Critical condition

April 07, 2004

IT'S DEPLORABLE but not surprising that the faulty laboratory equipment and procedures revealed last month at Maryland General Hospital were not the aberration officials there claimed but symptoms of a more widespread affliction.

Like peeling back layers of rotten fruit, the deeper state and federal inspectors looked into management of the hospital's lab, the more problems they found.

Lost or mishandled specimens, missing records, poorly trained staff stretched too thin, sloppy and disengaged management - this on top of previous discoveries of test results doctored to hide machine malfunctions.

The state has threatened fines of up to $10,000 a day if the hospital fails to immediately take corrective action, such as hiring professionals to monitor quality control, limiting lab work performed for other health care facilities and verifying that all patients who may have been given inaccurate test results are notified and offered retesting.

Such steps, while necessary, don't seem nearly adequate to the task of restoring public confidence in the hospital, which primarily serves Baltimore's urban poor.

What's called for is a change of leadership - at least of the laboratory, and perhaps higher.

The administrative director of the lab has been removed, and day-to-day operation taken over by a consultant. But hospital President Timothy Miller said no decision has been made yet about the lab's director, Dr. Philip Whelan, who was repeatedly faulted by the state for failing to act on problems reported to him or to report those shortcomings to his supervisors.

Meanwhile, the University of Maryland Health System, with which Maryland General is affiliated, is keeping its distance from the scandal.

If similarly poor service were revealed at a suburban hospital with a more upscale and politically well-connected clientele, it seems a safe bet the facility would be closed - at least temporarily, as a gesture to show that its managers acknowledge the gravity of the circumstances.

Such a signal has not been forthcoming from Maryland General's management. At risk - in addition to the patients involved - are the facility's image and credibility.

Rep. Elijah E. Cummings has scheduled a congressional hearing in May to examine what initially appeared to be a matter of defective testing equipment in Maryland General's lab, but has now been exposed as a systematic failure of the institution.

The Baltimore Democrat should demand to know not only how a major medical facility wound up in such a sorry state, but why it was allowed to continue for at least 18 months. And most important, how we can make sure it gets fixed.

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