Thursday, August 02, 2007
2 prosecutors had sought hospital probe - Senior officials denied the 2005 request for a grand jury inquiry into two deaths at troubled King/Drew, saying no crime had been alleged.
By Charles Ornstein August 02, 2007 in print edition B-1
Two Los Angeles County prosecutors unsuccessfully sought a grand jury investigation in 2005 into deaths at Martin Luther King Jr./Drew Medical Center, igniting a behind-the-scenes debate about whether alleged misconduct merited a wide-ranging criminal investigation.
The prosecutors' recommendation, which was outlined in a confidential April 8, 2005, memo, grew out of frustration with the slow pace of their inquiry into two patient deaths. In particular, they cited trouble obtaining hospital records and the county coroner's removal of autopsy findings that suggested substandard care by King/Drew nurses.
The memo, which was recently obtained by The Times, went on to propose a broad look by a grand jury at the King/Drew deaths, possible cover-ups of misconduct at the hospital and whether the coroner was properly examining deaths involving medical wrongdoing.
Senior officials in the county district attorney's office said they rejected the request because no specific crime had been alleged and problems at the troubled hospital were best addressed by county leaders.
Two years later, strong feelings persist on both sides of the debate. The senior prosecutor behind the recommendation said he wonders how many lives might have been saved at King/Drew had the district attorney acted aggressively.
"I did say that this could come back to haunt us," said Jeffrey Jonas, a 38-year veteran in the D.A.'s office who was then head deputy over specialized prosecutions. "I did say that this isn't the last we're going to hear about Martin Luther King. And sure enough it's been an ongoing thing."
King/Drew, now known as King-Harbor, faces possible closure because of continued lapses, including a recent high-profile death in the emergency room.
Jonas' views were heatedly disputed Wednesday by top district attorney officials.
"To think that the D.A.'s office can put on a cape and wave a magic wand and make MLK OK is absurd," said Richard Doyle, bureau director for specialized prosecutions, one of two officials who rejected the grand jury request. "We are here to prosecute crime that we can prove. That's our job. We're not here to cure the social ills created by other people."
And even when crimes may have been committed, he said, his office generally relies on other law-enforcement agencies to investigate first.
Criminal grand juries, which are generally impaneled for one month, have the power to subpoena documents, listen to witnesses and hand up indictments.
The district attorney's office began a preliminary inquiry into two deaths at King/Drew in January 2005 in response to a written request by county Supervisor Zev Yaroslavsky.
"These two incidents cry out for a review of whether any of the involved personnel bear criminal responsibility for their conduct," the supervisor wrote at the time.
In both cases, nurses were alleged either to have ignored patients' heart monitors or failed to ensure that they were audible.
The D.A.'s office assigned the matter to a deputy prosecutor, Vesna Maras, who was then handling medical-legal matters. Working with state regulators, she accumulated thousands of pages of records.
In an interview, she said she determined that a broader investigation was needed to understand what was happening.
"The situation is sad at that hospital, and it's sad that that standard of care is somehow acceptable -- because it isn't to me," Maras said. "It really bothered me."
Among other hurdles, Maras wrote in the 2005 memo, county Chief Medical Examiner-Coroner Dr. Lakshmanan Sathyavagiswaran ordered the removal of part of an autopsy report on a patient who died at King/Drew on Nov. 18, 2004.
Sathyavagiswaran and his office did not return repeated calls and e-mails seeking comment.
According to Maras' memo, deputy medical examiner Dr. Louis Pena had found that "there was a failure to provide the most basic nursing or medical care" to a 47-year-old patient who died. But the coroner deleted that opinion and ruled the manner of death "undetermined." (The memo refers to the patient as Jane Doe; her name was Sandra Sagastume.)
Pena had told Maras that "he was having trouble dealing with the working conditions at the coroner's office and did not want to challenge Lakshmanan constantly because of 'political ramifications,' " Maras wrote.
"Pena stated that other deputy medical examiners and coroner investigators also felt that they could not contradict Lakshmanan and expressed concern regarding his managerial style within the context of their ethical responsibilities."
Maras wrote that during an earlier meeting, the coroner "firmly pronounced that it is 'not his job' to analyze whether or not 'quality of care' issues contribute to a death."
When asked to explain his reasoning, "his attempt to answer this question was nothing short of surreal," Maras wrote.
Later, Maras wrote, "Lakshmanan's demeanor during our tempestuous 'dialogue' could best be described as dictatorial. He clearly stated that he was free to overrule the opinion of any deputy medical examiner and had the final say
Summarizing her concerns, Maras wrote, "It is not possible, in my opinion, to do an honest evaluation of those cases without simultaneously examining the coroner's conduct."
Doyle said he did not believe that the coroner's office did anything wrong. Defining cause of death is the coroner's job, he said, not the district attorney's.
"That's his call," Doyle said. "There's nothing that even smells faintly of a crime there. That is a purely procedural thing that is so far out of our expertise and has nothing of a crime written on it."
In an unusual turn of events, the memo surfaced this week during the trial of Phil Spector, the music producer who is accused of murdering a woman in his Alhambra home in February 2003. Prosecutors gave Spector's defense team a redacted copy of the memo because Pena was the deputy medical examiner who performed the autopsy of Lana Clarkson and testified about it in court. The judge in the trial, Larry Paul Fidler, said the document was irrelevant and could not be raised.
Doyle said he made the decision to reject the grand jury recommendation with special operations assistant D.A. Curt Hazell. Dist. Atty. Steve Cooley did not participate in the decision, but did not raise any objections. Doyle said decisions not to bring a case before a grand jury are fairly common.
Jonas, who now oversees the major fraud division, said he was told at the time by a senior official in the district attorney's office: "We don't want another Belmont."
Cooley closed a lengthy investigation into the handling of potential safety problems at the Belmont Learning Complex in 2003 without filing any criminal charges even though he had criticized his predecessor for what he called a "whitewash" of the problems.
Doyle said the reference to Belmont, if it occurred, did not have political overtones.
"We can't go getting into something that we don't have a focus on, that there isn't a goal and a target, that's just going to eat up valuable grand jury time with no result," he said.
After rejecting a grand jury probe, the district attorney's office continued to investigate the conduct of two nurses who cared for the two patients who died at King/Drew in 2004. Maras and a new supervisor, Dan Murphy, ultimately decided not to file criminal charges because the documentary evidence was insufficient and no witnesses were available, Murphy said.
Murphy, the current head deputy for specialized litigation, said the district attorney's office should not have to clean up King/Drew's messes. That responsibility rests elsewhere, he said.
"I don't know how the people that are responsible for governing this county can sit there and can have watched that place fester and erupt and boil over time after time after time after time after time and still be afraid because of, I guess, politics to do what needs to be done."
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charles.ornstein@latimes.com
