Paul V. Coates--Confidential File
Mrs. Mary McAlpin, of this city, died less than 48 hours ago.
There are powerful and conflicting versions as to why.
The lone agreement comes in that the story of her death began six weeks ago.
On June 15, she fell down at the home of her daughter, Mrs. Edna Logan, 20249 Walnut Drive, Walnut, Calif. She broke her left hip.
A few hours later she arrived at General Hospital in Los Angeles
And after four days more, when she had been built up physically for surgery, a pin was placed in her femur. The operation was reported a success.
In Ward 380 of General Hospital, Mrs. McAlpin began her recuperation period.
But what happened then is difficult to say.
There are those who believe she died, at 77, from the effects of old age.
And there are those who believe that she died as a result of indifference on the part of members of the hospital staff.
According to Robert Thomas, director of General Hospital, Mrs. McAlpin began to get bedsores on the day following her operation.
The record of her 38-day stay, he reports, shows that she received special care 54 times. Thirty of the written entries of this care make direct reference to the fact that she was "turned and moved" to prevent further damage to her body.
There are other reports, however.
One is from John Oftedal, M.D., of Pomona who examined Mrs. McAlpin immediately after her family removed her from General Hospital.
"Just to look at her turned my stomach.
"There were decubitus ulcers (bedsores) all over her body--her sides, her back, her knees, her hips.
"Some were the size of hen's eggs. Gangrene had sent in.
"Never had I seen anything like it."
"Bad bedsores are nearly always the result of poor nursing. They need a lot of attention--antibiotic therapy, cleaning, changing dressings, light treatment."
So I talked to a fellow patient of Mrs. McAlpin. Her name is Sammilee Ross. This is what she told me:
"I was with her for five days. There were no bandages on her sores. I listened to the nurses argue about who should feed her. So finally I started feeding her myself.
"Only once did I see a nurse actually feed her.
"The last two days I was there they didn't even change her bed--and it was dirty. I can assure you.
"I could hear them in the hallway, though, saying: 'All right, who's going to turn the big, fat slob over.' "
Sammilee Ross told me that the nurses often neglected to empty the bedpans, so she took the chore herself.
"I'd do it at night, too. Only I'd scald them to sterilize them. The nurses wouldn't."
Anyone who knows the conditions at County General Hospital knows there's a shortage of nurses. Were there enough in Ward 380 to do the required work?
Mrs. Ross says yes. "A good example is when the nurse brought a book of mine back which had been missing from my bedstand.
" 'I took it to read,' she told me, 'because I didn't have anything else to do.' "
Every night, Mrs. McAlpin was visited either by her son, Clarence McAlpin, or her daughter, Mrs. Edna Logan, or both.
Mrs. Logan told me:
"We'd beg them to give her something for the pain. To bathe her sores. We volunteered to clean them ourselves.
"One doctor told us we couldn't touch her. Another finally said it was OK. When other patients told us that the nurses weren't feeding her, we took food with us--liquids and custards."
Clarence McAlpin told me:
"Frequently the covers were off of her. Once, when she was sweating very much and I complained, the nurse told me, 'If you want her to have extra service, get her a private room.' "
Last Monday, Mrs. McAlpin was removed from General Hospital by her children. She was taken by ambulance to the Pomona Rest Home of Mrs. Cora Cozad.
"The poor woman was full of holes and sores. And so hungry," Mrs. Cozad told me. "I took one look at her and called Dr. Oftedal."
The doctor arrived within 10 minutes. He told me afterward that he checked the patient's heart and blood pressure and they were fine. But, he added, he had never seen anything as dreadful as the bedsores.
General Hospital Director Thomas explained to me that flesh varies with individuals and that Mrs. McAlpin's skin continued to break down despite good treatment.
"We were on the horns of a dilemma," he said. "Fracture cases shouldn't be moved. Bedsore cases should.
"I believe our staff did everything possible. The nurses don't record every service to a patient, so she undoubtedly received more attention than the record shows."
Dr. Harold Kade of the county coroner's office, who investigated the death yesterday, concurred with Thomas.
"It's not an unusual case," he said. "I listed the death causes as general arterial sclerosis and fracture of the left femur."
I checked also with a private physician, highly respected in medical circles here.
"If, as the report said, Mrs. McAlpin was moved 30--or even 60--times in 38 days, it wasn't enough," he stated.
"Bedsores are always a danger with elderly patients. And patients should be turned every four hours."
And, as the police officer who answered the "dead body" call reportedly remarked at the scene: