Image: Akilah Oliver and Oluchi McDonald
Ric Francis  /  AP
Akilah Oliver holds a photograph of her son, Oluchi McDonald, on March 23 in Los Angeles. McDonald was found dead on the floor of the Martin Luther King Jr. General Hospital in a pool of his own vomit.
updated 4/23/2004 8:02:21 PM ET 2004-04-24T00:02:21

It was early evening when Oluchi McDonald, vomiting and writhing in pain, was wheeled into the packed emergency room at Martin Luther King Jr. General Hospital.

Through the long night ahead, McDonald’s care would be neglected. He would be left alone with his pain as his heart rate soared and his blood pressure dropped. Eighteen hours later, the 20-year-old art student would be found dead on the floor in a pool of his own vomit. An autopsy would reveal he had intestinal gangrene.

“One of the things that bothered me so much was that Oluchi appeared to be invisible to his care providers,” said his mother, Akilah Oliver.

Shocking as McDonald’s death last year was to his family, it fit a pattern of serious and sometimes fatal problems that have put a landmark medical center in jeopardy.

Negligence, mismanagement claims
Two federal investigations have looked into claims of negligence and mismanagement at MLK Hospital, a community anchor built from the ashes of the 1965 Watts Riot. After five deaths blamed on negligence in the last year, the hospital is known to some as “Killer King.”

And MLK’s affiliated medical school, Charles R. Drew University of Medicine and Science, one of four historically black medical schools in the nation, recently lost its accreditation to train in some important specialties.

The crisis, detailed in documents obtained by The Associated Press and interviews with dozens of doctors, patients and others, has prompted a scramble to salvage King/Drew.

In recent weeks, the county has moved to fire five top administrators at the hospital, saying they ignored obvious and growing problems at the institution. County officials also blamed a nationwide health care funding crisis that has crippled public hospitals and a widespread nursing shortage that at one point left it with hundreds of vacancies.

But key state and federal lawmakers and former medical center managers blamed the county for a lack of oversight.

Some, including past medical students, accused the county of failing to get involved because of fear of being mired in racial politics.

As officials squabble, patients languish.

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“Back in the 70s, this hospital was outstanding,” said Derrell Sharp, 55, who recently waited nearly 30 hours in the hospital emergency room for treatment of leg pain. “The civil rights leader that this hospital is named after died so things could be equal ... and now look at it.”

History behind the hospital
On Aug. 11, 1965, California Highway Patrol officers stopped a man on suspicion of drunken driving in the Watts section of Los Angeles, then predominantly black.

The traffic stop escalated into a confrontation after the man’s mother and brother argued with officers from the CHP and LAPD, trying to block the arrest. A gathering crowd grew violent.

The resulting riot lasted six days, killed 34 people, injured more than 1,000 and caused $100 million in damage.

A state commission found that among the factors contributing to the community’s anger was a lack of public medical facilities.

Less than three years later, Los Angeles County broke ground on the Martin Luther King Jr. Hospital just south of Watts. It remains the only public hospital in South Los Angeles and serves about 1.5 million people in a 94-square-mile area.

Almost simultaneously, the Charles R. Drew Postgraduate Medical School was founded across the street. The school was named after a black physician who pioneered the concept of a blood bank during World War II.

Drew created a partnership with the University of California, Los Angeles, in the late 1970s to create a four-year undergraduate medical school in addition to its postgraduate program.

It joined other historically black medical schools — Morehouse College of Medicine in Atlanta, Howard University College of Medicine in Washington, D.C., and the Meharry Medical College in Nashville — that together train about 70 percent of minority physicians nationwide.

Between 1989 and 1999, 54 percent of Drew’s graduates returned to minority communities. By contrast, 36 percent of minority graduates of UCLA did so.

The hospital turned its location in a gang-infested neighborhood into an advantage of sorts, developing a reputation as a training ground for aspiring trauma surgeons. It trains one-quarter of U.S. armed forces surgeons.

Its flagship neonatal unit is named after civil rights leader Rosa Parks, who attended its dedication. In a community with above-average incidence of low birthweight babies, where 20 percent of mothers are drug-addicted, the complex saves nearly 95 percent of babies born under 2 pounds.

“It really is a national model,” said Dr. Robert K. Ross, president of The California Endowment, a private health foundation. “This is a university that is uniquely positioned to show the nation how the reduction of disparities of health care can occur.”

'Killer King'
Over time, King/Drew developed another reputation — as a place to avoid.

In 1995, prosecutors found that “gross negligence” at the hospital contributed to the death of a wounded deputy who was given the wrong heart medication after surgery. The death of another wounded deputy a few years earlier also was blamed on King/Drew’s negligence, said the president of the Association of Los Angeles Deputy Sheriffs.

Recent patient deaths and the investigations that followed exposed myriad problems.

After two patients died in the summer of 2003 while connected to heart monitors, a Jan. 8 report by an agency of the U.S. Department of Health and Human Services blasted the hospital for severe lapses in care due in part to a nursing shortage.

The report said nurses were instructed to downplay patients’ conditions, left critically ill patients unattended for hours and failed to give doctor-prescribed medicine.

In one case, a patient with leg gangrene, kidney failure and a collapsed lung died in the emergency room after waiting 22½ hours for treatment.

Problems with prescriptions
A March 3 federal report, prompted by a state complaint about the hospital pharmacy, found extensive problems with drug administration — failure to give the prescribed medicine, or giving the right medicine at the wrong times or dosage. Sometimes, federal surveyors intervened to get patients their medicines.

Image: William Watson
Ric Francis  /  AP
William Watson, 46, rests in bed at King/Drew Medical Center in Los Angeles on March 9.
In an egregious case, 46-year-old William Watson was mistakenly given the potent cancer drug Gleevec for four days, though he had been admitted for treatment of meningitis.

Watson’s attorney, Roger Rosen, said Watson is now blind in his right eye, which he attributes to the Gleevec.

Even after the pharmacy realized its mistake, records show nurses still made 40 errors with Watson’s medication, including with drugs for his swollen eye.

“I’m still afraid,” Watson said in a telephone interview from his hospital room before being released. “I don’t trust them because I don’t know what they’re giving me.”

Administration problems
Management problems at King/Drew were at the crux of a report commissioned by Los Angeles County and prepared by former U.S. Surgeon General David Satcher.

According to the Dec. 23 report, there was no “working partnership” between hospital administrators and the medical school. The report also faulted an ineffective board of trustees and Drew leadership.

The county is moving to fire nursing director Rosemary Haggins and other managers.

But Haggins described herself as a “sacrificial lamb” during testimony in January before a state Assembly committee hearing, insisting she had repeatedly asked county officials for permission to hire more nurses.

“I, as nursing director, reported to my superiors ... the critical issues as I assessed them,” she said. “And nothing — well, I didn’t get a response.”

Some see a touchy political issue as part of the problem.

The administrations of both hospital and university are predominantly black, and Ross, of the California Endowment, said, “There appears to have been a tendency to dance around the substantive issues at King/Drew because of racial politics.”

He added: “It’s the right time to be cognizant of it, but not be intimidated or awed by it, and cut through it.”

Los Angeles County Supervisor Yvonne Burke, who is black, dismissed that idea. She attributes the lack of accountability to cronyism among doctors who began their careers together decades ago and protected each other.

“I think that there’s been an awful lot of buddy-buddy things,” she said. “Doctors are really good at that.”

With their problems now well-documented, the hospital and college have been put on notice.

Training accreditation lost
The hospital has twice narrowly missed losing $200 million in federal funding — about half its annual budget — and the university recently lost its ability to train aspiring surgeons and radiologists.

The teaching hospital also has an “unfavorable” rating from the Accreditation Council on Graduate Medical Education, meaning Drew can’t reapply for accreditation in surgery and radiology.

One more “unfavorable” rating and the hospital would lose its ability to train all of Drew’s 300 doctors-in-training, a move that would effectively shut down all residency programs.

The turmoil has scared away residents and nurses who had planned to make their careers treating the working-class, mostly minority residents of South Los Angeles and could alienate promising new candidates at the medical school.

“To lose an institution like Drew would leave a deficit in the community that I’m not sure the other medical schools are ready to address,” said Dr. Louis Sullivan, head of a national commission on minority health care and former U.S. Secretary of Health and Human Services.

Community rallies support
Despite the problems, Los Angeles’ black community has grown increasingly bitter about plans to downsize King/Drew.

More than 200 people rallied at a Watts church earlier this year, and doctors and nurses at the neonatal unit, one of the hospital’s bright spots, are furious about plans to scale it back.

“My office was bombarded with doctors and community people who said they thought the hospital was being closed piece by piece and unit by unit,” said U.S. Rep. Maxine Waters, whose district includes King/Drew.

The problems also have affected the hospital’s aspiring doctors, 40 of whom have transferred elsewhere to finish their training.

Resident Dr. Anthony Charles will finish his surgical training in Ann Arbor, Mich., more than 2,200 miles from his wife.

He said he is disillusioned by what he saw at King/Drew and angry that leadership there squandered a chance to prove a minority hospital can succeed.

“They should have expected a higher standard, but that just wasn’t the case,” the 35-year-old said. “Maybe back in the 1970s that is what happened, but that’s not what I saw.”

© 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


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