King/Drew Federal Funding Threatened After Stun Gun Used To Subdue Patients; Third Citation in One Year

CMS officials have threatened to withhold about $200 million in federal funding for Martin Luther King Jr./Drew Medical Center over allegations that administrators continue to allow police to use Taser stun guns to subdue aggressive psychiatric patients, the Los Angeles Times reports (Ornstein, Los Angeles Times, 12/19).

CMS officials in June cited King/Drew for allowing police to use Tasers to subdue some patients. Investigators gave the facility 23 days to develop new policies to reduce the use of Tasers or risk losing federal funding. Hospital officials agreed to limit the use of police officers and Taser stun guns and remained eligible for federal funding (California Healthline, 6/24).

Following the June citation, hospital staff received training in how to better manage aggressive patients. Staff members were told to document all their actions prior to calling police (Los Angeles Times, 12/19).

State inspectors two years ago cited King/Drew for allowing county police to use Tasers without instituting formal guidelines for their use. King/Drew officials prohibited the use of Tasers following that citation, but Los Angeles County officials in March 2003 reversed the ban on Tasers, saying that they could be a useful tool but police needed additional training.

Most hospitals use specially trained medical personnel to calm aggressive psychiatric patients or subdue them with medication or minimal force rather than using Tasers, which fire two darts connected to electrical wires up to 21 feet and deliver as much as 50,000 volts of electricity over five seconds to immobilize a person (California Healthline, 6/24).

According to the warning issued Friday, inspectors in November found that King/Drew staff called county police to subdue a patient, eventually resulting in use of a Taser gun, "without having taken adequate steps to control the person beforehand," the Times reports. In the warning, CMS officials said the hospital's actions placed patients in "immediate jeopardy."

CMS officials again gave King/Drew 23 days to submit a solution to the problem. The warning is the third King/Drew has received from CMS this year.

The incident detailed in the warning occurred after King/Drew's operations were handed over to Navigant Consulting, a management consulting firm contracted for one year to repair problems at the facility. The consultants are re-evaluating the hospital and are expected to issue a "lengthy reform plan" on Jan. 3, according to the Times.

Los Angeles County Department of Health Services Chief Operating Officer Fred Leaf called the recent warning "really disturbing." He said, "It just makes me question even further the commitment of the staff in that particular facility. ... You can do all the training you want and you can establish all the protocols and procedures you want, but unless individuals take responsibility and perform properly, you're going to continue to have these kind of problems."

In a memo sent Friday to the county Board of Supervisors, Leaf said the health department had reassigned the police officer involved in the most recent Taser incident and would make other policy changes this week "to safeguard the hospital's federal funding," according to the Times.

Supervisor Gloria Molina said, "I have no idea what is wrong with this crew." She added, "They are putting us in the utmost of jeopardy here. We could be sanctioned to the point where (federal regulators) could close us down tomorrow if they want to" (Los Angeles Times, 12/19).

King/Drew's neonatal outpatient department on Friday received a $20,000 grant intended for new neonatal equipment from the Women's Discipleship Group. The donation was made during a holiday party that "took on added poignancy" because of problems the facility faces, according to the Times. During the party, hospital staff distributed donated gifts to about 500 children served by the hospital.

Wini Jackson, a community outreach coordinator for the Los Angeles County Probation Department, said, "I was very concerned that with all of these things going on, people would forget about the children. You have to look for the bright light in the darkness, and you must never forget about the children" (Becerra, Los Angeles Times, 12/18).