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Harbor-UCLA doctors allege toxic work environment, retaliation


Beginning a decade ago, staff at Harbor-UCLA Medical Center started to report the same high-ranking doctor, alleging jarring sexual comments and retaliatory behavior that routinely raised alarms inside the renowned teaching hospital.

Maria Garibay, then a medical secretary, told human resources in 2013 that her boss, Dr. Louis Kwong, the head of orthopedics, would openly discuss with his staff how the women he operated on under anesthesia “would groom their pubic areas,” according to her written complaint reviewed by The Times. Los Angeles County, which runs the public hospital in West Carson, found the complaint unsubstantiated.

In 2019, a medical student posted comments on a site used to assess orthopedic programs, accusing Kwong of entering an operating room to peek “under the hood” and gauge the size of a patient’s genitalia, among other claims. The post was flagged for the hospital’s director of risk management, who responded that they had “started working on this,” according to emails reviewed by The Times. Nothing happened.

After years of watching complaints against Kwong stall, three prominent Harbor-UCLA physicians — Drs. Haleh Badkoobehi, Jennifer Hsu and Madonna Fernandez-Frackelton — filed two lawsuits last month alleging years of sexual harassment and retaliation in orthopedics.

The physicians alleged that sexism, homophobia and harassment were openly tolerated within the department.

Following similar allegations, an organization that oversees teaching hospitals took the unusual step of placing the entire Harbor-UCLA Medical Center on probationary status in June, an action that could jeopardize the ability of the hospital — a critical facility for the poor and uninsured patients around the South Bay — to stay open. The move came after Fernandez-Frackelton and her residents each filed a complaint with the group.

According to the lawsuits, reported earlier by NBC News, Kwong asked a female faculty member if she wore G-string underwear, asked his secretary if she wore a push-up bra, and regularly used a slur to describe gay people. He engaged in “finger banging” of surgical hip wounds while making sexual sounds and saying he was “finding the G-spot,” the doctors alleged. He asked employees if they wanted to “take body shots” off Badkoobehi.

Kwong did not respond to a call or emails requesting comment. Harbor-UCLA said in a statement that accusations against Kwong had first been “officially reported” in fall 2021. At that point, the hospital said it hired an outside firm to lead “an impartial and in-depth investigation,” now in its final stages.

“Safeguarding patient care is our highest priority, which is why we immediately took steps to thoroughly investigate the allegations of misconduct,” the statement said.

After The Times inquired about earlier complaints, Harbor-UCLA said the 2013 allegations from Garibay were “unrelated” to the 2021 complaint and that posts on “social media and other public discussion forums,” such as Reddit and the Ortho-Doc spreadsheet, were “not considered official channels for registering complaints.”

The women said the unprofessional behavior sometimes jeopardized patients’ safety. Some residents complained they were being forced to get patients’ consent for treatment without adequately explaining the risks, and writing prescriptions for patients they never examined.

Kwong, a volunteer deputy sheriff, was sometimes armed when he scrubbed into surgery, storing his gun in a fanny pack, according to the lawsuits. And the physicians say Kwong would rearrange the operating room schedule, giving his elective surgeries priority over emergency operations.

“We had to basically play Tetris moving around pieces to try and appease him,” Hsu said in an interview.

Dr. Louis Kwong would sometimes bring his gun into Harbor-UCLA Medical Center, according to lawsuits filed this October by three doctors at the Torrance teaching hospital. The lawsuits allege widespread sexual harassment and retaliation within the hospital’s orthopedics department, which Kwong chaired.

(Handout)

Kwong was placed on administrative leave in spring of 2022, according to the physicians. That year, Kwong earned nearly $1 million, according to the county’s salary database.

Harbor-UCLA said it is against county policy to discipline an employee until an investigation has concluded, and that paid administrative leave is its only option.

While Kwong stays on county payroll, the three physicians say they’ve been punished for complaining about his conduct. Fernandez-Frackelton said she was stripped of her title as program director of emergency medicine, after complaining to the oversight body.

She was told the hospital had to “give a talented guy a chance before you turn into a pumpkin,” according to the lawsuit.

Badkoobehi, meanwhile, said she was removed as associate program director for orthopedic surgery residents after being asked to investigate a complaint that Kwong had endangered a patient by watching a baseball game on an operating room monitor.

“This system for investigating everything is beyond problematic,” Badkoobehi said in an interview. “They received complaint after complaint after complaint over many years, and they were covered up. They were ignored.”’

In spring 2022, the hospital’s top emergency medicine residents wanted to report an “unprofessional and toxic work environment” inside Kwong’s department, where they were required to do a rotation.

But they said they no longer believed the hospital leadership would act. Instead, the residents went to the Accreditation Council for Graduate Medical Education — elevating grievances that had roiled the teaching hospital for years to a body with the power to shut down the entire facility.

“Orthopedic Surgery Department leadership and hospital leadership at Harbor-UCLA have been made aware of and acknowledged these instances of unprofessional behavior,” the chief emergency residents wrote in their complaint. “However, we feel that no appropriately substantial changes have been made to correct these behaviors and improve this culture.”

After years of hearing similar allegations, Fernandez-Frackelton, who at the time oversaw the emergency medicine residents, decided to join them by filing her own complaint with the national board.

“I knew if I filed a complaint that [the oversight board] saw as legitimate, I was putting the residency, the hospital, everyone at risk,” she said in an interview.

Harbor-UCLA is one of only six accredited medical training institutions out of 880 across the nation facing a blanket probation. Of the six, Harbor-UCLA is by far the largest and best-known.

Doctors say the designation indicates the panel has found severe problems with the environment residents are training under.

In 2021, the panel put Tulane University School of Medicine’s Graduate Medical Education on probation after Black faculty members accused the school of racial discrimination. The panel put NYU’s emergency department on probation in 2022 after an investigation into doctors facing pressure to prioritize VIP patients. In 2019, the body put Los Angeles General Medical Center, then known as LAC+USC Medical Center, on probation. The panel didn’t give a reason, but the designation came after a medical resident had accused a fellow in the program of sexual assault. The probation designation has since been lifted.

The national oversight body can place a teaching hospital on probation if it finds the institution is not in “substantial compliance” with its requirements. Both the county Department of Health Services and the accreditation board declined to specify which requirements the hospital was no longer fulfilling.

Lawyers for the Department of Health Services declined a public records request for the oversight group’s report to the hospital on its shortcomings, saying it would have “a chilling effect” on future investigations.

While on probation, Harbor-UCLA cannot start any new accredited residency programs. The hospital also must tell future applicants it is on probation, which doctors say could cause some recent medical school graduates to rethink accepting a residency there.

“That is a huge red mark on any program, and it has huge implications because it impacts their ability to recruit good doctors — most medical students don’t want to go to a program on probation,” said a longtime physician with the Department of Health Services, who spoke on the condition of anonymity while discussing their employer. “For a whole institution to be placed on probation is a huge deal.”

Health Services said in a statement that hospital leadership was “already working to resolve the concerns of the council and expects to be able to do so in a very timely manner.” Officials did not respond to a list of questions about their plan to get off probation.

“Harbor-UCLA remains a premier institution, committed to excellence in both learning and care,” the statement said.

Harbor-UCLA has two years to show improvement or it could lose its accreditation, according to the panel’s policies.

The hospital has sought to reassure its doctors and patients that the probation will be short-lived.

“Our change in status will have no impact on our residents, our patients, or our ability to recruit new trainees,” Dr. Darrell Harrington, the associate medical director for education, wrote in a July open letter to staff and future applicants. “Although probationary status is considered a serious disciplinary decision by [the accreditation body], DHS and hospital leadership are confident full accreditation will be restored.”

But some Harbor residents say Harrington’s failure to address complaints at the lowest-level is a major reason why the institution now faces outside discipline.

“That’s been the overarching theme for the last few years that I’ve been here,” said a fourth-year resident at Harbor, who spoke on the condition of anonymity to avoid possible retaliation. “It’s just constantly battling against the powers that be to make what seemed to be very straightforward and simple changes happen.”

In her complaint to the oversight body, Fernandez-Frackelton accused Harrington of covering up complaints about Kwong.

“I, and many others, have exhausted all the appropriate channels in our department, our institution, and our human resources system to encourage the Department of Orthopedics to address these issues,” she wrote. “Dr. Harrington has protected and defended … Kwong, for many years.”

Harrington wrote in an email that “there are multiple sides to a story or complaint,” but said he couldn’t comment further due to the active litigation. Harbor-UCLA said in a statement that it “will not attempt to try its case via the press” and will provide full context for the allegations in a courtroom.

As an example, some point to the handling of allegations made by then-medical student Melani Cargle. In 2019, Cargle wrote an anonymous post on a live public document — called Ortho Match — that is regularly checked and updated by medical students applying to orthopedic surgery residencies. The post accused Kwong of entering the operating room to check the size of the patient’s genitalia and said he “legit walks around the hospital with a gun in his fanny pack,” according to a copy of the post shared by her attorney.

The post made its way onto Reddit, where a Harbor-UCLA staff member flagged it for the hospital’s risk management team, according to emails.

According to texts sent to Badkoobehi, one of the doctors suing Harbor-UCLA, Harrington was not pleased to see it elevated.

“I understand that a decision was made to push the issue to risk management and county counsel,” Harrington texted Badkoobehi in December 2019, according to messages shared with The Times. “I wish you would have called me about this. I’m very concerned that once the narrative is away from Harbor it is no longer under our control and may very well take on a risk mitigation and assumption that the Reddit thread represent real experiences and observations.

“This will undoubtedly be turned towards an investigation of reported events and personalities,” he wrote.



This story originally appeared on LA Times

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