny that Martin Luther King hospital was in need of radical intervention."

The proposal to shut the hospital's trauma unit is subject to final approval by the county supervisors after a public hearing, which has yet to be scheduled.

County health officials were quick to point out that King/Drew's emergency room will still be open, just not the trauma unit. The ER treats about 45,000 patients a year for such ailments as chest pain, infections and pneumonia.

The trauma unit, dedicated to treating life-threatening injuries from such incidents as shootings and car accidents, served 2,150 patients last year.

At a news conference Monday, all five supervisors endorsed the changes -- an unusual showing of unanimity on an issue that has frequently divided the board.

In part, the board's action was an effort to appease regulators, who have threatened to yank the hospital's federal funding several times this year for failings that included giving a patient with meningitis a potentially toxic cancer drug and using stun guns on mental patients.

Supervisor Michael Antonovich deemed the county's efforts to fix King/Drew over the last eight months "pathetic."

"It took so many losses of life and inferior medical treatments to bring us to the stage where we are today," he said at the supervisors' news conference.

In some instances over the last year, county officials have conceded that they were unaware of problems at King/Drew until they were identified by The Times.

County officials said they would make every effort to persuade other hospitals to open trauma centers. But health experts said the loss of King/Drew could further jeopardize a beleaguered system that has lost about 10 trauma units in the last two decades. The county now has 13, including King/Drew.

Just two of the county's trauma centers are within 11 miles of King/Drew: Harbor-UCLA and St. Francis medical centers.

King/Drew serves one of the most violent areas of the county, with the highest rate of homicides.

"Closing down a [trauma unit] within a couple miles of the most violent parts of the city? South Los Angeles? Compton? Lynwood?" asked Sal La Barbera, homicide supervisor in the Los Angeles Police Department's Southeast Division station, which covers Watts. "This will definitely have an impact on how many lives are saved.... Harbor [UCLA] is an extra 10 or 15 minutes."

Bryan Hubbard, a King/Drew trauma surgeon, said closing the center is "ludicrous."

"People will be dying in the streets or dying in transport to other facilities," he said, because they would have to travel farther during the crucial first hour after being injured.

The closure of the trauma unit, officials said, does not stem from failings in the unit, which has long been a source of great pride and prestige to the community. At one point, the U.S. military trained surgeons in the unit because it so closely simulated wartime medicine

Rather, the proposed closure is intended to relieve pressure on the rest of the hospital. Running a trauma unit is costly because the patients are so sick, many are uninsured and the hospital is required to have a host of specialist doctors on standby 24 hours a day to respond immediately when an emergency arises.

Health officials did not provide an estimate of how much money would be saved by the proposed closure.

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