Laboratory workers at Maryland General Hospital warned top hospital administrators and state officials in writing nearly two years ago of serious and long-standing testing problems that put patients and employees at risk.
The letter of July 25, 2002, cites "documented cases of apparent neglect and compromised patient care" - and inaction by hospital managers.
"We went to laboratory management and Human Resources with our concerns and were literally told it was none of our business," said the letter, obtained by The Sun. "As lab workers, we have to live with ourselves at the end of the day. We know that there is a patient attached to every specimen."
The letter - sent to hospital president and chief executive officer Timothy D. Miller and other officials there - is fresh evidence that Maryland General and state regulators had early knowledge of serious problems.
But those problems weren't taken seriously until this year, when state inspectors investigated a similar warning letter in December from a former employee, Kristin Turner.
State officials have confirmed the existence of the 2002 letter and acknowledged that they investigated at the time. They said they took the allegations seriously but found them vague and did not discover the serious problems until this year.
The hospital announced Tuesday the resignations of Miller and the medical director of the lab. Another lab executive had resigned earlier, and hospital spokesman Lee Kennedy said yesterday that another lab worker had been let go. He declined to provide details.
Kennedy said yesterday in a statement that the lab of "two years ago is not the same laboratory today" and noted it has been under new management since March 18 by a Utah firm, Park City Solutions.
"We have already acknowledged that there were problems and we are addressing those problems appropriately," he said. "That effort began several weeks ago."
Kennedy also noted the recent resignations and said the lab has a new medical director, among other staffing changes.
One of the authors of the 2002 letter was former lab technician Teresa Williams, who wrote a follow-up letter last month to the state after the lab scandal had become public. In the recent letter, Williams compared what was going on at Maryland General, which serves a large minority population, to the infamous experiments on blacks who believed they were being treated for syphilis but in fact were being denied treatment.
"It felt like the Tuskegee Experiments but on a larger scale where the victims were poor Blacks, Latinos and Whites," Williams recounted in the 11-page, March 31 letter sent to state Health Secretary Nelson J. Sabatini.
`A cloud of fear'
Williams, who quit her job at Maryland General in August 2002, said she and other laboratory workers repeatedly complained about poor lab practices and inadequate patient care but were rebuffed and threatened with the loss of their jobs.
Employees were forced to work "beneath a cloud of fear," Williams wrote last month in the letter, also obtained by The Sun. "When we did come forward we were labeled as troublemakers and were targeted by our employer with threats of retaliation."
Williams, who lives out-of-state, was not available for an interview. Her letter was sent to Sabatini as well to attorneys for the hospital and Turner. Turner's letter to the state in December triggered successful investigations leading to the resignations of Miller and others and promised reforms by Maryland General.
Sabatini confirmed yesterday that the March letter was sent to his office and that a prior letter complaining about the hospital lab had been sent in mid-2002. He said state inspectors responded to the 2002 letter with an inspection and did find problems. But, Sabatini said, the items in the 2002 letter were too general to lead inspectors to the specific deficiencies that have since turned up.
"This time," he said, referring to the most recent complaint, "we had very specific information."
The July 2002 letter did cite the example of an untrained clerk "being ordered to perform high complexity testing and verify patient results." And it used strong language in describing an atmosphere of intimidation that discouraged reform.
"We have no recourse and feel as though we have been targeted as troublemakers for coming forward with our concerns. No one will listen," said the letter. "Many people would like to come forward to tell of the atrocities that they have witnessed, but the costs are too high and the threats to job loss and retaliation are ever present."
According to Williams, the lab workers were so intimidated that when state inspectors did show up in October 2002, they were too scared to talk.
"Out of fear they remained silent," she wrote to Sabatini last month. By the time the inspectors arrived, she had quit the hospital.