http://www.latimes.com/news/local/la-me-mlk2oct02,1,713956.story?coll=la-headlines-california



Charles O , Times Staff Writer

Two emergency medicine residents at beleaguered Martin Luther King Jr./Drew Medical Center are facing criminal charges -- one for drunk driving, the other for stealing a hand from a cadaver in New Jersey and giving it to an exotic dancer.
A third ER resident began treating patients at the public hospital this summer before he received his medical degree, schedules and interviews show.
The latest revelations come three months after the emergency medicine residency program suspended its director amid an inquiry into his conduct.
A confidential survey of ER residents earlier this year turned up serious concerns about working conditions in the emergency room. Residents complained that the teaching was poor, the hours were excessive and senior physicians in charge of supervising their work were frequently absent, according to two residents who had been briefed on the results.
King/Drew's entire future is in flux after federal regulators notified the hospital late last month that it had failed a make-or-break inspection and would lose $200 million annually in federal funds by the end of the year. Officials are developing plans to radically restructure King/Drew in hopes of receiving federal funds in the future.
Reform plans could include ending the hospital's affiliation with the Charles R. Drew University of Medicine and Science, which runs the doctor training programs at the hospital, including the ER program. Some, if not all, training programs may be forced to close.
Los Angeles County health officials said they cannot comment on personnel matters other than to confirm that the three ER residents are current employees.
"Each case is investigated with appropriate action taken as necessary," county health department spokesman Michael W said in a statement.
Drew University spokesman Michael Downer referred questions to the county, which has a contract with the university to oversee the physician training programs.
The two residents facing criminal charges are second-year ER resident Ahmed R and third-year Cleveland E , one of the chief residents.
R , 26, turned himself in to New Jersey authorities Sept. 18 after being charged with second-degree theft for allegedly stealing the left hand of a cadaver around June 2002 while he was a medical student at the University of Medicine and Dentistry of New Jersey.
The charge carries a maximum sentence of up to 10 years in state prison. He is free on $1,000 bail.
Judson H , an assistant Middlesex County prosecutor, said police discovered the hand in a glass jar when they went to the home of the exotic dancer as part of a separate investigation. R and the dancer, Linda K , were reportedly acquaintances, the prosecutor said.
Authorities believe that the hand belonged to a cadaver that was donated to R 's medical school for scientific use. R was a first-year medical student at the time of the alleged crime, H said. He graduated from there in 2005.
K has been charged with wrongful disposition of human remains, a lesser felony.
R has worked at King/Drew since last year, and the hospital would have had no way of knowing about the accusations against him when he was hired. King/Drew, however, has allowed him to continue treating patients since the charges were filed last month.
If R is found guilty, he may have difficulty obtaining a medical license in California.
Rashed's New Jersey lawyer, Kalman G , said, "I am firmly convinced that my client will be exonerated at trial, and we're anxious for that to happen in the event that an indictment is returned."
Enmon, 29, was arrested about 11 p.m. July 1 and charged with a misdemeanor count of driving under the influence of alcohol, said Hermosa Beach Police Sgt. **** W . E 's trial is set for this week, and he has been representing himself, W said.
Separately, King/Drew allowed Thomas J to begin his residency in July even though he did not have his medical degree at the time.
Jacques had completed his coursework at the University of Wisconsin Medical School but did not receive his diploma until Aug. 27, school spokeswoman Dian L said.
County personnel rules explicitly require that all first-year residents have a degree of doctor of medicine or doctor of osteopathy from an approved school.
Health department spokesman W , relaying information from the hospital's human resources unit, said J became a county employee Aug. 27.
But King/Drew ER schedules obtained by The Times show that Jacques began treating patients before then. The health department declined to explain the discrepancy.
Neither R , E nor J could be reached for comment.


http://www.latimes.com/news/local/la-me-kingdrew2oct02,1,2411138.story?coll=la-headlines-california

Hospital Turmoil to Affect Staffing

Hundreds of King/Drew workers are expected to be reassigned as part of any restructuring plan.
By Evelyn Larrubia, Times Staff Writer
October 2, 2006


Public hospitals and clinics across Los Angeles County could be forced to absorb hundreds of displaced doctors, nurses and other health workers as the county radically revamps Martin Luther King Jr./Drew Medical Center.

Any plan for the troubled public hospital probably would require reassigning a good portion of its more than 2,200 employees so that King/Drew can get a fresh start with a new staff, three of Los Angeles County's five supervisors said last week.



There are no plans to lay off or fire employees en masse. In fact, civil service rules provide that workers cannot be terminated simply because their jobs are being eliminated or the hospital is closing or changing hands, county officials said.

It is unclear at this point what form the revamped King/Drew might take - whether it would be handed off to another county hospital or private entity, or whether it would continue as a smaller hospital or become a community clinic. A majority on the Board of Supervisors, however, favors turning management of the hospital over to another county hospital, Harbor-UCLA Medical Center. County officials are expected to present a detailed recommendation Tuesday.

Any solution would involve "a considerable movement of personnel," said Supervisor Zev Y . Supervisor Mike A said that King/Drew employees would have to reapply for their jobs, and at least some would not be rehired. Supervisor Gloria Molina said she would like "a new team of people from top to bottom."

That means the rest of the county must absorb a flood of workers. On one hand, that would be no problem: The Department of Health Services said it has roughly 5,000 vacant positions countywide because of a shortage of health workers.

On the other hand, the reassignments may not be the most efficient use of scarce county dollars. As the health department faces a projected deficit of nearly $1.2 billion in three years, at least some reassigned King/Drew staffers would have to be closely monitored, eating up valuable staff time and creating what county officials are calling "redundancies."

"No question it's going to cost us some money," Y said. "Money is not the issue."

The issue is restructuring a failing institution in a hurry. Federal officials have decided to cut funding to the hospital, about $200 million annually, by the end of the year because it has repeatedly harmed or killed patients despite years of attempts at reform. The county hopes to retain funding through a dramatic overhaul.

Staffers have been at the heart of King/Drew's problems. Reports and audits have repeatedly cited medical errors and poor care as cause for alarm. Moreover, a Times series in 2004 found systemic incompetence, neglect, inefficiency and lax discipline at the hospital, citing a consultant's observation that some employees had "retired in place."

About 650 workers have been disciplined since January 2004 for such lapses as sleeping on the job, turning down alarms on patient monitors and making fatal medical errors. Only about 250 of those were fired or resigned, according to a recent report.

Union officials are not happy with the prospects of mass transfers, particularly after so much effort has been invested in training staffers to meet federal standards.

"In America, a basic threshold is due process, and I don't think you can wholesale take a group of people and make a single, blanket decision about their future," said Kathy O , senior health policy analyst for Service Employees International Union 660. "I haven't ever heard of involuntary transfers in 10 years. Workers at King/Drew can be assured that they definitely have rights in any of these scenarios."

O could not immediately detail those rights.

The head of the county's Human Resources Department, Michael H , said civil service rules give the county much greater freedom in making transfers than in implementing layoffs.

He added that he thought the county had made a "big dent in getting rid of the bad apples" and that many fine workers fill King/Drew's halls and could go on to do well in other institutions.

It still is unclear whether employees of other county clinics and hospitals might transfer to King/Drew, or whether most of the staff would be hired from outside.

Peter G , a neurosurgeon who runs the quality committee at Los Angeles County-USC Medical Center, said that his hospital is so understaffed that he would be happy to get King/Drew nurses.

"We really, really need nurses for our patients," he said. "I would hope that we take every single one of those nurses."

Currently, more than 300 nurses and 130 physicians, not counting medical residents and temporary employees, work at King/Drew.

"If I were there, having read all the stories about issues at King/Drew, I think I'd be very nervous about what's going to happen," said David A , former chief medical officer at County-USC Medical Center, who now serves in the same position at Alameda County Medical Center.

A said health department personnel files are notorious for failing to note problems and instead are typically filled with positive reviews, even for unreliable workers. As a result, those forced to take King/Drew workers probably will have little ability to judge the quality of the incoming staff.



"Who knows who's seriously a problem versus those who stumbled who were otherwise righteous people?" he asked. "The civil service system in the county doesn't allow a way to judge someone well beyond their seniority."

Los Angeles County civil service rules require progressive discipline, so it can take months, if not years, to accumulate enough evidence to fire an employee. Henry, of human resources, acknowledged that some troubled workers remain on King/Drew's staff but said other health facilities would have to accept whoever is sent.

"They don't have any say in who they get," he said. "To prevent the problem at the other hospitals, that's going to be up to the managers at the other hospitals."

Y said the county has a plan to deal with unsatisfactory employees.

"Nobody who is not competent is going to be put in a position where they can do damage," Y said. "The truth is that some people are borderline and will be placed in an area with greater accountability, and they will either get with the program or be fired."

He declined to discuss the details of how such stringent oversight will be imposed.

J, director of the UC San Francisco nursing administration program, said as long as workers are divided among various institutions, an influx of King/Drew employees is unlikely to transform the culture at the receiving hospitals.

"You would have to take an entire unit of people and transfer them to another facility to get that culture transplanted," she said. "The likelihood of that happening is not great."

Y said the new King/Drew and other county hospitals would rise and fall depending on the overall quality of the workforce.

"The key to making this work . is to have competent staff," Y said. "Otherwise, you're just perpetuating the same problem under a different letterhead."

*

evelyn.larrubia@latimes.com

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