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Trying to fill a hole in medical clinic regulation

May 07, 2011|Michael Hiltzik

• Require that an accreditation body inspect a clinic within five business days of receiving a safety complaint

• Require that any revocation, suspension or reprimand of a clinic be made public within 24 hours, and that all inspection reports be available for public view, along with a list of all clinics, their owners and their medical license status

• Give the board the authority to make unannounced inspections, and to move for an injunction in court to shut down an outpatient facility that doesn't meet standards

What's stunning is that the board doesn't have these powers already.

To see how they would work in practice, let's examine the case of Almont Ambulatory Surgery Center, a Beverly Hills outpatient clinic specializing in weight-loss surgery.

For a few months in 2009, the center was accredited by the American Assn. for Accreditation of Ambulatory Surgery Facilities. The organization revoked Almont's accreditation in April that year, after its inspectors followed up on a safety complaint.

That action wasn't known to Willie Brooks Jr., a Pomona school custodian who had a laparoscopic gastric band implanted there a few weeks later. Brooks died three days after the operation from what the Riverside County coroner identified as "peritonitis due to lap band procedure due to obesity."

If SB 100 in its current form were the law then, Brooks would likely have learned about the revocation before having surgery. He might also have learned that less than a month before his operation, state health inspectors had visited the facility and written a 22-page list of health and safety deficiencies; these were serious enough for federal Medicare officials to conclude that they posed "immediate jeopardy to the health and safety" of its patients, and to withdraw the clinic's right to treat Medicare enrollees.

Brooks' family says in a lawsuit that the clinic didn't tell them about the inspection results. Had he known, Brooks might have chosen to have surgery elsewhere, and who knows — he might be alive today.

If SB 100 were the law in July 2009, the Joint Commission, another of the four independent accreditation agencies empowered by the medical board, might have thought twice before accrediting a facility called Beverly Hills Surgery Center, which had taken over Almont's location. It would have had no excuse for not knowing that the owners of Beverly Hills Surgery Center were Julian and Michael Omidi, that the medical board had revoked Julian's license and placed Michael's on probation, and that they had been involved with launching and managing Almont.

Maybe the Joint Commission would have found justification for accrediting Beverly Hills anyway. But it might have been led to wonder whether it was accrediting a clinic that had previously had its accreditation revoked by a different organization and was now just operating under a new name.

By the way, Los Angeles County coroner reports have stated that two other patients have died within days of receiving weight-loss operations at that clinic — while it's been under Joint Commission accreditation. Robert Silverman, a lawyer for the facility, has defended the care that the deceased patients received there, and noted that none of the patients died on the premises.

The potential for a flood of deaths and injuries from poorly regulated outpatient clinics has loomed ever since the Capen decision. We stand now on the edge of the water. How bad does the crisis have to get before the Legislature finally acts?

Michael Hiltzik's column appears Sundays and Wednesdays. Reach him at mhiltzik@latimes.com, read past columns at latimes.com/hiltzik, check out facebook.com/hiltzik and follow @latimeshiltzik on Twitter.

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