BRIAN LAMB, HOST: Tracy Weber and Charles Ornstein, you both have won prizes this year for what?
TRACY WEBER, METRO REPORTER, “LOS ANGELES TIMES“: We did an investigation and a look into a hospital in South Los Angeles that has been troubled for decades with problems with bad medical care and poor finances and patients’ deaths.
And we spent more than a year looking at it and came out with a series of stories last December about the hospital.
LAMB: Charles Ornstein, where did you get the idea?
CHARLES ORNSTEIN, METRO REPORTER, “LOS ANGELES TIMES“: We were looking at the whole healthcare system that serves Los Angeles County. And it’s such a – it’s such a delicate situation right now, because the hospitals are struggling with the weight of a huge uninsured population down there.
And the county healthcare system, in particular, has always been burdened with a great deal of financial uncertainty.
And so, we were looking at whether or not patients were doing well or dying at a disproportionate rate at hospitals that were owned and operated by Los Angeles County.
And what we found, almost immediately when we started looking at court records, malpractice records, inspection records, was that this one hospital – Martin Luther King Jr./Drew Medical Center – stood out. And over the course of time, it stood out more and more, both from the perspective of the care it provided to its patients, as well as how it wasted the money that it received from the county.
LAMB: What kind of a hospital is it?
WEBER: It’s a medium-sized hospital. And it was formed out of the – after the 1965 Watts riots.
One of the things people in the community said was, what we need more than anything down here is some health care.
It used to be down there that you were $25 sick. If you needed any kind of medical care, if you had – you had to be $25 sick to pay for a cab ride up to the county hospital.
And so, out of the – after the Watts riots, they built this hospital down there. And even though it was unofficial, it was built for the African American community and staffed with prominent African American doctors from the start.
And it was a point of pride for the community. When nothing else was down there, they had this new hospital.
But almost immediately, it started to get a reputation, and it was killed “Killer King.“ And things happened there that shouldn’t happen there.
And it had a unique position in Los Angeles history and in the community, because of its status as this hospital. So when problems occurred there, it was difficult to correct them, because it was – it had a racial overlay of, if you criticize the hospital, you were criticizing the care there provided by African Americans.
ORNSTEIN: And I think it’s – just to know, I mean, in the four decades since the Watts riots, so much has been lost in the community. It’s not as if this community has been built up and is now a thriving part of Los Angeles.
Businesses have left there. The General Motors plant has left there. You know, the big corporations which they identified with are gone.
And so, this hospital stood. And over the course of time, as Tracy said, whenever anybody tried to criticize it, you were racist and you were trying to crush the community.
And so, as a result, people just stood back. You know, I’m just not going to go there.
And we decided that the care for the community was more important than trying to take some politically correct perspective, and we just wanted to lay it out there as it was.
LAMB: In reading past stories and all, I guess the “Los Angeles Times“ started covering this in 1975. There were problems then.
LAMB: And what year was it built?
WEBER: It was built in 1973.
ORNSTEIN: Opened in ’72.
WEBER: Opened in ’72. And we began writing stories. And if we look back to the archives, we began writing stories. And then we did a major series on the hospital in 1989, focusing not so much on financial problems, but on the poor care provided there. It was a finalist for a Pulitzer Prize.
But then, over – the minute, you know, attention died down, so did the reforms. And during the ‘90s, occasionally something would happen, like a woman was given blood that was known to be HIV positive by the hospital, and she developed AIDS.
Or there were moonlighting problems among the doctors. And there would be a flurry of interest, and it would die down.
We decided, let’s just take a look at this hospital. Let’s be thorough. You know, the – what everyone says is, we don’t get enough money at this hospital. That’s why there are problems.
Or, we don’t have problems any different than any other public hospital in an urban area.
So, with those two things in mind, we just – well, let’s just really find out if this is true.
LAMB: Mr. Ornstein, where is it physically?
ORNSTEIN: The hospital is located in the Willowbrook community, which is an unincorporated part of Los Angeles County, right near the Watts area. It’s just south of Watts in the south-central portion of the county.
LAMB: So, those who fly into Los Angeles International Airport, do you fly over it?
ORNSTEIN: You do fly over it. It’s right by the 110 and 105 freeways, right near the intersection of the two. And it’s along the flight path into LAX airport.
LAMB: You call the hospital King/Drew. And the Charles Drew that you talk about is a famous African American blood specialist in history.
How did his name get attached to all of this out there in Los Angeles?
ORNSTEIN: Well, he is seen as a very, very prominent figure in the African American community. And there’s a medical school that’s affiliated with the hospital, and it’s called Charles R. Drew University of Medicine and Science.
It’s one of four historically black medical schools in the country, the other three being east of the Mississippi. This is the only one west of the Mississippi.
And it trains not only doctors, but it also trains allied health professionals and tries to find folks to serve minority communities in health professions.
So, the two linked up, the Charles Drew part and the King – Martin Luther King Hospital – and became King/Drew complex.
LAMB: What’s the budget for a year for this hospital, and how many beds do they have?
WEBER: Well, the beds have dropped significantly, because the hospital has – when we wrote our project, it was 233 beds. But now it varies. It’s about 180, I think, because they’ve had to close their trauma center and they’ve had to downsize various units because of problems there at the hospital.
And their budget, too, has varied in the past.
ORNSTEIN: It’s about $400 million, though. It’s a fairly significant budget.
You know, one point that we made in our series was that King/Drew had $400 million. Ten miles down the freeway was another public hospital called Harbor-UCLA Hospital, which is near Torrance, the Torrance community of Los Angeles County.
And the two hospitals had about the same budget, and yet you had Harbor-UCLA do twice as many surgeries, twice as many inpatient visits, saw twice as many people in their clinics.
And so, they did this for about the same amount of money as King/Drew. And King/Drew – and it also had 120 more beds. So something was clearly wrong, and yet King/Drew folks said that they didn’t receive enough money.
LAMB: Where does the money come from to support the hospital?
WEBER: They get money both federally and through the state and through the county. A lot of this money is like pass-through money, so it comes through the county, but it’s provided by all these sources. Roughly half their budget comes from the federal government.
And what we did with the series was to show where all that money went. And we found that, you know, they have enormous workers’ compensation problems at the hospital.
And people were falling – one thing we found when we started to look is, we sorted through their workers’ compensation problems and found all these people were falling off their chairs. And their workers’ compensation claims would be $300,000.
And people have been falling off their chairs since the hospital opened. And we had 120 chair falls worth $3.2 million. There were other workers’ compensation problems far outweighing the other county hospitals.
And you could see the money going to people just not showing up for work for months at a time. Just not coming in. And then they’d have to pay for people to cover for them.
They had a bunch of ways where money that was supposed to be used for caring for their patients were going to all these costs that had nothing to do with patient care.
LAMB: Well, talk about the, just the falling off the chair thing. I mean, literally, people said they fell off a chair.
I think one woman I read fell off the chair three times.
WEBER: Yes. When we – Charlie put together this spreadsheet to sort of look at the chair falls. And then also, when you sort them, you see it’s unbelievable sums of money.
And, you know, they fell off in different ways. I know – and in our story we talk about this one. She slipped off a chair, she toppled off one side, she fell off another way. And when these all add up, it’s an extraordinary amount of money.
And there’s also problems there with, you know, violence among some of the staffers, where, you know, there’s one case we cited in there where one nurse was – during a surgery, another nurse came in and belted him. He fell on the floor and ended up having …
ORNSTEIN: Four feet away from the patient who is under anesthesia.
WEBER: … during a knee surgery, and ends up having an enormous workers’ compensation claim paid out over a number of years.
And these people are still on the payroll, and they’re still – you know.
So, when we called up some of them, a couple – one nurse said, you know, well, the chairs were, you know, bad chairs. And then another nurse said, well, they weren’t really bad chairs.
ORNSTEIN: But yet the day our series ran, they sent in a team of inspectors to look to make sure the chairs really were all right.
LAMB: And you call the hospital “Killer King.“
ORNSTEIN: We don’t call the hospital “Killer King.“
LAMB: Well, I mean, in the stories. But there are five little kings. Who are the five little kings?
ORNSTEIN: The five little kings are the county board of supervisors. They’re the governing body of Los Angeles County. And they each represent roughly two million people.
So, it’s far more than even a member of Congress. Maybe a member of Congress would – they’d have four members of Congress and then just the one supervisorial district.
And they have immense power. The county budget is huge. The health department budget alone is about $3 billion. And so, they control an awful lot.
And they want to control all sorts of spending decisions. They have to approve all of the malpractice settlements that are over $100,000, all the large contracts. They’re very, very involved in the inner workings of the hospital.
And some would say that because of their inability to really get their hands around it, their lack of health experience, that’s one of the reasons this hospital has failed.
LAMB: There’s a famous name, at least nationally, in that group – Yvonne Braithwaite Burke – who was a congresswoman for a while and well known, and a speaker at the Democratic National Committee.
How long has she been on this supervisory group?
WEBER: She’s been 12 years.
LAMB: Twelve years.
WEBER: And she – well, it might be 13 now that …
LAMB: I remember 1992 as being the date that she went on there and …
WEBER: Yes. And she – and she’s – she represents both there where Harbor-UCLA, one county hospital is, and King/Drew. So, she’s actually over a hospital that is the, you know, the most efficient performer among the county hospitals, and King/Drew.
And she’s in a difficult position there, because she – the community, especially the more vocal members of the community, really put a lot of pressure on her to let them run the hospital the way they see fit. And they say that they don’t have the problems there.
And then she’s getting pressure from all these others who are saying, you know, do something about this. This is your hospital in your district.
And so, when they’ve had board decisions, she’s often the lone person saying, I think, you know, this hospital is doing OK, or at least is improving, turning the corner.
And there’s a lot of pressure on her, and she’s pulled in a lot of directions. But she has been over there, at that hospital for 12 years, and there’s been a lot of problems there. And she has difficulty stepping in and saying, let’s fix this thing.
LAMB: One of those, the defenders – people who are also known nationally from that area – is Maxine Waters. Explain how she’s involved in all of this.
ORNSTEIN: Maxine Waters is extremely involved in this. Every week on Saturday she has a meeting of the community to rally the troops, to save various parts of the hospital.
She was extraordinarily active last fall in trying to save the hospital trauma center, which was closed. She had rallies where she brought in Jesse Jackson and Angela Bassett and others, and really felt that the county was trying to close this hospital.
She’s also near, to be – put it on the table – she’s been very critical of the “Los Angeles Times“ and our coverage of King/Drew, has felt that we haven’t been accurate in our portrayals of the hospital, and that we also have an agenda to close it.
And at every turn we’ve had to say, and we’ll say it again, you know, our intention is not to close this hospital. It is that this hospital serves the community it was built to serve. I mean, that is what it should be doing.
LAMB: Well, deal with the race thing. I mean, you two are white. Did the “L.A. Times“ think about that before they had you two spend a year on this?
WEBER: You know, that was never an issue going into it. You know, that was never an issue about how we should tackle it, how we should approach it.
We did have an African American reporter, Darren Briscoe, working with us on the story for a while, but he left to take a job at “Newsweek“ midway through the project.
There’s two other reporters on here. Both of them are white, and the photographer is white.
But we never thought of that as an issue in whether or not we could cover the story. And even when Darren Briscoe was on it, he took some heat from the community as, you know, well, you’re this African American. Why are you doing this story as an African American reporter?
And I must say that the community there from when the time the hospital was built, the community it serves has roughly flipped, so that it’s now mostly Latino. Many new immigrants and many that don’t have any sort of organized voice.
And the group that was most critical of us was a small group that we refer to in the story as sort of the big seat (ph) community of people, many of them elderly African Americans who fought and remember when there wasn’t a hospital there.
And when they were highly critical of us, we actually could see why they were so defensive, because they really remembered when there was nothing for them, and fear so much that it will be taken away from them and they will be without this hospital.
LAMB: A five-part series. And there are lots of characters. Maybe that’s not the best word to use. But there are lots of stories. And there are some – well, forget the character.
But let’s talk about the first one I read about, the nine-year-old daughter of Elias and Sulma Tasejo, I believe.
What’s that story?
WEBER: It’s a heartbreaking story.
The Tasejos had a little girl named Dunia, who was running back from the ice cream truck one day. And she was clipped by a car going by and her mouth was bleeding.
They took her to King/Drew, and the assert that she’s just got these two broken baby teeth. But to do – to take precautions, they gave her a drug that would paralyze her so that she would hold still for a CT scan, they could make sure there were no internal injuries.
But they gave her enough drugs – and this was when all the errors started. Up till then all the care was appropriate.
They gave her enough drugs to drug a 300-pound man, you know, the paralyzing drugs.
Then the ventilator settings were wrong and she was wasn’t getting enough air and she was starting to go into distress.
They adjusted the ventilator settings, and then some doctor in the ER just pulled out her breathing tube without making sure she could breathe on her own.
She started to really suffocate, because she – her – you know, these drugs make it so your lungs cannot breathe. And then no nurses were watching her for another two hours.
And she – by the time they got her to the pediatric ICU, where a young doctor, fresh out of her first year of residency, checked her, she couldn’t get the instrument right to check whether she was getting enough oxygen, and she went into cardiac arrest and died.
They kept her sort of alive on life support for two days after that. But here’s a little girl goes in, two broken teeth. If they’d taken her home, she’d been alive. And she died.
LAMB: How did you find out about this?
WEBER: We first – and it was one of the very first things we looked at with King/Drew. I was making copies of inspection reports, and that one – and this one doesn’t – the inspection reports don’t say anything about the names.
But we saw this devastating recounting of medical errors by virtually everyone who cared for her across departments. So we tracked her down, and then found her family, who don’t speak English and who came to the United States from Guatemala a number of years ago, and who just don’t understand how this could have happened.
LAMB: There is a Jereatha Thomas who had a 27-year-old daughter named Demetria?
ORNSTEIN: That’s right.
LAMB: And this was in June of 2003. The 27-year-old daughter dies from what?
ORNSTEIN: She had a heart attack. And she was feeling kind of – she wasn’t all, you know, all there. And so her mom suggested she go to the hospital, took her to King/Drew.
And they didn’t diagnose the signs of her heart attack. They were saying that perhaps it was complications of diabetes, or maybe she was having a pulmonary embolism, which is a clot in your leg that affects your lungs.
And so, they were coming up with different diagnoses. By the time they realized it was a heart attack, it was too late. They transferred her to another hospital where she died almost immediately, two days later.
LAMB: What happened after that? Any lawsuits in these things that we know of?
ORNSTEIN: Well, her family, her mom filed a lawsuit. But beyond even the lawsuit, we’ve tracked her for several months, and had a chance to spend a lot of time with her.
She drove around at night crying. She would just drive aimlessly. Our photographer, Rob Gauthier, went with her and captured a very, very moving image of just tears streaming down her face as she’s just driving down these streets at night.
And she made friends with the clerk at the Wal-Mart’s – I’m sorry, at the Hallmark store. Because she was looking for a Christmas card for her daughter who had died.
And this woman saw that she was clearly just devastated, and kind of became her friend.
And, you know, we went to the cemeteries with them and saw the effect that they – that this had. It affected this community that the hospital was intended to serve.
And these people had no voice at all in the debate about the hospital. And it was so important to give them a voice.
LAMB: Barbara J. Robinson. Her death. Needle in a coronary artery. Who covered that?
WEBER: That was Charlie.
ORNSTEIN: In this case, they – after she died, they sent her to the mortuary. They embalmed her. They didn’t think anything of it.
A doctor at King/Drew called the coroner and said, we think you need to look a second time at this. I think that, you know, perhaps the pericardiocentisis, is what it’s called – the needle to extract fluid from the lining around the heart. And perhaps that that had actually punctured an artery, or part of the heart.
And the coroner recalled the body from the coroner’s – from the morgue. And they determined that, in fact, it was due to a medical error. But it wouldn’t have been caught if it weren’t for a doctor calling the coroner’s office and urging a second look.
LAMB: But you say it was a doctor from King/Drew.
ORNSTEIN: That’s right. That’s right.
LAMB: Now, are there internal disputes at King/Drew?
ORNSTEIN: Absolutely. Absolutely.
LAMB: In what way? How do you see them?
WEBER: Well, there are a lot of very caring and concerned staffers there who see problems happen.
One thing we did find is, a lot of times we’d contact these patients. No one had ever told them there had a been a mistake in their care, or that their loved one had died due to a mistake, or that something had happened.
But there are a lot of doctors and nurses within the hospital who see things happen and know they’re wrong, and feel very strong about …
ORNSTEIN: But they try to do something about them. And I think that – we spent a whole day talking about a pathologist at King/Drew named Dr. Dennis Hooper, who was there for a couple of – for a little more than a year. And his colleagues – all of them – said something is wrong here.
Dr. Hooper, in their view, was misdiagnosing patients. They wrote a letter to the administration. They met with the administration, and they were ignored.
LAMB: Now, you said in your article – one of your articles – that that was your first – the doctor, Dennis Hooper story – was your first signal that something was wrong there? I mean, how …
ORNSTEIN: That was the first signal for the county health director when he came in …
ORNSTEIN: … and saw that nobody had done anything about Dr. Hooper.
Because here it was on paper. These folks had taken a chance. This was a …
WEBER: And that’s very, very rare for a group of doctors to rat out another one of their doctors in a letter and list cases.
LAMB: Well, tell us more about him. Where is he today, by the way?
ORNSTEIN: Well, Dr. Hooper, after he left King/Drew, went to San Antonio. Well, he went to East Texas and then to San Antonio, where he was a pathologist at Baptist Medical Center in San Antonio.
After our series ran they placed him on leave, and he resigned a week later from his position on staff.
And the hospital said that they didn’t know about his difficulties in California, because King/Drew did not move to fire him. They didn’t move to take any disciplinary action against him. And they gave him, you know, a positive reference when anyone called.
LAMB: What’s his whole story?
WEBER: Well, Dr. Dennis Hooper – to explain, a pathologist is someone where tissues come back and they look through a slide and say, is it cancer, or is it cancer free? Or they look at biopsies. They do autopsies.
So, his job would be, if someone’s slides came in, you know, to take a look at and to make a determination, which leads the doctors – other doctors – to take action.
When the other five doctors that worked with Dr. Hooper wrote a letter saying, we believe he’s misdiagnosing looking at these slides. He’s sloppy. He works quickly.
No one took any action.
ORNSTEIN: They were saying he saw cancers that weren’t cancers, and that he didn’t notice cancers that were cancers. And so, he was making mistakes in terms of critical life-and-death issues with patients.
And they cited examples in their letter. They gave specific cases and case numbers.
WEBER: Cases for them …
ORNSTEIN: So, here’s your roadmap. Follow the roadmap, and you will see what we’re telling you about.
LAMB: Where is he from originally? Where did he go to law school? I mean, medical school, excuse me.
ORNSTEIN: He’s from a small town in Nevada – Ely, Nevada – where his father was postmaster. And he went to medical school at the University of Nevada at Reno, and went to undergraduate in Utah, I believe.
And had a Ph.D. in microbiology. Was in the Navy for a period of time. Left the Navy under somewhat mysterious circumstances.
LAMB: Now, is he white or black?
ORNSTEIN: He’s a white doctor.
LAMB: And is he the one that opened up the pathology clinics around?
LAMB: Explain how that worked.
WEBER: Well, he opened up a bunch of pathology clinics. And there were clinics that were both studying a cure for a vaccine for HIV. And then there were clinics that were doing regular pathology work on contract from hospitals and such.
But he was getting other physicians to invest in these clinics that he was starting to look for a cure for HIV.
ORNSTEIN: This is before he was at King/Drew. This is in the years leading up to his time at King/Drew.
But this whole lab empire kind of crashed. It all folded and, you know, went bankrupt. And the bankruptcy was going on while he was at King/Drew.
WEBER: But as part of this story, we began to look at Dr. Hooper because of these things at King/Drew. We had got ahold of the letter from the other doctors.
And one of the most tragic parts of Dr. Hooper was six months after this letter that other doctors sent him, nothing goes on. A woman named Johnnie Mae Williams comes into King/Drew. She has a minor gynecological problem. And she’s got some bleeding, and they decided to just test to see if there’s anything else going on.
And while Dr. Hooper was looking at her slides, he mixed another patient’s brain cancer slide in with slides of her endometrial lining and said she had cancer.
So, immediately, the hospital calls Johnnie Mae and says, come back to the hospital. You know, this is – we need to take care of this. They removed all of her reproductive organs.
Other pathologists then go back in and look at those organs. You know, once you have a surgery, they review them. And there’s no cancer anywhere. She’s never had cancer.
And they, you know, check back and find out this mistake had occurred. And in Johnnie Mae’s records, you can see five doctors were told that she never had had cancer. And no one ever called her.
So, two years later we’re trying to track down, looking into Dr. Hooper, trying to track down whatever happened to her. We go and we find her, and no one had ever told her that she’d never had cancer. She thought she was a cancer survivor. And when people would criticize the hospital she’d say, no, that hospital saved my life.
And it was so devastating to tell this woman, who had wanted to have more children, that they’d made a mistake.
LAMB: And who told her?
WEBER: I had to tell her. I didn’t have to tell her. I didn’t know that she didn’t know. I would have only assumed. And it was just a heartbreaking moment.
LAMB: But what were the circumstances? Where did you find her?
WEBER: Well, it took a long time to track her down, because she was living in a home – a recovery home. And we tracked her down through a relative.
And when we got there, we said that we had wanted to talk about King/Drew. And, you know, I had asked her if she – you know, what had happened in her care. And she had no idea who Dr. Hooper was, that any mistake had been made.
She thought she was a lucky person, because she had had cancer and they had caught it and saved her. She had a boyfriend at the time.
And she just started shaking uncontrollably and saying, basically, I thought that hospital had saved my life.
LAMB: How old is she?
WEBER: She’s 43 now. When we told her, she would have been 42, right? And it was just very, very sad.
LAMB: How hard is it to talk about Dr. Hooper without running into your own legal problems? How much can you say about him?
ORNSTEIN: Well, we can – all of our stories were screened by our attorneys at the paper. We had to be very, very, very vigilant in terms of getting documentation from all of these records.
Dr. Hooper has a medical board accusation against him. And so, the allegations against him about confusing the slides come from the medical board accusation, which at this point has not been adjudicated.
We gave him an opportunity to respond to us. I flew to San Antonio to speak to him. He wouldn’t speak to me.
We’ve tried subsequently to give him additional opportunities to do so.
LAMB: How old a man is he?
ORNSTEIN: He’s in his 40s as well.
LAMB: And why did King/Drew hire him in the first place?
WEBER: Well, that’s another part – one of the reasons we did write about Dr. Hooper is because, in his case alone, you see a lot of the failings of King/Drew. They don’t screen their doctors appropriately when they …
ORNSTEIN: They acknowledged that they didn’t in his case screen him. They didn’t make calls to references. They did simply a criminal background check. Found out he was all right. And that’s all you need.
LAMB: Roberta Nesbit. Found to be cancer-free, but wasn’t. Died at age 57. What’s her story? Who did that?
ORNSTEIN: Dr. Roberta Nesbit was not a King/Drew patient. She was a woman who lived in San Diego who went to one of these clinics and had a mole tested. And her …
LAMB: One of Dr. Hooper’s clinics.
ORNSTEIN: It was not one of Dr. – it was not a clinic that Dr. Hooper ran. He was serving as a pathologist on contract, a fill-in pathologist for a pathologist on vacation.
Roberta Nesbit comes in. She has a mole on her leg. Her doctor wants it looked at. And so, they do a pathology on it, and she’s determined not to be – not to have cancer.
A year later this thing has grown back and looking fairly odd, so the doctor orders up another pathology, and it turns out to be a very deep melanoma that ultimately kills her.
And they find the slide, and Dr. Hooper contends that that was not the slide that he looked at 14 months earlier, that somebody in the lab had mixed it up. But ultimately, he chose to settle the case. And that settlement was on the board of the Nevada medical board, on the Web site.
LAMB: From what you know, if Dr. Hooper wants another job in medicine in this country, can he get it, the way this thing’s set up?
WEBER: Well, you know, the medical board of California – each state has their own medical board that looks at – in his – as of now, he has an accusation against him. And on his record would be the settlement of the Roberta Nesbit case.
But it depends on how good a screening they do. We went back. We knew he had worked at the V.A. in Reno. So we went back and found that he had had problems at the V.A. in Reno. And that they had determined that his misdiagnoses at the hospital there did not rise to the level that they’d have to tell anyone.
Our experts that we asked said, well, those – that his error rate is higher than we consider to be acceptable as, you know, pathologists.
But lawsuits are, you know, and legal ramifications are so high for hospitals and employers, in general, that you don’t really know how much a hospital will reveal about how a doctor performs …
ORNSTEIN: Every hospital has its own screening committee. Every hospital has its own guidelines and makes its own determinations.
So, a doctor that one hospital may not hire is a doctor that another hospital may. And their screening processes that are in place vary across the country.
You can’t hire a doctor that doesn’t have a license in your state. But barring that, you can pretty much hire anyone you want. So it’s up to individual hospitals to make those determinations on the number of lawsuits that you’ve had against you. Is that a number that we’re not comfortable having?
LAMB: Who’s Dr. George Locke? And why is he a story in your series?
WEBER: Dr. George Locke was the head of the neurosurgery and neuroscience – well, they call it neurosciences department at King/Drew, which is neurology and neurosurgery.
He’s a neurosurgeon who has been a prominent figure at that hospital – or had been, he recently retired – had been a prominent figure at that hospital for decades.
But in our story we wrote about him because he was one of the highest paid people in Los Angeles County. He earned almost $1 million – or over $1 million – over a two-year period.
And what we determined was that he had performed only a handful of surgeries during that time, that he had, you know, compared to his counterparts had done very little as far as publications, had a smaller staff than the other hospitals. And his staff itself had performed substantially less surgery.
ORNSTEIN: He had a larger staff, but the staff performed …
WEBER: He had a larger staff, and his staff had performed substantially less surgeries.
We compared his salary, the number of surgeries to his counterparts at other hospitals – public hospitals – around the state. And, you know, they – one – the chief of neurosurgery at UC-San Francisco had done twice as much himself as Dr. George Locke’s whole staff. Yet he was one of the highest paid doctors.
We also determined that he worked very few hours for his pay, or, you know, compared to his time card. So he would put in for the number of hours he was at the hospital, but actually was not at the hospital during those hours.
LAMB: You also put in the little thing about him, when he arrives in the parking lot, that he waits for a female assistant to come out and get his papers and stuff?
ORNSTEIN: Rob has a – Rob has a wonderful photo showing that.
WEBER: Our photographer has a picture of that actual event occurring.
ORNSTEIN: At the hospital.
WEBER: He had – he would have – he would wait by his car until a female assistant would come take his bag and carry it inside. And then when he was ready to go at night an assistant would come out and carry his bag out.
LAMB: Would he talk to you?
ORNSTEIN: Dr. Locke’s lawyer sent us a letter. Dr. Locke himself did not speak to us. The lawyer indicated that medicine does not know time cards.
And so, although doctors have to put their hours on time cards, that they should not be held to those hours, because they may come in on their off hours or they may be available at home.
Although hospital officials indicated that the time card is a record of when you were at the hospital, and that it is – it is, you know, (INAUDIBLE) at this hospital does know time cards. That’s what the hospital indicated.
He also indicated that as chairman of the department, his role was not to perform surgeries. His role was oversight. And also disputed the figure for the number of articles he had written, although he did not provide an alternate number, and we received our number by looking through the National Library of Medicine.
LAMB: What were the circumstances in which he left?
ORNSTEIN: He retired earlier this year.
LAMB: So, with no accusations against him?
ORNSTEIN: There was no accusation against him.
LAMB: And how far can you go, again, with reporting this kind of thing without defaming him?
WEBER: We’re very careful.
The hospital does – I mean, the county has done and is performing an audit of him and his work there at the hospital.
ORNSTEIN: We depend on official records – records that the country keeps, records that we submitted Public Records Act requests for. We submitted more than 100 Public Records Act requests.
We asked for the number of surgeries performed by all physicians. That was a county record that was given to us.
We asked for the – as far as the number of scholarly articles, that was a fact from the National Library of Medicine.
As far as, you know, the number of hours Dr. Locke works, that’s his time cards that he submits relative to the number of hours he’s actually there.
So this is very much dependent upon public documents kept in an official capacity by the county and the county’s very own records.
LAMB: You talk about physician’s assistants and nurses and residents.
Let’s try Andrew Josiah, a physician’s assistant. What was that story?
ORNSTEIN: Andrew Josiah was in the orthopedic surgery department at King/Drew. He was a physician’s assistant. And he had been found guilty of child abuse, a felony child abuse charge for – the allegation was that he attempted to drown his son.
And he was sentenced to a work furlough program where he would go at night to a halfway house, and then during the day he’d go to work. Well, actually, it’s the reverse, because he worked at night.
So during the day he’d go to the halfway house. At night he’d go to work.
And King/Drew knew about the conviction, knew that he was assigned to this and, in fact, allowed him to keep working at the hospital, despite his conviction.
LAMB: Physician’s assistants never show up? Or are never on time? I mean, or …
WEBER: Well, we have – and again, what we tried to do with this story is have a bunch of records that would show this. So we gathered up records from the Civil Service Commission, because if you’re disciplined for something, all of your records go to civil service, and you can see this.
And we would find records of physician’s assistants who would say, you know, had been absent chronically for months at a time. And they’d say, you’re going to be suspended for five days. You need to come to work. And then they’d be absent for months more at a time.
And it was unbelievable. And we even have a memo – a copy of a memo – within the orthopedic surgery department saying, you guys are never coming for work, never on time. No one’s ever here.
ORNSTEIN: Encouraging doctors just to act as if they’re not there. So they’re paying these folks to be there and they’re telling the doctors, just work as if they’re not there.
LAMB: If I’m listening to this right now, I’m wondering, what about my hospital? I mean, I can hear people saying, how much of this goes on in other places? And why are you picking on this one place?
ORNSTEIN: And that’s a great question. And that, you know, is one thing that’s often said is, every hospital has problems.
There is no question every hospital has problems. There are 100,000 medical errors each year that kill people in hospitals across the country. And when you divide that out by the number of hospitals there’s, you know, dozens in each hospital.
So, I think that’s a very fair question. And we took that to heart. And what we tried to do was be as rigid in comparison as we could.
We got millions of records from the state department of health services, of all of their inspections, to all hospitals in the state of California, and looked at the number of substantiated deficiencies at those hospitals so that we could determine not just when they went in for a complaint, but how many times they actually found a problem.
And King/Drew was in the bottom 2.5 percent of all hospitals in the state of California.
We looked at malpractice records. We sent out Public Records Act requests to 17 public hospitals in the state of California – every public hospital in the state of California, across the University of California teaching hospitals.
And when you adjusted for the number of patients that they take care of, King/Drew was at the very top of malpractice rates.
While each one of these things, on its own, may – you know, you could criticize it as a faulty indicator. When taken as a whole, in addition to what the regulators and the accreditors were finding when they went in, King/Drew very clearly stood out as an outlier.
The federal government said it. The hospital accreditors, called JCAHO said it. The – you know, the accreditors of the hospital’s training program said it, and our own analysis found it, as well.
LAMB: Is federal money still going to this hospital?
ORNSTEIN: It is.
WEBER: It is. But several times in the past year they’ve threatened to pull that money, which would be roughly half the budget of the hospital.
LAMB: Who would pull it?
WEBER: The federal Centers for Medicare and Medicaid.
And they – these federal – one thing we did learn during this – and you made the mention of other people in other cities wondering about their hospitals – one that thing was clear by our series was that, Charlie and I would go in and find some substantial medical lapse that occurred, for instance, patients connected to cardiac monitors and the nurses ignored them while they were – their conditions deteriorated and they died.
And then the state and federal inspectors – or state inspectors and then federal – would come in and do their inspections and find a bunch of other problems.
It is clear that many of those things were unknown to them before we reported these stories. So, it is very difficult to know the quality of your hospital unless you have someone with the time and the resources, such as the “L.A. Times“ had, to really go in and take a look at a hospital.
It’s very difficult to tell, because these inspectors go in when a problem is reported to them.
LAMB: Did the hospital know you were going to write this series?
LAMB: How soon in advance did they know?
WEBER: Well, at the beginning I was nervous about filing a lot of Public Records Act requests, that they would know exactly what we were doing.
But we filed so many, about so many things – and learned that things were public records along the way – that they sort of didn’t have an idea of the whole scope of it. But they clearly knew.
ORNSTEIN: But we were also at the hospital constantly. We were attending meetings, meeting with the folks who worked there, meeting with people who used to work there.
We made it very clear and wanted to give everybody an opportunity to talk to us. We were not only trying to present one side of the story. We were trying to present the whole story.
And that involved understanding their views, understanding their struggles.
We’ve talked earlier about the money and about the wasted money at the hospital.
But yet, if you work there, it looks like that hospital doesn’t get enough money. It’s dirty. It’s, you know, blood caked on stuff. Old, unusable equipment.
The low level doctors and nurses really are not making a whole lot of money. And so, you question, why are we being targeted? Why are we being punished?
But when you look at the broader, overall budgets and you do the actual digging in, you then understand.
But you don’t want to discount them as wackos, because they’re not wacko. These are people who – they know what they see. And to them it doesn’t make sense.
WEBER: They don’t have ink cartridges, say, for the copy machine. Yet they don’t know that the chair of their department’s making $450,000 a year.
LAMB: Is that exorbitant?
WEBER: For a public hospital, and for the amount of work that many of these doctors did. The top, say, 20 doctors at that hospital – highest paid doctors at the hospital – made more than their counterparts at the other public hospitals within the county and within the state.
ORNSTEIN: Now, they argue that it isn’t exorbitant, because compared with hospitals nationally, they’re below the 50th percentile.
But these folks often have private practices, so this is not their only source of income, as well as the fact that this is a public hospital, and you’re dedicated to public service. And doctors at other public hospitals make significantly less, and they’re doing it.
WEBER: You choose to work at a teaching hospital in most cases. The other doctors I spoke to, that there were counterparts at UC-San Francisco or Harbor-UCLA said, well, I’m choosing to work in a teaching hospital, because it’s so stimulating.
LAMB: The residents, people that, I guess, go to the Charles Drew Medical School across the street, come over as residents?
ORNSTEIN: They’re overseen by Charles Drew, but they don’t go across the street, actually work in the hospital.
WEBER: Residents are folks who have completed their medical school training and they are going to be specialists in certain areas. And the hospital has training programs in, say, surgery and pediatrics and family medicine.
And these residents, then, are trained by doctors from Drew.
LAMB: Dr. Penelope Velasco, 28 years old, a resident involved in three malpractice suits. How?
WEBER: Dr. Velasco – and we chose examples within this story because we felt that they expressed a broader thing. So we chose her because she was a young doctor who, in the course of her training, was involved in three, to varying degrees, in three malpractice cases. And what does that show?
Because residents are supposed to make mistakes. Residents are learning how to be specialists. But they’re supposed to have a senior doctor looking right over them, so if something happens, they can immediately be corrected, fixed or anticipated.
But in Dr. Velasco’s case, we saw cases where, for instance, one family that we also are – we also sort of profile within another story, Sherry Ridley came in and she had some ovarian cysts.
In the course of taking out her cysts, Dr. Velasco stitched through her colon.
Now, if you stitch through someone’s colon, it’s a bad thing. But if you catch it right away, you patch it up and everything’s fine.
In the case of Sherry Ridley, no one saw Dr. Velasco, no one overseeing her saw that she had stitched through the colon. And then despite evidence that, you know, she was bloating and she had problems, they didn’t go in for two weeks and see what the problem was.
And by that time, you know, the infection had set in. It was seeping out into – it was – her family describes her as looking like a monster.
A second repair attempt failed. And then over the next month, she really – she gained – how much?
ORNSTEIN: She doubled in weight.
WEBER: Doubled in weight and she was just – her family said visitors didn’t even recognize her. And more and more tubes. And they kept opening her up to try and clean her out. And it was just a horrible story.
And Dr. Velasco was involved in two other cases involving babies, where there were bad outcomes.
And we used her in the story to say, you know, one of the points of having a training program is that you oversee your residents. And time and time again involving cases with medical lapses, it was a resident that no one had been watching.
ORNSTEIN: It’s important to note, Dr. Velasco contends that she did not – there was no proof that she did, in fact, stitch through the colon.
There were medical records that indicated that she had. But her contention is that she did not do that. And in the other cases, she contended that her actions at all times were proper and appropriate.
LAMB: Is there any way either one of you would ever be treated at King/Drew Hospital today?
WEBER: Well, I think that we are …
ORNSTEIN: We’re probably persona non grata at that hospital.
LAMB: How many other hospitals in the country do you think you could go to and get this number of stories?
WEBER: I think very few, because one of the things that was very unique about King/Drew is, because of its historical place, and because of, you know, where it was and how it came about, people left it alone much more than I think they would another hospital.
I think at another hospital – urban hospital – and I think there are urban hospitals that are very troubled – I think that they would not have let this go on for decades like this.
I think that there wouldn’t have been this racial overlay, these racial politics played that kept them from going in and saying, you know, that’s it. We’re going to bring someone in there. We’re going to change this whole place. We’re going to clean it from top to bottom.
ORNSTEIN: This group, Navigant Consulting, it’s an outside firm that’s gone into many, many hospitals to handle turnarounds. They’re the ones being paid the $15 million.
They came in, and in January issued a 1,000-page report outlining problems at the hospital.
They say they’ve never seen a hospital in their history as bad as this particular hospital is.
One thing you hear a lot from these supervisors is, you know, this hospital didn’t become this way overnight.
LAMB: You’re talking about the county supervisors.
ORNSTEIN: This hospital didn’t become the way it is overnight. It’s not going to be fixed overnight. It took 30 years for the problems to develop.
But this board of supervisors, every member of this board has been on the board for at least eight years. One of them has been on the board more than 20 years.
LAMB: Which one?
ORNSTEIN: Mike Antonovich, who represents the northern part of the county.
LAMB: And there’s a connection to the defeated mayor of Los Angles, James Hahn, in all this. And what is it?
WEBER: His father was the supervisor – Supervisor Kenny Hahn – was the supervisor – Kenneth Hahn – over, down around the Watts area. And he fought to get that hospital in there.
And he was a white supervisor. And they took a vote back then to raise money for the hospital. And the voters of Los Angeles County – mostly white – voted against having a hospital there.
And he was relentless. And he was – he was a big champion of the community, very involved, got that hospital built.
Even now they have little shuttles that take people to and from the hospital. They’re called Hahn …
ORNSTEIN: The Hahn shuttles.
WEBER: … the Hahn shuttles.
ORNSTEIN: A beloved, deeply beloved figure in the community. And in fact, his father’s legacy helped propel him to his first mayoral win. Of course, he lost recently in his re-election.
WEBER: And his sister is a council member on the city council.
But also in the hospital, there’s no fewer than a dozen places where there’s pictures of Supervisor Kenny Hahn shaking Martin Luther King’s hand. He went out to the airport and met his plane when no other white politicians would do so.
ORNSTEIN: Nobody else would do that.
LAMB: But why is this a racial thing, though? Why wouldn’t the black politicians be as outraged about this as the, you know, the white reporters?
WEBER: There are some. But, for instance – and there are some. But it’s a question we asked, too. We would think that you’d be out protesting, demanding – we demand equality of care at Harbor-UCLA, 10 miles down the road. This community deserves that same care.
LAMB: Is the Harbor-UCLA a white hospital?
ORNSTEIN: No. It serves a predominately minority community.
LAMB: It’s the same setup …
ORNSTEIN: Probably not as poor of a community, and with slightly better health statistics. But it’s a very – it’s an overwhelmingly minority hospital that’s a public hospital – vastly a number of people uninsured.
The issue is, I think, they’re worried about losing the hospital. That is their great fear, is that the last bastion of the civil rights movement in Los Angeles will be gone.
So, to them, it’s very, very important that something be there, because this community has no other options for care.
WEBER: But I also think they’re worried of losing control of the hospital, because that hospital, unlike most others, is their hospital. It’s that community’s hospital. And it’s the hospital that – you walk in the lobby there, there are photos of civil rights leaders.
You know, it doesn’t look like a hospital lobby. It has pictures of Coretta Scott King. And, you know, it’s – it has a place in that community that’s unlike any others.
And if you – if that hospital is taken over and becomes – and its leadership and its doctors look like any other hospital – that means something to that community.
LAMB: And you run in your second part of the five-part series statistics on the Harbor-UCLA versus King/Drew.
And you show that the emergency room visits in fiscal 2004, that King/Drew had 45,000 and Harbor had 72,000.
That patient admissions at King/Drew had 11,000 and Harbor had 21,000. Yet King/Drew spends more money. Overall cost per patient in fiscal 2003, King/Drew was $2,218, Harbor-UCLA $1,403.
Malpractice claims from ’99 through 2003, King/Drew was $20 million, Harbor-UCLA was $11 million.
Why this disparity? I mean, could you – did you study much about Harbor-UCLA?
ORNSTEIN: We did. And I think, you know, what we’ve heard time and again is, it goes back to the culture, the expectations, the way that management lays out policies and people are expected to adhere to them.
At King/Drew, unfortunately – and this has been identified not just by us, it’s been identified by the federal regulators, by the consultants, every consultant that goes in there.
There was a policy of, you know – one quote from a consultant in 2002 said the employees retired in place there, that people did not have a common mission.
That they went in there and they kind of saw it as, they were entitled to their jobs. Not that they owed their jobs to the people that came into the hospital.
And they’re talking – right now the hardest thing is to change the culture there.
LAMB: What’s the story of Eric Townsend and the pharmacy and 38,700 pills stolen?
WEBER: What was interesting about Eric Townsend is, Eric Townsend was a low level clerk in there. And he was able to make off with all of these drugs from the pharmacy and sell them out of his garage in South Los Angeles without anyone ever knowing all these pills were gone.
In his file, in federal court, there’s a search warrant that detailed how they had an undercover informant go to his house, buy all of these pills.
And who notified the hospital that he had been stealing these pills and selling them was the FBI and the police, who said to him, did you know all these pills are gone?
The informant told the FBI that she had been buying drugs from Eric Townsend for years.
LAMB: What happened to him?
WEBER: So, he did a prison term, and he’s out now.
But just recently they installed security cameras at that hospital. And we found many …
ORNSTEIN: It took years.
WEBER: Years. And we found many other instances where nurses and such were taking drugs from that pharmacy without anyone knowing about it.
LAMB: At this point, after you’ve been through all this – and you did some Kaiser Permanente, a media internship at one point?
ORNSTEIN: It was not through Kaiser Permanente. It was through the Kaiser Family Foundation, which isn’t related to the insurer. It’s a charitable healthcare philanthropy. And I did a media fellowship through them.
LAMB: But a personal question to the two of you. If either one of you were going into the hospital right now, what kind of questions would you ask before you go in?
WEBER: I would want to know exactly what medicine I’m getting, what dosage, when am I supposed to be taking it.
Because one thing at King/Drew was the number of medication errors were astonishing. You know, the number – the wrong medication was given, the type of medication was given at the wrong time.
I would want to know everything about the procedure being done to me, who was going to be present, who was going to be overseeing them. I would have a lot more questions.
ORNSTEIN: (INAUDIBLE) opinion (ph), just wanting to make sure that, you know, the diagnoses were, in fact, correct.
You know, I think you tend to find in a hospital, similar to maybe what you find in government. The inclination to, once things start going, for everybody to kind of buy in to one perspective and not necessarily be open to the full range of options.
You know, it’s kind of human nature to do that. But you occasionally want somebody to say stop, you know.
A number of hospitals right now, before they operate they – it’s an enforced pause where you take a minute and you just – anybody, from the lowest level clerk to the highest level doctor can say, you know what? I don’t feel comfortable about this. And this they won’t do the surgery.
You want people to pause and to think and to check names, and to do everything that they’re supposed to do. And you want to just make sure that they know that, not only you as the patient are watching, but people are watching out for you.
LAMB: After – and if you had worked at Medicare, or whatever, at federal, why wouldn’t you immediately, if you hear these stories say, this place has either got to be shut down or it’s got to – or is that whole $15 million …
ORNSTEIN: That is the $15 million question. As one supervisor called it, the $64 question.
But they – you know, the issue is, this community depends on the hospital. If it goes away, what happens? Are more people injured if there is no hospital than are injured if there is a hospital? They’re struggling with this. They’re struggling deeply.
The federal government required them to bring in these outside consultants at a huge cost, to try to fix the hospital. They said, we’re giving you one more chance. If these consultants can’t turn it around, we’re just not going to support you.
We’re six months into the consultancy. There are some signs of progress. There are other signs of lack of progress.
And so, we’ll see where it goes. It is a perilous time right now, and there’s no answer.
WEBER: You know, we spent so much time, and we kept – you know, when people were attacking us for doing this story, we kept our focus on these victims, the families.
One of the toughest stuff was just keeping in touch with them during this, because their lives were so, in such turmoil. And they expected – they have bad, you know, schools. They have – you know, they see law enforcement targeting them.
They have – there’s no businesses down there.
And they expected poor health care. And we just kept focusing on them, saying, where would they go if this hospital wasn’t there? They don’t have cars. They don’t have a way to make it somewhere.
This hospital needs to be there for them, and it’s to – they need to have the same health care as other folks from around L.A. County.
LAMB: What was the biggest surprise reaction you got after the series ran?
ORNSTEIN: The biggest surprise was that the reaction was overwhelmingly positive. I think we had braced ourselves for a lot of criticism of being branded racist for explaining the problems at this hospital.
But what we found was that people, including many members of the community e-mailed us and thanked us and called us to say thank you.
LAMB: We’re out of time, but I want to make sure that anybody who wants to read this series, they can find it through your Web site, which is …
ORNSTEIN: www.latimes.com/kingdrew, one word.
LAMB: And they can also find it through cspan.org. We’ll have it linked there for anybody that wants to see it.
Thanks to Tracy Weber and Charles Ornstein, the winners of the Pulitzer Prize, along with your other colleagues at the newspaper, and also the RFK Award.
Thanks for joining us.
ORNSTEIN: Thank you.
WEBER: Thank you.