No criminal charges will be filed against medical staff at a troubled inner-city hospital over the death of a homeless woman who writhed in pain on the emergency room floor for nearly an hour, a county prosecutor concluded Tuesday.
A nurse at Martin Luther King Jr.-Harbor Hospital was not criminally negligent despite refusing to examine Edith Rodriguez _ who was kneeling and screaming in pain with a perforated bowel _ and telling her to get off the floor, according to the report by Deputy District Attorney Susan Schwartz.
"Prompt intervention would not have saved her life," Schwartz wrote in the report to the Los Angeles County Sheriff’s Department about the May 2007 death.
"It cannot be proved beyond a reasonable doubt" that the nurse’s actions were a substantial factor in the death "or that any member of the MLK nursing or medical staff was criminally negligent," the report said.
Doctors made a wrong diagnosis and failed to treat the patient properly until it was too late, but "a mistake, even a negligent mistake, does not amount to ’criminal negligence,’" the report said.
The county Department of Health Services, which oversees the hospital, had not seen the report and could not immediately comment, spokesman Michael Wilson said.
Rodriguez’s death was one of several that came amid allegations of shoddy care at the county-run hospital, which was built in South Los Angeles after the 1965 Watts riot to provide much-needed medical care to the poor, heavily minority area.
The Centers for Medicare & Medicaid Services revoked $200 million in federal funding last summer, and the hospital, previously called Martin Luther King Jr.-Drew Medical Center, was closed to all but outpatient care.
Rodriguez, 43, died of the perforated bowel on May 9, 2007. The report said she had been seen at the hospital at least six times in the month before her death and had spent 14 hours there a day earlier.
Doctors diagnosed gallstones and had prescribed painkillers, the report said.
She was brought in again by two county police officers responding to a call of a woman "yelling for help" outside the hospital entrance, the report said. She was brought into the emergency room complaining, "I am hurting, something burst in my stomach."
She also vomited and slid out of a wheelchair several times, but the triage nurse _ who determines the order in which patients are seen _ refused to examine her, telling county police officers that the woman had already been seen and discharged, the report said.
At one point, the report said, Rodriguez was "on her knees and screaming in pain," and the nurse, Linda Ruttlen, told her: "Get off the floor and onto a chair."
The nurse then ignored Rodriguez as she lay in a fetal position, according to the report.
Another patient in the emergency room called 911 and asked for an ambulance for Rodriguez, but the emergency operator refused because Rodriguez was already in an emergency room, the report said.
Eventually, county police who had taken Rodriguez into the emergency room decided to take her to jail on a parole violation so she could receive medical care there, but she became unresponsive as she was taken in a wheelchair to a patrol car, then later pronounced dead in the emergency room, the report said.
The coroner’s office ruled her death accidental. The district attorney’s office last year declined to file criminal charges against the county police officers who were arresting Rodriguez, saying they acted properly and with compassion.
The new report called Ruttlen’s failure to triage Rodriguez "reckless, in light of Rodriguez’ observable physical signs of acute distress and in the face of repeated warnings from other hospital staff and patients that Rodriguez was in grave distress."
However, Dr. Henry B. Hwu, an expert in colon and rectal surgery who reviewed the case for the district attorney’s office, believed that Rodriguez probably had reached the "point of no return" at least 24 hours before her final visit to the emergency room and could not have been saved.
In turn, Ruttlen, he said, "was led into a false sense of security because the patient had been seen five times in the two weeks prior" to her death, according to the report.
Ruttlen could not be reached for comment Tuesday. There was no phone listing in her name in Los Angeles.
Another reviewer, lawyer and physician Dr. Mark Brown, noted that Rodriguez had a history of drug abuse and that hospital staff could "rationally conclude" that she was only trying to enter the hospital again to obtain "food, shelter and narcotics and was not in medical crisis."
The decision not to file criminal charges was disappointing, said Franklin Casco Jr., an attorney for Rodriguez’s family in a $45 million lawsuit claiming negligence, medical malpractice, discrimination and wrongful death.
"Lady justice may be blind in the eyes of the district attorney’s office when it comes to the death of Ms. Rodriguez, but I guarantee you that lady justice will not be blind in a civil courtroom," Casco said.
Casco acknowledged it was hard to file criminal charges in such cases.
"Did they intentionally kill her? It’s really tough," he said. "I wouldn’t say it was clear-cut."
The lawsuit names the county, the hospital, Ruttlen, other medical staff, five county police officers and the company that provided private guards for the hospital. The suit seeks $1 million in damages for each of the 45 minutes that Rodriguez spent on the emergency room floor. The suit, filed in November, has yet to go to trial.
