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Complaint alleges long delays and privacy violations at County-USC emergency room

Photo: The new County-USC hospital, a state-of-the-art, $1.02-billion facility, opened in 2008. Credit: Brian Vander Brug/Los Angeles Times Los Angeles County health officials launched an investigation this week into allegations that the emergency room at County-USC Medical Center is so crowded, patients wait an average of 35 hours to be seen -- sometimes without any vital signs being taken -- and hospital workers fail to protect patient privacy.

Within hours of receiving the complaint Tuesday, John Schunhoff, the interim director of the Los Angeles County Department of Health Services, contacted the Board of Supervisors to inform them his department had begun an inquiry.

A county spokesman disputed the claim of 35-hour waits at the hospital's emergency room, saying the average wait is less than nine hours and varies depending on the patient’s illness.

The complaint, made by a healthcare professional who sought care at County-USC’s emergency room May 4, attracted the attention of the county’s top health officials and county supervisors already grappling with allegations of substandard patient care at another county-run hospital, Olive View-UCLA Medical Center in Sylmar.

In the complaint, the patient said she went to County-USC because of abdominal pain, and wrote that she was “surprised to witness an institutional disregard for basic standards of care.”

Among the allegations:

*  Patients’ names were posted on monitors facing a waiting room describing their symptoms, such as “John Doe, Penile Abscess,” while also listing dates of birth.

*  The patient described seeing 300 patients waiting in two rooms, with many forced to stand because of a lack of seats. The patient said a nurse told her that the average wait time was 35 hours.

*  The patient alleged that only 10 nurses were overseeing the waiting rooms, and the nurses seemed “disgruntled and overwhelmed.”

*  The patient said she waited eight hours before deciding to seek treatment at another hospital, and in that time, no nurse took her vital signs, a practice she alleged put patients in danger.

“If this could be substantiated, it would be hugely problematic because it would show systemic problems,” said Supervisor Mark Ridley-Thomas, of the complaints made about County-USC, which is in Boyle Heights just east of downtown Los Angeles.

Michael Wilson, a spokesman for the Department of Health Services, said the agency has continued making improvements in county-run emergency rooms “by reducing waiting times, increasing patient throughput, and completing timely medical screen exams.”

County-USC moved into a newer, smaller facility in 2008, and skeptics have complained about the fewer number of beds – a drop of more than 25% from the old facility.

The reduction in beds forced the county in 2008 to transfer some patients to another county hospital in Downey.

In November 2009, County-USC made an agreement to transfer some poor patients to Silver Lake Medical Center. County-USC also has arrangements to transfer Medi-Cal patients to private hospitals when there are no available inpatient beds.

-- Rong-Gong Lin II and Molly Hennessy-Fiske

Photo: The new County-USC hospital, a state-of-the-art, $1.02-billion facility, opened in 2008. Credit: Brian Van Der Brug/Los Angeles Times

Comments () | Archives (29)

The problem described is a societal/systemic problem with our healthcare. LAC-USC does its best with what little it's got. It has faithfully served the local community for generations. Its lack of ability to treat every single patient in a "timely manner" is due to a necessary triage system based on severity of illness and not time of arrival. The volume of patients often times overwhelm the hospital's capability. To place blame on the symptom and not the source is shortsighted and simply unfair.

Ah, yes! How's that "change" thing working for ya? Hordes of illegal aliens that California seems so fond of are swamping the city and the state.

But your city council, of course, is too busy have a snit about Arizona's laws -- which, of course, are absolutely not their business!

I would like to thank this ONE PERSON for brining this complaint about LAC + USC to the attention of the public. Now I would like to bring something else to the public's attention: http://www.latimes.com/news/custom/topofthetimes/topstories/la-me-trauma-20100502,0,1282058.story

I've been to this hospital before to pick up my friend. This was my first time being at a hospital like THIS one. Metal detectors and security searches greet you at the entrances. I remember it was difficult to find the waiting rooms and there were very few seats available. Can't say anything about the care receive here but it was an eye opening experience to me. Nurses and Medical Assistants working behind the thick bulletproof glass were kind of rude, but can't hold it against them because it must be stressful working in that environment. Hopefully these allegations can be investigated and this hospital can clean up its act if they turn out to be true. Waiting 30+ hrs in the ER is absurd

This is nonsense, I had a heart attack in December of 2007 and the LAC/USC Medical Center took immediate and excellent care of me, and 2+ years later all I can say is thanks.

However don't ever tell them you moved, even if it is in L.A. County, because if you do, you will be in for a serious bout of administrative hell.

Please stop with these diatribes against county hospitals. The emergency department is for EMERGENCIES. The lack of primary care in Los Angeles is not the county's fault. When people come in to have their back pain that's been going on for 5 years checked out in the emergency department, then they are going to have to wait behind the person that is having a heart attack. Sorry.

The county hospitals take care of those that no one else wants to take care of, with a tremendous lack of resources. People want good care and fast care, but don't want to pay for it. In that setting these hospitals are doing a tremendous job.

Want a real scandal? How about the patients getting dumped from private hospitals because they don't have insurance.

This is a terrible job by these reporters.

Welcome to government run health care. This is what you liberals are fighting so hard for.. 35 hours waits for the ER. No thanks. Keep the government out of my health care!

LAC-USC is and early version of Obamacare.

Yep, and some people a fighting to keep this kind of healthcare standing... I'm from Europe, and i can only say good things about our Healthcare... My only fear is to ever have to have to go to the hospital here... THis facility is a $ 1+ billion facility...This is amazing...We don't have such "state of the art " facilities in Europe... But i guess you can't have money for your patients left, at this pricetag..The average wait time in Europe (France) is about 15 minutes... I noticed here that nurses are the industry where there are the most drug addicted workers... America does not seize to amaze me, in good and very bad... People are ok to pay and have mandatory car insurance, but refuse to have the same for their health... I always thought the American healthcare system (so heavily privatized) to be a crime against humanity, until i saw that Americans voted to keep it this way...
Amazing, amazing...And tax dollars are robbed again

Probably the reason CA is so miffed is cause now the illegals are less likely to spill into AZ, so more for CA! They asked for it they deserve it!

Every hospital has a wait time...even if you walk in with a possible heart attack. I walked in to Barstow community hospital with severe chest pains..it was 2 hours before I was seen...by then I was passed out in the hallway where they left me.

This is the kind of treatment we can look forward to EVERYWHERE when the Obamacare nightmare kicks in.

Olive View-UCLA Medical Center in Sylmar
I took my friend to this emergency room when he had a car accident.
He hurt his neck during the car accident. We waited 4 hours, then a nurce came out and put a neck brace on him backwards. BACKWARDS! We then waited another 3 hours, until they realized he has insurance and took him in. They turned the neck brace around the correct way and x rayed him. He had a broke neck, recomended another hospital and we left with his head and neck all wrapped up. That hospital is a joke. They have serious issues. Do not go there if you have a serious issue and want to live.

If you are able to wait 35 hours then obviously it's NOT AN EMERGENCY! Just because YOU think it's an emergency does not mean the professionals at the ER do. Your penile abscess can go to the Obama sponsored, taxpayer funded clinic down the street during normal business hours. It does not need nor deserve an ER at 230 in the morning after you have been in pain for over 7 weeks. It's not the hospitals fault, it's the idiots who abuse the system. Just wait until you all have your entitlement health care. 35 hours will seem like a walk in the park.

Sounds like Stroger hospital in Cook County, IL. One more absurd reason not to cut off Medi-Cal and Healthy Families to everyone in these tough times. I know why a stroke or heart attack is immediate to the top of the list, because you will die if its not treated in a matter of hours. You can have a 2nd attack and die immediently because something is blocked to your brain our heart. I imagine the waits skyrocketing to 72 hours if we cut the budget. First, we won't be able to hire more nurses, doctors, etc. because County funds go to county run hospitals and Arnie is taking that away. So I imagine all will suffer, even those with good health insurance. Deport the illegals, but realize we are running California at the double the population with half the money they spent in the 90's, smaller gov't for the world's 3rd largest economy. Only freaks like Arnie and Meg Whitmann believe that.

Are you kidding me? Is anyone really surprised by this? I have had to wait 10 hours or more at Harbor. I have seen people on gurneys with stab wounds. I saw a woman who was hugely pregnant. She was walking around groaning. I thought she was going to give birth right on the floor. I am grateful that I have insurance now and can avoid county facilities. It's not their fault that they are overcrowded or that staffing is so thin. At least there is something but it should be better.

Thanks Mike, well said. Andrew doesn't look at the root of the problem, only the surface. Ky, being behind bullet proof glass and going through metal detectors, did that tell you anything? Did you have a chance do make of snap shot, or even a mental snap shot of who was waiting in the waiting rooms/ I think Mike said it well. What is everyone complaining about? Mike you hit the nail on the head. Your right, city council? Wanting to boycott Az. when we are having our own problems here in CA. Again Mike well said. All I can say is when it comes election time, remember those councils who are wanting to boycott AZ

Want to see the wait time drop dramatically??? Prop 187!!! Look it up.

Welcome to the New Los Angeles.

It sounds like something from a third world country. You wanted an international city, well you've got one. Enjoy.

You can all thank the illegal immigrants for this mess. Next time you have a huge long wait, just remember, you are also paying for the person sitting next to you. As long as you support illegal immigration, this type of problem will continue. Its not the hospital's fault, most of their patients cant pay so something has to give.

Illegals swamp county hospitals in this illegal alien sanctuary county. It doesn't matter if you have the best healthcare money can buy. If you get into a car accident and the fire dept transports you, good luck. They will take you to the nearest county contracted hospital. You will wait for hours while you hear moaning in spanish all around you. Ban illegals from county hospitals and they will be empty. I love what that hospital in Florida did to that illegal from Central America. They put him on a plane and sent him back to his country. If L.A. County hospitals did that then you might hear crickets in the hospitals.

The LAC+USC Executive Team meets every morning at 9am (in the Administrative Conference Room in the Inpatient Tower) to discuss problems but nothing is ever fixed. Under the lack of leadership under Pete Delgado, CEO, the waiting times in the ER have increased, waiting time for appointments have increased, urgent specialty referrals are delayed for months, and the Average Length of Stay has increased. This is why uninsured patients are transferred to private hospitals and the LAC+USC reimbursed these hospitals.

However, Pete Delgado if often away from the hospital on conferences paid by third parties (do I see a conflict of interest) and the Auditor-Controller should investigate this. This should not be delegated to the LAC-DHS as they are unwilling to investigate P Delgado for past transgressions.

If these "issues" are truly discussed at their 9am Executive Meetings, why do these problems continue - is the Executive Team incompetent?

Or, if they are not discussed at the 9am Executive Meeting, what in the world are they discussing?

Finally, Joint Commission is coming May 18-20, 2010 and we are not prepared. If the L.A. Times were to ask the front-line rank and file employees, they would tell you they are unaware of next weeks visit.

We are in trouble.

Dear Board of Supervisors,

Can you please investigate why:
1. The lines in the Information Booth (2nd floor entrance, Inpatient Tower) are so long?
2. Why the restrooms are so filthy throughout the new hospital?
3. Why the same people (Executive Committee members) are on all various department-wide committees (when are they at the hospital managing)?
4. Why we have a fully staffed OB unit (highly paid Clinical Nursing Director) and only deliver 3-4 babies per day (on a good day) - what do they do the rest of the time?
5. Why the Rand Schader (5P21) AIDS Clinic is without an administrator (the last one retired March 2010) . Chris Arevalo is overseeing it, but there is no day-to-day Administrator.

Thank you.

Wanna experience for yourself what the Superdome was like after hurricane Katrina, right here in your own backyard? Head on over to the emergency room at County+USC on a Friday night.

I am speaking from a DHS employee point of view. I have been with DHS for 11+ years, and I have seen all walks of life come thru those doors. The majority of the people that walk into either one of the county hospitals are not illegal. Just because they look latin, asian, armenian, african, or any other ethnicity, it does not make them illegal. With the economy taking a dive as it did, we have everyone, and I do mean everyone, come thru those doors.

Even people with insurance, and what people need to understand is when people come in with insurance, and they are transferred, the insurance companies DO NOT pay for their medical services rendered at the county hospital. So, guess who that cost falls one? You guessed right, the tax payers.

All county facilities are severly understaffed, and with overtime taken away (due to the budget), they have to make due with what they can. But it is not just county facilities, ladies and gentlemen. I am fortunate to have insurance, and have take my children to emergency rooms with the Providence group. We had to wait 5 hours to be seen, and once seen, sent home within the hour? A friend of mine was miscarrying and went to Valley Pres in Van Nuys, and they sent her home with a prescription!! They told her she was 15 weeks, but her baby had died at 10 weeks, and they sent her home!! She miscarried the baby in her bathroom, and we took her back, to which the doctor said..."Opps"!! It took them 12 HOURS to admit her into a room!!! W.T.H!!!

This is a COUNTY WIDE problem that is not going to go away anytime soon. It happens at ALL emergency rooms, not just County Run.

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