LOS ANGELES -- Overcrowding in the emergency room at Harbor-UCLA Medical Center is placing patients in immediate jeopardy, according to state inspectors working on behalf of the federal government.
The Los Angeles County Department of Health Services expects to receive a formal citation based on last week's inspection, another blow to the county's fragile emergency room system.
In August, the county was forced to close most of Martin Luther King Jr.-Harbor Hospital in South Los Angeles after its federal funding was revoked because of lapses in care.
The federal government has also threatened to pull funding from another hospital in the county system, Olive View-UCLA Medical Center in Sylmar, because of deficiencies in care.
The expected citation for Harbor-UCLA, located in an unincorporated part of the county near Torrance, will require the county to establish a plan of correction or risk losing its federal funding.
The investigation was prompted by the Dec. 22 death of William Harold Jones Jr., an emergency room patient who left the hospital before treatment was finished and was found dead in a parking lot across the street.
Jones, 56, was admitted to the emergency room about 1 a.m. complaining of generalized body pain, according to the Los Angeles County coroner's office.
At 6:20 a.m., he told the staff he was going to use the restroom, but he never returned, the coroner's office said. The hospital realized a little after 9 a.m. that he had not returned.
Shortly after noon, a passerby found Jones dead on the sidewalk across the street from the hospital.
The coroner listed Jones' death as accidental and found that he was suffering from diabetes and end-stage renal disease. He also had cocaine in his system.
State officials launched the inspection of Harbor-UCLA last week on behalf of the U.S. Centers for Medicare and Medicaid Services.
Los Angeles County health services Director Dr. Bruce Chernof said in a statement Tuesday that inspectors told the county to expect a citation that would say Harbor-UCLA placed patients in "immediate jeopardy."
Chernof said in the statement that the county is already working on submitting a plan of correction to the inspectors.
Overcrowding in Harbor-UCLA's emergency room and delays in patient treatment were expected to be highlighted in the citation, according to Chernof's statement.
Chernof was not available for further comment.
The expected citation is the most recent in a series of problems at county emergency rooms.
In June, the federal government cited King-Harbor Hospital after a May incident in which a woman writhed in pain for 45 minutes on the floor of the emergency room lobby without receiving medical attention; she later died. Most of the hospital was shut down in August.
In October, a 33-year-old patient complaining of chest pains died of a heart attack several hours after arriving at Olive View-UCLA. He was never given a test to check if his heart was functioning properly.
The incident prompted a federal investigation of the Sylmar facility and in December, the federal government threatened to terminate the hospital's Medicare funding unless it showed evidence that the problems have been fixed.
As the county struggles with its public hospitals, other facilities have felt the strain.
Downey Regional Medical Center, which is close to King-Harbor, had 211 patients about 10 days ago, even though the facility is licensed for 199 beds, said Robert Fuller, the facility's executive vice president.
"It's not unusual to hold 10 or more patients in the emergency room waiting for rooms upstairs, and we never used to do that," Fuller said. "It's a daily battle to try to find the beds and the nurses to take care of all the patients."
Jim Lott, executive vice president of the Hospital Assn. of Southern California, said it's a tragic situation any time a patient dies after seeking treatment at a hospital.
"But patients leaving hospital emergency rooms, unfortunately, is not all that rare," Lott said.
"Our emergency rooms are on overload, our hospital beds are filled to the brim," he said.