The troubles with Martin Luther King-Harbor (formerly MLK-Bell Hospital) are nothing new. The hospital officially opened its doors in 1972, being born out of the chaos of the 1965 Watts Riots. Immediately after the riots, it became readily apparent that a hospital in the Watts area was sorely needed. The hospital itself was looked at as a victory for the African-American minority which made up the majority of the South Los Angeles area (Steinhauer). However, since its inception the hospital has been plagued by administrative and medical problems. More specifically, over the past four years the county has issued stern warnings to the hospital to fix their numerous problems. Some examples of negligence that was uncovered include employees who failed to wash their hands, equipment not being cleaned properly, and nurses who did not know how to administer basic tasks such as checking in on patients (King-Harbor). However, the final straw came in May 2007 when the details of the death of Edith Rodriguez in the hospital’s waiting room became public and the top headline for every news program.
Fatal Results from Incompetence
Edith Rodriguez was a 43-year-old mother of three who lived in the South Los Angeles area. She was living in poverty and had many health problems. Early in the morning on May 9th, Edith was rushed to the emergency room at King-Harbor complaining of severe pain in her stomach. She had already been to the same emergency room three times, and had received nothing but pain medication and a release. This time, the staff refused to see her, saying there was nothing more to be done and to go home. Rodriguez refused to leave, and eventually started vomiting blood in the waiting room while the hospital staff did absolutely nothing. In panic, her boyfriend called 911 from an outside pay phone and pleaded for help, but was told that since she was already at a hospital there was nothing they could do. As if that was not enough, another person who was also in the waiting room called 911 from her cell phone, pleading for the operator to send help. The operator responded rudely and informed her that this simply was not an emergency and to stay off the emergency line. Edith Rodriguez died early in the morning of a perforated bowel, which according to the coroner developed in the last 24 hours of her life (ABC News).
What makes this case even more shocking is the video and audio evidence explicitly demonstrating the incompetence of several individuals which directly led to Rodriguez’s death. Almost immediately, the 911 audiotapes of both the boyfriend and the concerned Samaritan were made public. The bureaucracy displayed in the refusal to send help was shocking. The first operator said that since Rodriguez was already in a hospital that he was not allowed to send for help. The second operator was just extremely rude and condescending and in no way was trying to help what was obviously a life-or-death situation. What is even more damning however is the existence of a videotape showing Rodriguez falling out of her wheelchair, collapsing on the floor in a pool of her own blood and vomit. No one did anything to help her. In fact, on the video, a janitor is shown mopping up around her as she laid there literally dying in front of the hospital staff (How a Hospital).
Though it was the death of Edith Rodriguez that proved to be the final nail in the coffin for the hospital in the public’s eye, there were many other instances of gross neglect leading to the death of those who should not have. As stated here in this story by the LA Times,
Hers was one in a series of cases allegedly mishandled by King-Harbor, formerly known as King/Drew. In 1994, a woman was infected with HIV after the hospital mistakenly gave her a transfusion with blood that had tested positive for the virus. Years later, a woman died after drinking a glass of tissue preservative left by her bedside. In 2000, a 9-year-old died from a cascade of errors stemming from treatment of two broken teeth.Clearly, something had to be done. The death of Edith Rodriguez served as the facilitator to getting the word out to the public that the King-Harbor medical facility was one of the worst in the nation. The federal government responded by withdrawing its $200 million grant after the hospital failed numerous tests (King-Harbor). Unfortunately, the decision was made to shut it down rather than try and turn it around one more time.
Why Should the Hospital Remain Open?
Los Angeles already has enough problems providing ample medical care to its citizens. Closing down one of its biggest hospitals obviously does nothing to alleviate this problem. Shutting down the hospital is akin to “cutting your nose off to spite your face”. Instead of looking for solutions, the powers that be are merely taking the easy way out. As the former administrator of the federal Medicare and Medicaid programs Thomas Scully points out in this Op-Ed urging for the hospital to remain open, “…neither pointing fingers nor closing it down will help. The problems at the hospital have festered for years and will require many more years — and cool heads — to fix”.
The closure of King-Harbor is just another hardship to a minority community (the residents of South Los Angeles) faced with too many. Already an area known for its widespread poverty and poor living conditions, taking away the main source of medical care is only significantly adding on to the problems that already plague the area. As Scully notes in his Op-Ed, “King-Harbor treated nearly 47,000 patients last year, and closing it would just force patients to go farther away to other facilities that could quickly find themselves overwhelmed”. With the plan right now for the hospital to be closed for 12-18 months (King-Harbor), that leaves about 70,000 potential patients who have to find other places to be treated. Many of the surrounding private facilities are already crowded, and this will only put a larger strain on these facilities. This will lead to longer hospital rides and potentially more unnecessary deaths.
Even though it is currently being suggested that the hospital be reopened as soon as possible, the actual act of closing it down in the first place is going to delay its eventual reintroduction, potentially by many years. Not only will there be an obligatory period of inactivity for 12-18 months, but the facility has to start completely over. The time it will take to regain all the proper permits and licenses is going to be significant. Instead of treating potentially tens of thousands of patients, they will be helping absolutely nobody. Currently, the plan is to reach out to the private sector and hope to find interest on that end. However, many in the field have already expressed significant doubt over the likelihood that any private entity will come within a mile of the much maligned hospital. If a private suitor cannot be persuaded to take over the operations, then many months and potentially years are added to the wait for the hospital and ER to be reopened through public means (King-Harbor).
Possible Solutions
Instead of shutting down the facility, surplus staff and volunteers from the surrounding area should be reassigned under the county’s supervision. Medical operatives who supervised the hospital in its last days should instead be moved there temporarily while an exhaustive review is conducted. Those who are found to be competent can stay on but under a probationary status, while new staff is hired at attractive rates to persuade more people to work there. What happened in the past “overhauls” of King-Harbor simply cannot happen again. The last time the staff was reviewed, the powers-that-be decided to retain 75% of them (Close King-Harbor). Obviously, this was far too many. From the top to the bottom, sweeping changes are an absolute necessity. Tens of millions of taxpayers’ dollars have already been spent on failed consulting firms (Close King-Harbor), so that mistake needs not be repeated. Retain only those who have repeatedly showcased their competency and willingness to better the situation. Put county and state medical officials in charge of the operations and let them have free reign to put together a top-rate staff.
Once these drastic changes have begun, the next step in the process is to launch a massive public relations campaign. Let it be known to the people of Los Angeles (especially those in South L.A.) that their government is apologizing for the horrible state in which the hospital was run, and how such inadequacies will not be tolerated. Both local and national reporters should be invited to visit the hospital and see the many improvements for themselves. This will be the start of a good-will campaign to gain back the trust of those who have been burned in the past. It will also help repair relations between city and county officials with the minorities in the area who have been receiving unequal treatment due to the fear of political correctness. For many years, King-Harbor had numerous problems that went unfixed because people were scared to anger the community. The hospital had been seen as a place created for the African-American community and run mainly by African-Americans, so local officials were hesitant to intervene (Steinhauer). This is of course a ridiculous notion, as the hospital instead was neglected and the problems were compounded.
Do the Media and Elected Officials Care Enough?
Today, the American media is too focused on the war in Iraq and the failed policies of the President’s foreign policy to give the proper time to domestic issues such as insuring proper healthcare is made available to its citizens. With the upcoming Presidential elections in 2008, healthcare is an issue that is bound to come back into importance. However, just how important is it going to be made of by the media? So far, the only notable mention of healthcare recently has been Hillary Clinton’s proclamation for a much more socialized medical system. What should be more of an issue is the actual availability of proper medical facilities to ALL citizens regardless of status rather than who pays for it, which is something that candidates from both political parties should agree on. While the problems with King-Harbor would appear to be more of a local and state concern, that is not fully the case. The hospital had been the recipient of hundreds of millions of dollars in federal aid, and will depend on such aid in the future if a private company does not come in and takeover responsibility. Will the topic of under funded public hospitals in major cities in areas of poverty take center stage in any round of the Presidential debates? Most likely not. It is up to the local press here in Los Angeles to make a point to bring the topic back into the nation’s attention. While the horrible story of Edith Rodriguez will not be forgotten, the closure of the actual hospital received far less press. What is not being reported is the potential of hundreds of thousands of lives being affected for the worse because there is not a proper hospital or emergency room made available to them.
Righting a Wrong
Out of the failure of the previous Hospital rises the potential for something great. With the need now greater than ever to provide competent health care to the local population, city and county officials can use this disaster as a great opportunity to mend fences and do something truly for the greater good of the city. The infrastructure is still in place at the hospital along with all the proper supplies and equipment to have a well run medical facility that would meet the needs of the citizens of this city. Those in power must not be tempted to take the easy way out and ignore the problem. It was easy to just shut the hospital down and say they will try and address it in a few years. It takes a lot more initiative and courage to stand up and demand justice for the local residents who are in desperate need of basic human services that should always be made available to them. Martin Luther King-Harbor Hospital should be reopened immediately with a new staff dedicated to making the system work and helping those who are in need.
Works Cited
"Close King-Harbor." Los Angeles Times 24 June 2007. 11 Sept. 2007 http://www.latimes.com/news/opinion/editorials/la-ed-king-harbor24jun24,0,4095761.story?coll=la-news-comment-editorials.
Ornstein, Charles. "How a Hospital Death Became a Cause Celebre." Los Angeles Times 15 June 200. 11 Sept. 2007 http://www.latimes.com/news/local/la-me-king15jun15,1,633441.story?coll=la-headlines-california.
Ornstein, Charles, Tracy Weber, and Jack Leonard. "King-Harbor Fails Final Check, Will Close Soon." Los Angeles Times 11 Aug. 2007. 11 Sept. 2007 http://www.latimes.com/news/local/la-me-king11aug11,0,3698687.story?page=1&coll=la-home-center.
Scully, Thomas. "Closing King-Harbor Isn't the Answer." Los Angeles Times 15 June 2007. 11 Sept. 2007 http://www.latimes.com/news/opinion/commentary/la-oe-scully15jun15,1,4363655.story.
Steinhauer, Jennifer. "A Hospital, Pulse of a Neighborhood, is Mourned." New York Times 21 Aug. 2007. 11 Sept. 2007 http://www.nytimes.com/2007/08/21/us/21kingharbor.html?hp=&adxnnl=1&adxnnlx=1190186817-1NxTe7BeKyVZYApXTKCsHA.
"Woman's Death in L.A. Hospital Remains a Mystery." ABC News. 14 June 2007. GMA. 11 Sept. 2007 http://abcnews.go.com/GMA/story?id=3273239&page=1.
5 comments:
When you take the issue of King-Harbor to a national level, I can see why you say the media is too focused on the War in Iraq, though many would argue not enough attention is paid to that issue.
But if you ever caught a local newscast--the subject of King-Harbor was featured on every channel and on almost every newscast in the weeks leading up to, and the weeks after the closing of that hospital. Nothing may have changed--but the local media (in the second largest market in the country, mind you) was all over it.
And on another note--just a passing thought--how would the city be able pay for "exhaustive reviews" and the hiring of new personnel when it's having to pay nearly $1.5 million in a single discrimination lawsuit settlement? (Tennie Pierce, LAFD). It sounds to me as if this problem transcends the local government...all the way to the last person and last dollar. The city and county can't seem to control their own employees...let alone regulate the resurgence of a fundamentally flawed (primary objective of most Emergency Rooms: help people, don't let them die on the floor) hospital.
I do agree that a complete overhaul in staffing may be quite necessary to salvage King Harbor, however, having better and more qualified individuals running the hospital may not be the cure-all. It is to my understanding that many patients at King Harbor are undocumented aliens, unable to pay for treatment. While King Harbor cannot and must not neglect these individuals treatment, such practices puts a great financial strain on the hospital, which will again lead to the revamped hospital’s demise.
The closing of King-Harbor is certainly a hard decision to make considering that so many people depend on it. I understand that many malpractice suits have gone against the hospital and it's inexperienced staff have generated mush debate, but I think it all comes down to the overlying issue of money.
Taking a look at the demographics, a majority of King-Harbor's patients are ethnically Hispanic. Unfortunately, I know from another class that a significant portion of these Mexicans either do not possess sufficient health insurance or are even possess legal status in the United States to begin with. What seems to happen, particularly when a patient is illegal, is that they will go to the emergency room, receive treatment, and essentially forge legal documents and foot the bill to the hospital. Such practices leech funds from hospitals leaving less money to spend on other things.
Personally, I wouldn't close down the hospital just because of it's poor performance, because doing so would ultimately lead to several more deaths because instead those in need of medical care would have to travel further distances to receive treatment. Instead, the staff should be restructured with better trained employees.
Well written article.
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