By Gustavo Arellano
By R. Scott Moxley
By Alfonso Delgado
By Courtney Hamilton
By Joel Beers
By Peter Maguire
By Charles Lam
By Charles Lam
Santa Ana's Western Medical Center is one of only three trauma centers in Orange County, serving mostly working-class and poor residents, many of whom lack health insurance. And the hospital is falling apart. Paint is flaking off the walls and the wallpaper, which hasn't been changed in 15 years, is peeling away. Dirt and dust inhabits what is supposed to be a pathogen-free environment, and blood-stained carpets and sheets abound.
What's more—less, actually—medical equipment such as scalpels are in such short supply and so overused they sometimes break mid-operation. The lack of sanitation and supplies is so widespread the hospital failed a test survey last summer by the Joint Commission on Accreditation of Health Care Organizations, which accredits hospitals.
"The survey was a disaster," said Dr. Michael Fitzgibbons, Western Medical Center's supervisor of infectious diseases. "They found dirt and dust everywhere. I'm sick of it. It's an insult to patients to have blood on the sheets or on the ceiling."
Fitzgibbons, a soft-spoken, bespectacled Republican, is hardly an alarmist rabble-rouser. And he isn't the only physician who's frustrated. Over the past several months, many Western Medical Center doctors have begun applying to work at other Orange County hospitals.
"This whole for-profit model has been a disaster," Fitzgibbons said. "Basically, you have these hostile administrators that don't want to deal with quality-of-care issues."
Businesses typically invest 5 percent in capital improvements and research and development. Western Medical Center has a $150 million to $200 million revenue stream per year. Based on that, Fitzgibbons said, $1 million would be a good number to put into routine maintenance. "But they don't even do that. They haven't changed a carpet in 15 years. We're worried that they will just let the hospitals lose money and then close them to build condos. What will happen when these hospitals close? People will die."
Fitzgibbons is so mad about the sorry state of affairs at Western Medical Center that he agreed to share his concerns with the Weekly despite the fact the hospitals' owner, Costa Mesa-based Integrated HealthCare Holdings Inc. (IHHI), has sued him for libel and interfering with the company's business practices. Long before he went public, Fitzgibbons shared his outrage with IHHI officials—and they did nothing. Shortly after the survey took place, on June 5, 2005, he sent an e-mail to the company demanding they fix problems that had been ignored for years.
"As you are aware, the mock survey found a number of deficiencies," Fitzgibbons wrote. "We are at risk of receiving a conditional accreditation; this would be a critical black eye indeed. I have asked for years . . . that we improve housekeeping to improve the hospital's cleanliness . . . including painting, wallpapering, repair of holes in walls, replacement of carpets and broken beds."
By then, Fitzgibbons had already gotten into trouble for trying to raise money to help the rest of the medical staff become investors in the hospital, which had been losing cash ever since IHHI purchased it—and three other Orange County hospitals—from Tenet Corp.
On May 9, 2005, IHHI received a notice of default when it was unable to make scheduled payments on a $50 million loan. Ten days later, Fitzgibbons, who was then Western Medical Center's chief of staff, wrote an e-mail to other doctors describing the financial situation at the hospital as "ominous."
IHHI sued Fitzgibbons, charging him with defamation and interfering with the company's business. The hospital's medical staff rallied behind Fitzgibbons and urged IHHI to drop its suit. Meanwhile, the lawsuit spurred many Western Medical Center doctors to apply for medical privileges at other Orange County hospitals. Western Medical Center continued to lose cash, reporting a total of $20 million in losses during the past two quarters alone.
In December, IHHI finally offered to drop its lawsuit against Fitzgibbons—if he agreed to pay his own legal bills. But Fitzgibbons refused to back down. On Dec. 14, his lawyers sent a letter to IHHI saying he'd accept their offer only if the company would reimburse him and other doctors who contributed to his defense fund, extend his contract at the hospital, provide a written apology and "agree that it will not utilize civil litigation as a means of pursuing a complaint about the conduct of any Medical Staff member."
IHHI refused his offer.
"IHHI will not bow to the action of any individual who, in its judgment, interferes with and wrongfully obstructs its rights and abilities to conduct business activities," wrote IHHI attorney Deborah Tropp. "Your client continues to take the position that his complaints were based on quality of care issues. We suggest you re-read the e-mails authored by your client which prompted this lawsuit. There is no quality of care language contained in those e-mails whatsoever."
But Fitzgibbons says he sent the May 19 e-mail to potential investors whom he hoped could help save Western Medical Center from going bankrupt—an action he said can hardly be construed as an attempt to sabotage the hospital. The same goes for his June 5 e-mail alerting IHHI officials to the hospital's sanitary deterioration.
"IHHI was looking for a way to go after me because I speak up about quality-of-care issues," Fitzgibbons said. "This is a new paradigm in health care. Hospitals don't sue doctors. We're their customers. They knew that if they could shut me up, they could control the rest of the medical staff. But I'm not going to back down. I didn't do anything wrong. I want my day in court."