Health Dept. Lays Off Second Whistle-Blower

A Los Angeles County health department physicist Monday was permanently laid off from his job monitoring X-ray machinery at several public clinics, he said, after repeatedly reporting to his superiors that aging equipment has over-radiated hundreds of patients.

Reuven Zach, a medical radiation physicist hired more than four years ago to monitor radiation equipment at two county hospitals and seven public health clinics in the San Fernando Valley, became the second person in less than a week to accuse health officials of laying him off in retaliation for his whistle-blowing.

Irving Cohen, county Department of Health Services finance director, said the new layoff list, effective Monday, designated 17 employees for release and others for transfer. He said it was compiled strictly on the basis of seniority and will save the county $650,000 a year.

Last week, a fiscal officer with five years on the job at Martin Luther King Jr./ Drew Medical Center in Watts charged that she was laid off after reporting that the county hospital had lost millions of dollars because of billing foul-ups.

Now Zach, stationed at Olive View Medical Center in Sylmar, contends that he has been laid off because he was too critical of radiation practices at county facilities, which he contends have wasted money and harmed patients.

The most recent in his series of critical memorandums is a letter he sent to Supervisor Mike Antonovich on Sept. 23 warning that public health clinics have substituted old, expired X-ray film for new film, which he said has “disappeared” from the clinics.

Health officials had no comment on the allegations that old film had been substituted for new film, and Antonovich’s spokesman said his office was studying Zach’s charges.

During an interview, Zach produced a box of old X-ray film with an expiration date of December, 1984, which he said he had personally confiscated from a health clinic last May. He said the old film made up about one-third of the clinic’s film inventory.

“The problem with using old film is that the X-ray will be foggy and you can’t see the fine detail,” Zach said. “In order to get an image at all you have to increase the level of radiation.”

In addition to citing faulty film, Zach has criticized the lack of maintenance on X-ray machinery and the lack of proper X-ray technique by county radiation personnel.

In a separate, independent look at the X-ray machinery, the health department’s Division of Occupational Health and Radiation Management has recently cited five public clinics that Zach monitors in the San Fernando Valley for deficiencies that increase a patient’s risk of overexposure to radiation.

Repeatedly in the last two years, reports show that the county’s occupational health inspectors have cited clinics for using X-ray machines with malfunctioning or improperly used collimators--devices that limit the size of the X-ray beam.

“If the collimater is not functioning, you can’t aim the X-ray beam accurately and properly to the region of interest and you may have to reshoot it,” Zach said.

In a memo April 12, 1988, to Dr. Issa Yaghmai, chairman of the Olive View radiology department, Zach complained about “very old X-ray machines, which are hardly serviced,” and “unprofessional conduct” by technologists.

“In my opinion,” Zach wrote, “this intolerable situation is a direct result of inadequate and unprofessional supervision.”

Yaghmai declined to comment on Zach’s charges, but hospital Personnel Director Charles Canales said that Zach’s layoff is not retaliatory. Of the 2,000 employees on the hospital’s staff, Canales said that one other employee, a clinical psychologist with six months on the job, is also being permanently laid off.

Zach is the only medical radiation physicist stationed at Olive View, responsible for monitoring radiation machinery and nuclear medicine at that hospital, as well as at High Desert Hospital in Lancaster and satellite public health clinics in Glendale, North Hollywood, Valencia, San Fernando, Canoga Park, Tujunga and Van Nuys.

Zach said he has studied a significant number of discarded X-rays at the public clinics. These, he said, betray malfunctioning equipment, old film or improper radiation techniques. He produced discarded X-rays of children--very susceptible to radiation--who, he said, were improperly X-rayed, forcing the picture to be retaken. In one case, the X-ray of a 3-year-old child on March 22, 1988, shows that half the child’s head was needlessly X-rayed, along with her torso.

Similarly, on Jan. 2, 1988, the X-ray of a 2-year-old child was so murky, because of “bad technique,” Zach said, that it had to be reshot.

Far from resenting Zach’s criticisms, Canales said that health department personnel fully appreciate that “it’s part of his job . . . to aggressively pursue any concerns that he had as far as safeguarding procedures” in radiology.

He said that Zach was laid off because his job is one that the hospital could most afford to lose without jeopardizing patient care.

Of Zach, he said, “There is nothing of a negative nature (in Zach’s personnel file) indicating we were displeased with his performance.”