Metropolitan News-Enterprise


Wednesday, June 5, 2002


Page 3


Claims Board Recommends $800,000 Settlement of Medical Negligence Case




County supervisors have been asked to pay $800,000 to settle the case of jail inmate Larry Small, who suffered permanent brain damage when medical staff allegedly botched his treatment.

The payout would be the largest over the last year resulting from Los Angeles County jail medical care, which has come under increasing public scrutiny as inmates continue to file mounting malpractice claims. The Sheriff’s Department, which runs the jails, is legally responsible for providing medical care to inmates.

A county claims panel recommended the settlement for Small after a briefing by lawyers Monday and a review of documents that suggested the jail’s medical staff missed clear evidence in a blood test of severe disease. He was later found unconscious in his jail cell and was rushed to a hospital, where doctors discovered a brain lesion.

Small had been jailed on a third-strike burglary charge in Castaic.

There have been three other cases of medical malpractice against the Sheriff’s Department since June of last year. Those were settled for a total of $130,450, Deputy County Counsel Gary N. Miller said. He noted that the Department of Health Services has settled 122 cases for nearly $15.5 million in the same time period, he said.

In the suit, Small and his wife claim that in October 1997, Small complained to the North County Correctional Facility medical staff about a fever and weight loss. Medical workers found an abnormally low red blood cell concentration and a blood test suggested a problem with his kidneys, but Small’s only treated was Tylenol and an order to drink more fluids, according to medical records.

He later developed a rash and was given ointment, but no follow-up tests were performed for several weeks. There was no additional treatment, according to the complaint.

On Jan. 4, 1998, Small was found unconscious and taken to Henry Mayo Newhall Memorial Hospital, where the lesion was discovered. He was later sent to LAC-USC Medical Center and was discharged on April 9, 1998.

Meanwhile, his felony was reduced to a misdemeanor.

Small filed a claim for his injuries on January 20, 1998. In August, he filed a civil rights and medical malpractice lawsuit in Los Angeles Superior Court against the county. He has continued to have problems with his memory and brain function, according to the complaint.

Miller said the Board of Supervisors is expected to act on the matter June 18.

Currently, the jail has a medical staff of about 60, including two medical doctors, two dentists and 50 nurses—nearly all of whom are registered nurses, Correctional Services Division Commander Marc Klugman said.

Of the 7,000 inmates in the North and East County jails, the medical staff sees an average of 6,500 inmates a day to administer medication, Klugman said.

The Sheriff’s Department now uses a database that allows jail medical staff easy access to inmates’ medical records and allows them to order pharmaceuticals and lab exams online.

The Jail Health Information System has been introduced incrementally over the past 18 months and is unique to Los Angeles, Klugman said.

“J-HIS is really important [because] in a hospital setting, the patients are stationary and the doctors move around; in jail, it’s just the opposite,” Klugman said. The system gives medical staff better information on an inmate no matter what facility he is moved to, Klugman continued.

Klugman said the number of malpractice cases brought against the Sheriff’s Department is not large when considering that the department sees over 80,000 medical records a year.

“We’re doing a good job,” Klugman said. “Are we perfect? No. Can we do better? Yes.”

Klugman said inmates are provided with care that compares with community standards and in many cases exceeds the care people would have access to outside jail. He said the department is looking for better ways get doctors to sick inmates, rather than have inmates seek attention or follow-up exams.


Copyright 2002, Metropolitan News Company