State argues to close King

California health regulators outlined their case Friday against Martin Luther King Jr.-Harbor Hospital, saying repeated lapses in care have harmed patients and warrant the revocation of its license.

The allegations by the California Department of Health Services, detailed in a 32-page document, cite findings from nine inspections between October 2004 and June 2007. In particular, the report said, the hospital has failed to ensure the competency of its nurses and the protection of its patients.

The state’s attempt to revoke King-Harbor’s license, which was announced last week, is the most serious threat yet to the troubled hospital. If upheld, it would force the hospital to close.

This is the first time the state has attempted to revoke a hospital’s license since 2004.

King-Harbor, formerly known as King/Drew, can remain open while it challenges the state’s action, a process that can take a year or longer.

As a precaution, the Los Angeles County Board of Supervisors earlier this week ordered county health officials to prepare plans for treating patients elsewhere.

Kathleen Billingsley, deputy director of the state health department, said the state can withdraw its accusation if it finds that King-Harbor has fixed its problems.

“I hope that the hospital can be successful and that the people who have been accessing care at Martin Luther King hospital will continue to be able to do so in a safe manner,” she said.

Among the cases cited in the state’s accusation is that of Edith Isabel Rodriguez, a 43-year-old woman who died May 9 after writhing on the floor of the emergency room lobby for 45 minutes as employees ignored her.

Linda Ruttlen, the triage nurse who allegedly rebuffed Rodriguez’s pleas, had been cited by the hospital in January 2006 for her failure to follow proper procedures for dealing with patients with chest pain, the report said. The hospital took no steps to ensure that her performance improved, according to the report.

Ruttlen was placed on administrative leave after Rodriguez’s death and subsequently resigned. Her lawyer, Paul Bickenbach, said this week that his client denies the accusations against her, but that he couldn’t comment further because of anticipated litigation. Ruttlen hopes to go back to work at King-Harbor, Bickenbach said.

Rodriguez’s three children have filed a claim for damages against the county, which is required before a lawsuit can be filed.

Other examples cited by the state include a dialysis patient who was forced to wake her nurse in June 2005 when a needle became dislodged from her arm, spurting blood. Also mentioned was an AIDS patient who died in October 2004 after a nurse failed to notice that his vital signs were plummeting, as shown on his cardiac monitor.

Dr. Bruce Chernof, director of the county Department of Health Services, said his office takes the state’s action seriously but wants to reassure the community that the hospital remains open.

“It’s very important for me that, whatever ultimately happens, there is a thoughtful transition and we don’t scare the community,” he said.

King-Harbor has been unable to meet minimum federal standards for patient care since January 2004.

After the hospital failed what was billed as a make-or-break federal inspection last September, the county slashed services there, ended its physician training programs and reduced the number of beds to 48 from about 250.

Then, earlier this month, the U.S. Centers for Medicare and Medicaid Services cited the hospital for placing emergency room patients in immediate jeopardy. The hospital quickly made improvements that satisfied the government.

The Medicare agency is slated to conduct another top-to-bottom review of King-Harbor next month. If the hospital fails, federal officials have said they will pull certification and funding without delay.

“We do not underestimate the challenge involved in turning around a facility that had reached the condition of MLK-Harbor,” Medicare agency acting administrator Leslie V. Norwalk wrote to Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee. “Those challenges are formidable.”

In a statement, Baucus said he continues to be “very concerned about what is going on at MLK-Harbor Hospital.”

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charles.ornstein@latimes.com

Times staff writer Jack Leonard contributed to this report.