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Trauma Unit's Future Unclear

Burke calls plan to close facility at King/Drew hospital rushed. County health chief says drastic action is needed.

September 21, 2004|Jia-Rui Chong and Sue Fox | Times Staff Writers

Los Angeles County Supervisor Yvonne Brathwaite Burke said Monday that the county's health department chief had made a rushed recommendation to close the trauma unit at the troubled Martin Luther King Jr./Drew Medical Center and that the department had given supervisors incomplete information before they backed the closure plan.

The health department chief, Thomas Garthwaite, meantime, provided the most detailed public rationale to date for the proposal to close the trauma unit. And he gained some important, although hedged, support from an influential doctor who said area hospitals could absorb patients currently treated at King/Drew -- at least if they got more money.

King/Drew's problems, which have included numerous cases of poor care and in some instances have contributed to patient deaths, are too serious to solve without large-scale change, Garthwaite said.

"If we do not take drastic action, King/Drew will be closed," he said. "We have been told we cannot go on operating the way it is."

The comments by Burke in an interview and by Garthwaite at a news conference came as county supervisors prepared for a potentially raucous public discussion today on the future of the county-owned hospital.

Last week, supervisors unanimously suggested closing the trauma unit this year. The move drew widespread protest from political figures and from the residents, mostly black and Latino, of the communities served by the hospital, which is in Willowbrook, south of Watts. The areas around King/Drew include neighborhoods with the highest rates of shootings and homicides in the county.

On Friday, Burke, who represents the area, expressed second thoughts about closing the trauma unit and proposed postponing a decision.

In an interview Monday, Burke said the proposal was premature and could cost some patients their lives. She said she had been unhappy all along with the decision -- forged in closed-session meetings earlier this month -- but had agreed "to go along because this is the only way to save the hospital."

After the decision, she said, reading newspaper reports and hearing protests from medical workers and constituents convinced her that the proposal demanded more study by a team of medical consultants that the county has yet to hire.

The county health department, she said, had failed to give the supervisors important information before the decision on issues such as whether other hospitals could absorb the patients currently treated at King/Drew. The hospital treated roughly 2,100 trauma patients last year and is expected to treat about 1,800 this year, officials said. The decline in numbers came about because of an earlier decision to reduce the geographical area served by King/Drew's trauma unit.

"I have now found out that California Hospital is going to take a while to get a trauma center going," Burke said, referring to a hospital in downtown Los Angeles that health officials hope will open a trauma unit.

"I also heard the city paramedics making these statements that there might be a threat to life" because diverting patients to other hospitals would lengthen their ambulance rides. "I just think that there was not the groundwork done."

"All I'm asking for is a second opinion," Burke said. "If I was going to have a toe operated on, I'd want a second opinion."

Burke acknowledged, however, that she does not currently have support on the board for postponing a decision.

Garthwaite, she said, first suggested closing the trauma center during a closed-door discussion with supervisors about reforms that federal regulators have demanded at the beleaguered hospital. She said Garthwaite was "so rushed" to draft a written proposal for the board that not enough time went into thinking through the controversial plan.

In defending his decision Monday, however, Garthwaite insisted that the county has no safe alternative to closing the trauma unit.

"My name is on the line to determine whether care is safe or not," he said. "My name's going to say we need to decompress that hospital."

Health department officials are open to an alternative, he said, but he added: "I don't know what it could be."

"We have a dozen very skilled and experienced administrators in the discussion on this," he said. "No one else can see something obvious."

Garthwaite stressed that the proposal to close the trauma unit is not designed to save money.

Indeed, rerouting patients to other hospitals would probably raise the county's costs. Instead, he said, the problem is that trauma centers require a lot of resources other than money. Closing the trauma center at King/Drew could free overworked nurses, doctors and pharmacists to take care of other patients.

"We have to slow down the influx of patients," he said.

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