The first rule in medicine is: do no harm. But doing harm is precisely what some Los Angeles hospitals are being accused of when it comes to patients who happen to be homeless.
As CNN's Anderson Cooper reports, the claim is that hospitals don't like dealing with homeless patients, who are often uninsured and sometimes unpleasant to treat. So they literally dump them on the streets of Skid Row, even if the patients come from other places in Los Angeles, and are in no condition to fend for themselves.
While there have been allegations of hospital dumping for years, people only started paying attention to them because of a videotape recorded by a camera outside a homeless shelter.
The tape shows a 63-year-old homeless woman named Carol Ann Reyes wandering in the street. The pictures may seem unremarkable, but the story that goes with it is disturbing. Reyes had just been discharged from Kaiser Permanente Bellflower hospital where, after taking a fall, she had been treated for three days.
The hospital confirms she was put in a taxi and the driver was told to take her to Skid Row. Why was she wearing little more than a hospital gown? Because the hospital admits they had lost her clothes and sent her away without pants or even shoes. They did, however, give her a diaper.
"The cab came this way. He did a u-turn. Pulled around. And stopped. The driver didn't even get out of the car. The back door opened and this little lady got out in her hospital gown," says Rev. Andy Bales, who runs the Union Rescue Mission, the biggest shelter in Skid Row.
Skid Row is a 50 square-block area home to some 11,000 people, with the highest concentration of homeless in the country.
Asked if he was surprised to see Reyes get out of the taxi, Rev. Bales says, "I was stunned and shocked and frozen for a moment. I couldn't believe my eyes. She was really confused."
She was confused, investigators later found, because she was suffering from dementia. That shouldn't have come as a surprise to Kaiser hospital officials.
Their own medical records show Reyes was disoriented as to time and place. Her speech was slurred, she had extremely high blood pressure, and a persistent cough and fever. Even with these medical problems, they decided to discharge her and sent her to the streets of Skid Row.
"They're dumping a 62-year-old woman with dementia in the heart of Skid Row? That's what's going on. And it's shocking and it's criminal," argues Rocky Delgadillo, the Los Angeles City Attorney.
His office is investigating more than 50 cases of alleged homeless dumping on Skid Row. "These may be the perfect victims. Because a homeless individual dumped on Skid Row disappears into the chaos of Skid Row within minutes. It's hard for us to find them and then get the evidence that we need."
What should hospitals do with homeless patients? The California Health Code requires all hospitals to make "appropriate arrangements for post-hospital care" and for "continuing health-care requirements" before discharging any patient.
Kaiser didn't do that in Carol Ann Reyes' case, Delgadillo says. She was sent to Skid Row last March without any medication or instructions for follow-up care.
Asked what it's like down there, Delgadillo says, "Cardboard shanties. It's a dangerous place, both physically, as well as the drug dealers that congregate on Skid Row, gangs that come here to find easy prey."
"Not the kind of place an elderly woman with dementia should be," Cooper remarks.
"No, in fact, if she'd made it around the corner, she might not be with us today," Delgadillo says.
Carol Ann Reyes is with us today because a worker from Bales' mission rescued her from the street. She's now under the protection of a court-appointed conservator. She suffers from mild dementia and other medical problems. The conservator allowed 60 Minutes to videotape her meeting her lawyer, but not to ask her any questions. Her lawyers have filed suit against Kaiser hospital.
Before she was hospitalized, Reyes had been sleeping in a park, 16 miles away from the crime-ridden streets of Skid Row.
"Sometimes, individuals end up here that are just released from county jail," explains Deputy City Attorney Jose Egurbide, who investigates hospital dumping cases, and showed 60 Minutes around Skid Row.