@ Health Services oe aweeees ees RISK MANAGEMENT DIVISION PERFORMANCE MANAGEMENT 5801 E. Slauson Avenue, 1 Floor, Suite 150, Commerce, California 90040 (323) 914-6361 ida Sots DHSPMU-Online@dhs lacounty,qov Fret Ditrct | ees ae atte imei atene arrs CONFIDENTIAL rm ore is February 27, 2024 ISSUED VIA FEDEX AND ELECTRONIC MAIL Employee No.: ia Date of Hire: 12/26/2007 Dear Dr. Kwong: NOTICE OF DISCHARGE This is to notify you that effective close of business day on Wednesday, February 28, 2024, the Department of Health Services (DHS or Department), Health Services Administration (HSA), is discharging you from your permanent position of Chief Physician | at Harbor-UCLA Medical Center (Harbor-UCLA) and from County Service In a letter dated January 31, 2024, you were notified of the Department's intent to discharge you, the specific grounds for the proposed action, and of your right to respond ‘Along with the Notice of Intent to Discharge (NOID), you were provided with all documnents supporting the proposed action, as identified within the NOID letter dated January 31, 2024. (Exhibit A1)* On February 16, 2024, you submitted a written response c/o your attorney, Jennifer R. Lucas of Ferber Law via electronic mail. In your written response, you denied the allegations, accepted responsibility for any act you took that may have violated County policy and asked that the intended discharge be reconsidered. (Exhibit B1) After full consideration of all facts and responses, DHS has decided to proceed with your discharge from County service. 4 The NOID letter included exhibits, which comprised the evidentiary documents used by DHS to support the basis of this action. Since the exhibits were provided to you with the NOID previously issued to you, they are not attached hereto, 660966 2 ‘To advance the health of cur patents and aur communities by providing extraordinary care"Louis Kwong, MD Employees IE Page 2 of 18 DOH: 12/26/2007 BASI: This action is due to your inappropriate conduct towards others at work, your failure to report ‘outside employment, and your conduct unbecoming of a manager in violation of the DHS Discipline Manual & Guidelines (DM&G), Department policy and related policies as follows DHS DM&G Subsection 400 (Exhibit A): Subsection B. Basic Job Performance * Item No. 6: Abuse of supervisory or management authority or conduct unbecoming management or supervisory authority. * Item No. 7: Failure to perform management and/or supervisory responsibilities competently or promptly. Subsection D. Disruptive Behavior: Harassment, Discrimination, and Discourtesy * Item No. 5: Failure to act on report of conduct cited in D1-D4 within established County Policies. Subsection G. General Misconduct and Inappropriate Behavior. * Item No. 11: Failure to comply with County or Departmental policies, procedures, rules, and regulations, Penal and/or Safety codes. Section H. Health and Safety Related Misconduct. © Item No. 11: Endangering self, patients, the public, other employees or workforce members by violating safety rules, codes, laws, or ordinances. * Item No. 15: Reckless or careless behavior that endangers self and/or others, including safety violations. DHS Code of Conduct (Exhibit B), states in part: rassment and Workplace Violence All workforce members have the right to work in an environment free of harassment. We will not tolerate any type of harassment, including but not limited to harassment based on the diverse characteristics or cultural backgrounds of those who work with us. Degrading or humiliating remarks, jokes, slurs, forms of physical or psychological intimidation, or other harassing conduct is not acceptable in the workplace.Louis Kwong, MD Employee Page 3 of 18 DOH: 12/26/2007 Harassment also includes incidents of workplace violence. Workplace violence includes robbery and other commercial crimes, stalking, violence directed at the Department, terrorism and hate crimes committed by workforce members. * Disry, Behavior All workforce members should be treated with respect and dignity, and as valuable members of the health care team. Disrespectful or disruptive behavior is not acceptable. Disruptive behavior includes any behavior that interferes with communication, teamwork, or safe patient care. Disruptive behavior can be obvious, for example, verbal outbursts of anger, throwing objects, or disrespectful language. However, it can also be passive or less obvious, such as, not answering questions or returning calls, not performing assigned tasks, impatience with questions, or missing, being late for, or being inattentive at meetings. In any case, disruptive behavior will not be tolerated. DHS Policy No. 740, Outside Employmentincompatible Activity, Conflict of Interest, Stato of California Conflict of Interest and Disclosure Code, and Dual Compensation (Exhibit C) All employees who intend to engage in outside employment, including to provide expert witness testimony shall obtain prior approval to engage in such activity. Human Resources Managers shall provide the ‘Outside Employment/Incompatible Activity, Conflict of Interest, State of California Conflict of interest Disclosure Code, and Dual Compensation,” hereafter referred to the "Outside Employment” form to employees for use in notifying the Department of their intent to engage in outside activities. DHS Policy No. 535, Bank Accounts (Exhibit D) Bank accounts are often created to increase security over County funds collected at County facilities. Before any bank account may be established, it is necessary for the region, hospital, or the Department facility to clear intended action through Fiscal Services staff. DHS Policy No. 747.300 Workforce Behavioral Expectations (Exhibit E) The Department of Health Services (DHS) will not tolerate any disruptive, inappropriate, or unprofessional behavior/conduct by any workforce member towards another workforce member, the public, or patients.Louis Kwong, MD Employeet ED Page 4 of 18 DOH: 12/26/2007 ‘Any workforce member, including medical or professional staff, who engage in inappropriate conduct, or exhibit disruptive or unprofessional behavior, or who fail to exercise sound judgment in dealing with other workforce members, patients, or the public may be subject to appropriate corrective action, up to and including discharge. ‘Additionally, your conduct violated the County of Los Angeles, Department of Human Resources, Policies, Procedures, and Guidelines No. 812 - County Policy of Equity (CPOE) (Exhibit F), which states in part: Section 10. Duties of Supervisors and Managers: Under these Procedures, supervisors and managers have an affirmative duty to perform certain duties as enumerated below. For purposes of this Policy, supervisors and managers, include: any employee regardless of job description or title, having authority, in the interest of the employer, to hire, transfer, suspend, layoff, recall, promote, discharge, assign, reward, or discipline other employees, or responsibility to direct them, or to adjust their grievances, or effectively to recommend this action, if, in connection with the foregoing, the exercise of this authority is not of a merely routine or clerical nature, but requires the use of independent judgment NOTE: FAILURE BY ANY SUPERVISOR OR MANAGER TO CARRY OUT THESE DUTIES MAY BE CAUSE FOR DISCIPLINE. [EMPHASIS ADDED] Section 11, Duty of all Supervisors and Managers to Report: ‘Supervisors and Managers have the affirmative duty to report potential violations of the Policy. Supervisors and managers are required to report potential violations of the Policy to CISU even when a complaining or reporting party requests that no action be taken. Section 12: Additional Duties of All Supervisors and Managers 2 County of Los Angeles Policy of Equity is more restrictive than state or federal anti-discnmination, antiharassment laws, and is designed to stop behavior that is inappropriate for the workplace before it rises. to a level that may violate these laws. Therefore, any violation of this Policy should not be construed as an admission or acknowledgment of lability for wrongdoing on the part of the County. The standards of proof for determination violations of the CPOE are different from those that apply to California Fair Employment and Housing Act (FEHA),Louis Kwong, MD Employee Page 5 of 18 DOH: 12/26/2007 Supervisors and managers are also responsible for: * Being aware of, abiding by, and understanding the Policy and Procedures, as well as any modifications that may be made to them; * Actively monitoring the work environment to ensure that conduct which potentially violates the County Policy of Equity is not occurring; * Informing County employees under their supervision of the types of prohibitive behavior, and the County's procedures for reporting and resolving complaints arising under the Policy; ‘+ Stopping conduct that potentially violates the Policy and taking immediate and appropriate administrative action whether or not the involved County employees are within their line of supervision; and * If a situation requires separation of the involved parties, particular care must be taken to avoid actions that appear to punish the complaining party. (Note: Supervisors are not required to place themselves in physical harms way to separate the parties.) In the signed and dated Agreement of Understandings, you acknowledged receipt of the following policies: (Exhibits G and H) DHS Policies: DHS Policy No. 535, Bank Accounts DHS Policy No. 740, Outside Employmentincompatible Activity, Conflict of Interest, State of California Conflict of Interest and Disclosure Code, and Dual Compensation DHS Policy No. 747.300 Workforce Behavioral Expectations Los Angeles County Policy Policy, No. 812 County Policy of Equity, CPOE This action is consistent with DM&G Section 200, Progressive and Non-Progressive Discipline (Exhibit |) DHS generally subscribes to the theory of “progressive discipline,” whereby misconduct is addressed at the lowest possible level reasonably anticipated to result in the desired improvement of performance or positive change in behavior. Under this approach, each time an employee is disciplined, he or she mayLouis Kwong, MD Employe Page 6 of 18 DOH: 12/26/2007 receive an increasingly higher level of discipline. However, DHS reserves the right to impose discipline at any level (up to and including discharge) when warranted, given the totality of the circumstances. [EMPHASIS ADDED] ‘This action is also consistent with Civil Service Rule 18.031 (Ex! it J) Failure of an employee to perform his or her assigned duties so as to meet fully explicitly stated or implied standards of performance may constitute adequate grounds for discharge, reduction or suspension. Where appropriate, such grounds may include, but are not limited to, qualitative as well as quantitative elements of performance, such as failure to exercise sound judgment, failure to report information accurately and completely, failure to deal effectively with the public, and failure to make productive use of human, financial and other assigned resources. Grounds for discharge, reduction or suspension may also include any behavior or pattorn of behavior which negatively affects an employee's productivity, or which is unbecoming a county employee; or any behavior or condition which impairs an employee's qualifications for his or her position or for continued county employment. [Emphasis Added] FACTS The facts supporting this discharge are as follows: Background (Collectively Exhibits K, L, and M)° 1. You have held the position of Chief Physician | of Orthopedic Surgery at Harbor- UCLA Medical Center since February 1, 2018. 2. You have signed and acknowledged the Agreement of Understanding annually since the start of your tenure with Harbor-UCLA. Notably, on July 21, 2021 and July 21, 2022 «Included in this form are three (3) Policy Attestations. You indicated “NO” under the section “Outside Employment’ which states: | do not engage or plan to engage in any outside employment or reportable voluntary activities. | have the DHS policy on outside employment and 2 The investigation report attached to this letter as an exhibit is fuly incorporated by reference and provides further facts and evidence of the basis for this action. The report has been redacted to only include information relevant to this discipline and to protect confidential personnel information.Louis Kwong, MD Employees| Page 7 of 18 DOH: 12/26/2007 acknowledge that | have responsibility to report any change in my outside employment status to my supervisor. Abuse of authority/Conflict of interest/Failure to Report Outside Employment: Zimmer Biomet (Exhibits K and M) 3. On December 23, 2021, the Department of Auditor-Controller, Office of County Investigations (OCI) received a complaint filed by Dr. ES Physician Specialist, Surgery-Orthopedics, alleging that you failed to disclose outside employment with Zimmer Biomet and that you have an inappropriate special working relationship with this vendor. The complaint further alleged that you required certain employees to pay an annual fee for participation in an exclusive club you created for residents that you then deposited into a non-county related bank account. 4. OCI determined that the complaint presented potential fraud violations and forwarded the complaint to the Department's Audit & Compliance Division (A&CD), OCI #2021- 18564, for further investigation. A&CD concluded that you violated Department policies and substantiated the following: 5. You failed to disclose your employment activities and financial interests with Zimmer Biomet for the following years: 2015, 2016, 2017, 2018, 2019 and 2020. 6. Your name is on the Zimmer Biomet’s website (www.zimmerbiomet.com) as an affiliate doctor and can be found on the website in their “Find a Doctor” section with a name search. 7. Per www.openpaymentsdata.cms.gov,* you received approximately, $738,648.53 from Zimmer Biomet between 2016 and 2022. 8. The payments received were listed as consulting fees, royalty and license, travel and lodging and food / beverage “Per their website, Zimmer Biomet is a global medical technology leader offering innovative implants and digital technologies across all stages of the patient journey. © Open Payments collects and publishes information about financial relationships between drug and medical device companies (referred to as "reporting entities") and certain health care providers (referred to 1s "covered recipients"). These relationships may involve payments to providers for things including but not limited to research, meals, travel, gifts or speaking fees, 4 Using an integrative approach, DocSpot pulls together data from over 600 publicly available sources into ‘one unified interface. Sources include state medical boards, hospital and clinic physician directories, and reviews from around the web. The sources of the data on each provider's profile page are shown for the convenience of both the prospective patient and the provider. To keep the data fresh, DocSpot re-visits the ‘sources on a regular basis,Louis Kwong, MD Employe Page 8 of 18 DOH: 12/26/2007 9. Per www.docspot.com*, you received approximately $768,912.00 in consulting fees, royalties and licenses from Zimmer Biomet Holdings, Inc and Zimmer Holding, Inc. between August 2013 through November 2020. Failure to Report Outside Employment: Lundquist institute (Exhibits L and M) 10.During the course of the foregoing investigation, it was revealed that you were a member of the Lundquist Institute. 14. Your name is listed on website of Lundquist Institute (hitps://lundquist org)’ under the tab “Our Researcher’ as an “Investigator” and co-director of Thrombosis Research of LA Biomed (Trial Group). 12.1n 2020 and 2021, you failed to disclose your membership activities with Lundquist Institute. Improperly solicitating Donations from Residents for a Non-County program (Exhibit M) 13. By your own admission, approximately ten (10) years ago, you set up a private bank account with funds obtained from County employees. You did this on your own accord and without obtaining management approval. 14. You encouraged residents to pay an annual donation of up to $500 under the guise that the funds were being contributed to a 501(c)(3) non-profit account. 15. The investigation verified that Harbor Orthopedic Research and Education Fund had a bank account at Bank of America. They reviewed the bank statements dated from 2015 to 2023 and verified that there were several deposits made in the account, some in the amount of $500. 16. Additionally, checks issued from the account were reviewed. The checks from the account were issued to various individuals for raffle items, gift cards / alumni raffie, desserts, graduation party, embroidered jackets, registrations for courses, and lodging, Inappropriate conduct in violation of CPOE (Collectively, Exhibits N*,O, and P) 7 Formerly known as Los Angeles Biomedical Research Institute (LA BioMed) ® The investigation report attached to this letter as an exhibit is fully incorporated by reference and provides further facts and evidence of the basis for this action. The report has been redacted to only includeLouis Kwong, MD. Employee IE Page 9 of 18 DOH: 12/26/2007 17. Between November 2021 and November 2023, the Board of Supervisors’ County Intake Specialist Unit (CISU) received numerous complaints filed against you alleging that you had engaged in inappropriate conduct at work. 18.CISU determined that the complaints presented potential violations of the CPOE and forwarded the matter to the County Equity Investigations Unit (CEIU) for investigation. You were provided “Complaint Notification and Designation Letters” for the following cases: Case No: CISU Intake #2021- 110737; #2022-11424; #2022-113430; #2022- 111368; #2022-112393; #2023-120979; and #2023-122764. All the cases were Designated 19. You were notified that the foregoing CPOE complaints filed against you had been investigated by the CEIU and had undergone a briefing by the County Equity Oversight Panel (CEOP). 20. The CEOP as well as the Department concluded that your actions violated department policies. Inappropriate conduct towards others in violation of CPOE on the basis of Sex, Race, Gender, and Sexual Orientation and Failure to Report possible violations of CPOE: Duty of ail Supervisors and Managers to Report (Exhibit N) Incident 1 21.On muttiple occasions, several members of the surgical team witnessed you lifting the surgical covers of African-American male patients to look at their genitalia while they were under anesthesia for non-medical reasons. Witnesses saw you engage in the foregoing conduct and heard you making associated inappropriate comments including, ‘check under the hood,” and “genitals of the day,” or words to that effect. 22. Dr. EE ecalis an incident wherein [IEEE Surgical Technician, informed the surgical team “to check out a penis,” of a patient because it was very large. She observed you lifting the drapes to look at the patient's penis while he was under anesthesia. Dr. I 2is0 heard you making comments related to patients’ genitalia on more than one occasion, including commenting on penis size, on whether someone was a “grower or shower.” that Asian men have small penises, and that someone should “check under the hood,” 23, EEE Physician Assistant, said that you ‘would joke about looking at black male genitalia after the patient was asleep.”Louis Kwong, MD. Employect Page 10 of 18 DOH: 12/26/2007 24. Tram Vu, Physician's Assistant, heard you comment on “an African-American patient's genitalia out of surgery.” Specifically, she heard you discuss “how large it was to residents in clinic.” Incident 2 25.On more than one occasion, you made inappropriate comments of a sexual nature during surgery and/or in the presence of others, including Dr. [land vs ll as follows: * You commented on female patients’ bodies including whether patients had groomed their genitalia + When explaining how to conduct a posterior total hip replacement which requires going into the muscle, you commented that it was like finding the “g-spot.” * Heard you make a sexual innuendo during the surgery about “hammering a patient,” and about female patients’ fat roll above their abdomen. Incident 3 26.You made inappropriate comments that Dr. iE was sexually obsessed with you alluding that she had a crush on you. This comment was heard by others at work including Dr. i! Vs. INEM and Ms. Incident 4 27. You regularly made inappropriate comments of a sexual nature to staff, These comments were frequently heard by the staff at Harbor-UCLA. The statements are as follows: © Dr. RB heard you make sexual innuendoes and references to patients’ enitalia at various times. . ‘Administrative Manger |, heard you make sexual innuendoes in Spanish © [RR Physician Assistant, heard you tell a resident clinic that you were into auto-erotic asphyxiation. Incident 5 28. You frequently made inappropriate comments about women’s appearance. * You commented to Di about her hair and appearance. These comments were heard by Dr.Louis Kwong, MD Employees Page 11 of 18 DOH: 12/26/2007 * You discussed your prior sexual encounters with women, including their physical appearance, with Dr «Ms. [stated that you told her that you could recognize her by her “beautiful” eyes. * You commented to Ms. about her appearance at a Christmas party, and that she looked “sexy” in the dress she was wearing ‘= Your foregoing comments made others at work fee! uncomfortable. Incident 6 29.You discussed your preference of sexual_positions with Dr. Your conversations were overhead by Dr. Ms. SE Ms. Ms. ME oc vc Incident 7 30.Dr. [EEE stated he recalled you making jokes of a sexual nature at one of the annual end of the year roasts. Incident 8 31. During your “Sex and Joints Lecture” you discussed which position caused a penile fracture. You asked the attendees which sexual position can cause a penile fracture. Dr. BBM stated penile fracture is not an orthopedic issue, and not relevant in an orthopedic lecture. Incident 9 32. You compared the qualification of two (2) residency candidates by identifying their race. During candidate interviews in 2021, Dr,| Jand Dr. st 2t<0 that you referenced two (2) African-American candidates, and referenced them as “brother versus brother.” It was not uncommon for you to compare the qualifications of candidates, however, during this incident you referred to the candidates’ race. Dr [EEE stated that comparison of candidates had been previously done, but the comparison was done on the colleges they attended. Incident 10 33. During the end of the year roasts (annual meetings held at the end of the year), you failed to report incidents that were potential CPOE violations:Louis Kwong, MD. Employee# Page 12 of 18 DOH: 12/26/2007 © Dr. tated that Dr. [had a “micro penis,” and made statements about Dr. sexuality + Or. stated that you failed to report when male genitalia was ‘shown at a roast or when it was commented that certain female residents “like it ‘on top.” You did not file a CPOE complaint. Incident 11 34. Dr. [informed you that he was romantically involved with a patient. You did not file a CPOE complaint nor take any other administrative actions once you became aware of this inappropriate relationship with a patient. Incident 12 35.Dr. [EEE shared with you a Facebook post from Dr. [EEE about her visiting a strip club. In her post she stated that she visited a strip club with other interns. Also present were senior residents who observed the interns getting lap dances from the dancers. You acknowledged that you were aware of these visits. You did not file a CPOE complaint. Incident 13 36. Dr. I made you aware of comments made by Harbor-UCLA staff of gang raping her. You did not file a CPOE complaint Incident 14 37. During a residency match meeting, a picture of an African-American candidate was held up for all to see. A resident stated that candidate “looked like he raped cheerleaders.” The statement was made in your presence. Dr. IEE and Dr. HB acknowledge that you did not make the comment. You did not file a CPOE ‘complaint. Incident 15 38. Or. EE O. BI and Ms. Bi claimed that residents referred to African- American patients as “BAP” (Black Angry Patients) and that you were aware of these statements, as they were made in your presence. You did not file a CPOE complaint.Louis Kwong, MD Employeett| Page 13 of 18 DOH: 12/26/2007 Incident 16 39. You were made aware of a text message from Dr. Eto Dr. using the word “nigger.” You acknowledged that you were aware of the message. You failed to file a CPOE complaint Bringing a weapon to work (Collectively, Exhibits M and N) 40.You regularly brought your utility knife to work and discussed having it in your possession with others and/or in front of others as follows: ¢ ERB witnessed you carrying and using a 3-inch knife for food on more than one occasion. © Dr. [Eiifalso saw you keeping your knife in your boot during one or more faculty meetings. ° Ms. Ms. [I and Ms. IIB said that they witnessed you independently and on separate occasions showing off your knife and carrying it in your boot pocket while at work. Ms. witnessed you remove a small knife from your boot to cut fruit and cut a letter open. Mr. Jwitnessed you carrying a knife in the pouch of your fanny pack Ms. lg witnessed you carrying a knife in your belt while in the clinic. Dr essed you carrying a knife in a sheath at the office. Ms. Miiliheard you say that you were carrying a multipurpose knife and that the “thing at the end of it” could crack a window. Your regular possession and discussion of the knife you brought to work made others feel uncomfortable at work. Notably, Ms. [stated the knife you carried was not just a boy scout's pocketknife because it could be used to kill someone Bringing a 1n to the operating room (Collectively, Exhibits M and N) 41. You brought a knife into the operating room on at least one occasion. Mr. Iii witnessed you carrying your knife while in the locker room which is directly adjacent to the operating room and offered you to use it to cut something off his scrubs. ADMINISTRATIVE INTERVIEW On November 27, 2023, i and SNIININE from the Department's Audit & Compliance Division, interviewed you regarding the foregoing fraud allegations. (Exhibit Q)Louis Kwong, MD. Employee IE Page 14 of 18 DOH: 12/26/2007 Also, present was your attorney, Michelle Finkel Ferber, Ferber Law, a Professional Corporation. You made the following statements: * You have done consulting work for Zimmer Biomet for approximately thirty (30) years. (Exhibit @, Page 22, Lines 17-19; Page 23, Lines 7-9) * The consulting work included teaching, designing, and implanting. (Exhibit Q, Page 22, Lines 17-19) * For approximately, ten (10) or fifteen (15) years, you have conducted research work. (Exhibit Q, Page 23, Lines 7-9) + You admitted that you have received compensation from Zimmer Biomet. (Exhibit Q, Page 23, Line 2-4) * You prefer Zimmer Biomet devices over other County approved devices. (Exhibit Q, Page 24, Lines 10-12) * You admitted flying twice with residents on private airplanes to Zimmer Biomet's office in Indiana. (Exhibit Q, Page 26, Lines 10-20) «The decision to make these flights was your own as Department Chair (Exhibit Q Page 27, Lines 21-25; Page 28, Line 1) * You admitted that you did not disclose your employment with Zimmer Biomet, and stated you were not aware it was something that you had to do. (Exhibit Q, Page 28, Lines 15-23) * You stated that you have done many years of research for the Lundquist Institute, and extensive records exist of said research. (Exhibit Q, Page 29, Lines 2-15) + However, you stated you have not received any salary or compensation. (Exhibit Q, Page 32, Lines 1-4) * You admitted that the Harbor Orthopedic Research and Education Fund is not County affiliated. (Exhibit Q, Page 35, Lines 6-13) * You started the fund approximately ten (10) years ago and have access to the funds. (Exhibit Q, Page 27, Line 25; Page 38, Lines 1-2; Lines 22-23)Louis Kwong, MD Employeett| Page 15 of 18 DOH: 12/26/2007 * You admitted that you solicited donations from employees and that they are not mandatory but strongly recommended. (Exhibit Q, Page 40, Lines 24-25) * The recommended donation amount is $1,000, once a year. (Exhibit Q, Page 41, Lines 2-9) * You make the request for donations at faculty meetings. (Exhibit @, Page 41, Lines 15-16) * You stated that you never inappropriately used the funds. (Exhibit Q, Page 43, Lines 16-18) IMPACT Harbor-UCLA, the County, and DHS remain dedicated to upholding the highest standards of patient care, trust, and responsibility. You demonstrated serious lapses in judgment when you repeatedly and knowingly violated several County and Department policies. For starters, your blatant failure to disclose outside employment with Zimmer Biomet and Lundquist, despite knowing the Department's associated policy, are clear and intentional violations. Zimmer Biomet and Lundquist not only compensated you for your work but provided you with financial incentives for business referrals, which created a clear conflict of interest since the Department had contracts with them. Your outside employment intersected with your primary responsibilities as Chief Physician | at Harbor-UCLA in a manner that compromised your impartiality, objectivity, and your ability to perform your essential duties honestly and ethically at the Department. Your decision to hide your employment with these companies for 6 years demonstrates your propensity for dishonesty. As a doctor, you are expected to act with integrity and transparency, your repeated failure to disclose outside employment is contrary to this professional ‘expectation and has eroded the Department's trust in your ability to be honest. Next, you created an exclusive club at work and used your position to solicit donations from residents under your charge. You then opened a non-County bank account for the club you created, without authorization from your management. You did this on County time in a County facility. Your actions demonstrated a misuse of authority, created a negative and elitist work environment, undermined morale and teamwork, and violated County and Department policies. As a doctor, you are expected to lead by example, your actions of creating an unauthorized club, soliciting funds from residents who reported to you, and opening an unauthorized, non-business-related bank account for County employees is contrary to the expectations of a leader. Equally conceming are your repeated violations of the County Policy of Equity. As aLouis Kwong, MD Employee Page 16 of 18 DOH: 12/26/2007 high-ranking doctor at Harbor-UCLA, you are held to a high standard and are expected to be professional at work and always exhibit proper decorum. You failed to meet these expectations on many occasions as described herein. All workforce members have the right to work in an environment free from inappropriate and harassing conduct. Your inappropriate, disparaging comments and actions were offensive, and created an uncomfortable, hostile, and demoralizing work environment for others. You used your position and authority as a leader in the Department to engage in behavior that is threatening in nature to staff. Not only are you a leader, but you are also a mentor and a teacher. However, your behavior and actions are contrary to the true intention of these roles, As a leader, you are responsible for creating an environment that is welcoming, educational and engaging for staff. Instead, your actions undermine trust and respect within the workplace which directly impacts teamwork and collaboration. Further, the County has a responsibility to protect the well-being of all work force members. You, as a manager, are responsible for protecting the rights of others at work and are a mandated reporter. You failed to fulfil the duty of a mandated reporter when you did not report several potential equity issues that were reported to you directly or that you became aware of. Next, by your own admission you regularly brought a knife to work. You openly displayed carrying the knife and discussed having it in your possession with others. Bringing a knife to work, specifically into a healthcare setting creates an environment of fear, intimidation, and insecurity among staff and jeopardizes the safety and well-being others including the patients we serve and is a violation of established safety protocols. More concerning is you bringing your knife into the operating room. The presence of a weapon in the operating room introduced unnecessary risks and distractions that could have compromised patient safety and the quality of medical care. Your conduct undermines the sanctity of the healthcare environment, is reckless, and dangerous. Dr. Kwong, overall, your inappropriate actions reflect negatively on the Departmen'ts values, ethics, and professionalism. Harbor-UCLA is unwavering in its commitment to the health and safety of its patients and staff. It deeply values the trust that the public, it patients, and their families place in the institution. Safeguarding patient care is Harbor- UCLA's highest priority. As a County and Department employee, you are entrusted with the responsibility of upholding the public interest and serving the needs of the community with integrity and accountability. Your actions, notably, your abuse of power, ethical lapses, instances of impropriety, and inappropriate and unsafe behavior have negatively impacted others at work and tamished the Department's reputation. Your actions have eroded the Department's confidence and trust in your ability to fulfill your professional responsibilities of Chief Physician I at Harbor-UCLA competently, safely, and with ethical integrity. More importantly your actions are not aligned with the County's core philosophy of “enriching lives through caring and effective service.”Louis Kwong, MD Employee# Page 17 of 18 DOH: 12/26/2007 WORK HISTORY AND PERTINENT BACKGROUND In deciding to take this proposed action against you, management reviewed and gave consideration to your entire work record as described below. 42. You entered County service on December 26, 2007, and you currently hold the position of Chief Physician | 43. In 2015, you were appointed to Chair of the Orthopedic Department and Program Director of the Orthopedic Residency Program. 44. Your current job duties and responsibilities are listed in your Class Specification (Exhibit R) Some of your duties include: * Direct or assist in directing the training of interns, resident physicians, and medical and technical students in the work of the division. 45. Your performance for your three (3) most recent Physician Performance Expectation reviews are as follows: * April 1, 2018, through March 1, 2019: Overall “Exceeded Expectations” (Exhibit S) + April 1, 2019, through March 31, 2020: Overall “Far Exceeded Expectations” (Exhibit T) * April 1, 2020, through March 31, 2021: Overall “Far Exceeded Expectations’ (Exhibit U) INCLUSION DHS is discharging you from your permanent position of Chief Physician I, based on your failure to comply with the DHS policies. This Notice of Discharge is an official disciplinary action and will become part of your Official Personnel File. EMPLOYEE RIGHTS As provided by the Civil Service Rules, you have the right to appeal this action and request a hearing before the Los Angeles County Civil Service Commission within fifteen (15) business days from the date the letter was mailed or hand-delivered to youLouis Kwong, MD. Employee IEE Page 18 of 18 DOH: 12/26/2007 ‘Your request for a hearing must be in writing, signed by you or your representative, and state the ruling or action you are appealing. In your letter, you must provide your mailing address and describe in plain language, and in detail, sufficient specific facts and reasons upon which you base your appeal Your written response and request for a hearing must be sent to the Los Angeles Gounty Service Commission, 522 Kenneth Hahn Hall of Administration, 222 North Los Angeles, CA 90012. A copy of your appeal should also be sent to DHS Performance Management at © DHSPMU- unty.gov. Respectfully, Griselda Gutierrez, Chief Physician Ill Harbor-UCLA Medical Center Department of Health Services CM:ZB:nvb BRjo Enclosures Nina Park, Chief Deputy Director, HS, Operations Karyl Smith, On-Site Human Resources Administrator Official Personnel File Exhibit(s): A1-B4 At. Notice of intent to Discharge letter dated January 31, 2024 B1. Response to Notice of Intent to Discharge dated February 16, 2024