King-Harbor on the road to shutdown

You never know when the traditional media will latch on to a story, but they've certainly raised the case of L.A.'s King-Harbor Medical Center to new heights by publicizing the tragic story of a woman who died while waiting in the lobby of the emergency room while hospital staff casually walked by her. It's become a powerful symbol of our broken health care system. In fact, King-Harbor has been troubled almost since the moment it opened in 1972, and the tales of woe emanating from the medical center are numerous.

Among the cases cited:

• One patient in King-Harbor's emergency room told a triage nurse on April 30 that he was seeing "aliens and devils" and that he was thinking about drinking bleach to commit suicide. He was left in the lobby for more than an hour and not seen by a physician for almost seven hours. A mental health evaluation was not completed for 17 hours after he arrived, according to the federal report.

At that time, the patient denied being suicidal and was discharged without receiving treatment.

• A female patient went to the emergency room on March 8 complaining of two weeks of stomach pain. She said she had nausea and rated her pain as a 10 on a scale of 1 to 10. "The patient identified that the pain she was experiencing was constant and that nothing provided relief."

Even so, she was given no treatment to alleviate pain or reduce her fever. Two hours later, she was checked again and again offered no treatment. She was not seen by a physician until nearly seven hours after she arrived. "The patient experienced severe pain throughout her [emergency stay]," the report said. Eleven hours after she arrived, she went to surgery.

• A patient went to the emergency room on May 11 complaining of spotting during pregnancy. An hour later, a triage nurse saw her, gave her a pregnancy test and sent her back to the waiting area. When staff called her name two hours later, she had left without being seen.

Three days later, the same woman returned to the hospital with complaints of vaginal bleeding and severe pain. A nurse didn't evaluate how much she was bleeding and had her wait four hours without pain medication. During an ultrasound, she had a miscarriage and was discharged a short time later.

So today, state regulators have moved to close the hospital. But is that the right thing to do?

Both the governor and a portion of the LA County Board of Supervisors seem resigned to King-Harbor's closure:

Two of the five members of the Los Angeles County Board of Supervisors said Thursday that they now support closing the hospital without delay.

"I think it's over for us," Supervisor Gloria Molina said. "I'm in fact terrified that somebody else might be hurt or neglected or abused at Martin Luther King hospital."

Supervisor Mike Antonovich agreed. "The time has come to put patients' lives before incompetent employees or political agendas," he said.

The state's decision, which was approved by Gov. Arnold Schwarzenegger, is subject to appeal. That process could take six months to a year.

So for the next year, King-Harbor would remain open until the process is complete. But what would be in place in the wake of any closure? In the CA-37 debate, the district which includes the area around King-Harbor, almost all of the candidates stressed the fact that there are few options for the low-income residents that King-Harbor serves. Most of them use public transportation and can't afford an ambulance to take them to the next closest hospital. And the trauma centers in the area are already overburdened, and another 47,000 ER visits per year (the approximate average at King-Harbor) could create the very problem regulators are seeking to avoid. If there is an extended, year-long process to close King-Harbor, plans MUST be made to provide for some replacement access for the citizens who would be left with practically no alternative should they become sick or injured. Community advocates are saying the same thing.

"We are playing with not only fire, we have gasoline in the other hand," said Lark Galloway Gilliam, executive director of Community Health Councils. "That emergency room, you can't let that go. Closure to me is not an option."

Finally, this really stresses the need for a better safety net for all citizens than a crippled emergency room system that acts as a faux-universal care apparatus. People deserve better than this. They need to have access to preventative care instead of going to the ER for a fever. King-Harbor's problems are part of the larger health care crisis in America.