Coroner releases new report on Natalie Wood death

LOS ANGELES (AP) — Some of the bruises found on Natalie Wood's body may have occurred before the actress drowned in the waters off Southern California more than 30 years ago, according to a newly released coroner's report on one of Hollywood's most mysterious deaths.

The case took another twist Monday when officials released a 10-page addendum to Wood's 1981 autopsy that cites unexplained bruises and scratches on Wood's face and arms as significant factors that led to officials changing her death certificate last year from a drowning to "drowning and other undetermined factors."

Officials were careful about their conclusions because they lacked several pieces of evidence for their review.

Bruises on Wood's arms, a scratch on her neck and superficial abrasions to the actress' face may have occurred before Wood ended up in the waters off Catalina Island in November 1981, but coroner's officials wrote they could not definitely determine when the injuries occurred.

The findings have not altered a sheriff's department investigation into Wood's death, which a spokesman described as ongoing.

Wood, 43, was on a yacht with her actor-husband Robert Wagner, co-star Christopher Walken and the boat captain on Thanksgiving weekend in 1981 before somehow ending up in the water. A dinghy that had been attached to the boat was found along the island's shoreline, but investigators could not locate it to review it last year.

Investigators initially reported that it had no scratches on its hull, and Wood's fingernails were not preserved for analysis.

Several of the original coroner's investigators who worked on the case were re-interviewed, and officials attempted to test some items taken during the investigation into Wood's death and an autopsy, but they could not be located.

"The location of the bruises, the multiplicity of the bruises, lack of head trauma, or facial bruising support bruising having occurred prior to entry in the water," the report states. "Since there are unanswered questions and limited additional evidence available for evaluation, it is opined by this Medical Examiner that the manner of death should be left as undetermined," Chief Medical Examiner Dr. Lakshmanan Sathyavagiswaran wrote in the report completed in June.

Officials also considered that Wood wasn't wearing a life jacket and had no history of suicide attempts and didn't leave a note as reasons to amend its report and the death certificate.

The report was released Monday after sheriff's officials released a security hold.

Sheriff's spokesman Steve Whitmore said the agency has known about the findings in the newly released autopsy report for several months and it does not change the status of the investigation, which remains open. He said Wagner is not considered a suspect in Wood's death.

Wood, famed for roles in such films as "West Side Story" and "Rebel Without a Cause," was nominated for three Academy Awards during her lifetime. Her death stunned the world and has remained one of Hollywood's most enduring mysteries. The original detective on the case, Wagner and Walken have all said they considered her death an accident.

Conflicting versions of what happened on the yacht have contributed to the mystery of how the actress died. Wood, Wagner and Walken had all been drinking heavily in the hours before the actress disappeared.

The newly released report states there are conflicting statements about when the boat's occupants discovered Wood was missing. The report estimates her time of death was around midnight, and she was reported missing at 1:30 a.m.

The renewed inquiry came after the boat's captain, Dennis Davern, told "48 Hours Mystery" and the "Today" show that he heard Wagner and Wood arguing the night of her disappearance and believed Wagner was to blame for her death.

Wagner wrote in a 2008 memoir that he and Walken argued that night. He wrote that Walken went to bed and he stayed up for a while, but when he went to bed, he noticed that his wife and a dinghy attached to the yacht were missing.

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Anthony McCartney can be reached at http://twitter.com/mccartneyAP

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Really?: The Claim: Hand Sanitizer Stops Norovirus Spread

Really?

Anahad O’Connor tackles health myths.

THE FACTS

As public health officials struggle to contain a series of viral outbreaks this winter, many people are reaching for bottles of hand sanitizer.

Studies show that alcohol-based sanitizers, particularly those with 60 percent ethanol or more, can reduce microbial counts on contaminated hands and reduce the spread of some strains of the flu. But against norovirus, the severe gastrointestinal illness gripping many parts of the country, they may be useless.

Some viruses, like influenza, are coated in lipids, “envelopes” that alcohol can rupture. But non-enveloped viruses, like norovirus, are generally not affected.

Bleach is effective against norovirus, and can be used to decontaminate countertops and surfaces. And for people, the best strategy may be washing hands with plain old soap and water.

In 2011, the Centers for Disease Control and Prevention studied 91 long-term care facilities. During the winter of 2006-07, they identified 73 outbreaks, 29 of which were confirmed to be norovirus.

The facilities where staff members used alcohol-based sanitizers, were six times more likely to have an outbreak of norovirus than the facilities where the staff preferred using soap and water.

The C.D.C. says that as a means of preventing norovirus infection, alcohol-based sanitizers can be used “in addition” to hand washing, never as a substitute.

THE BOTTOM LINE

Hand sanitizers can reduce the spread of some viruses, like the flu. But against norovirus they are largely ineffective; better to use soap and water.

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Ex-subprime bond trader accused of fraud faces extradition to U.S.

As the mortgage market collapsed in 2007, bond trader Kareem Serageldin had a tricky job – placing a value on more than $3 billion in toxic mortgage securities decaying on the books of Credit Suisse, the giant Swiss bank.

On Monday, a British court approved Serageldin’s extradition to New York to face criminal charges that he inflated the bonds’ value by $540 million to impress his bosses, angling for millions of dollars in year-end bonuses and a shot at a big promotion.

Serageldin, a U.S. citizen living in London, had been granted $7.3 million in compensation for 2007 before Credit Suisse learned of the alleged scheme and withheld $5.2 million of the pay.

In a rare criminal prosecution of Wall Street stemming from the financial crisis, the former global head of structured credit for Credit Suisse was indicted last February on conspiracy and fraud charges. Two underlings pleaded guilty and have been cooperating with federal prosecutors and securities regulators.

Announcing the indictment, U.S. Atty. Preet Bharara in Manhattan characterized the case as “greed run amok, piggybacking on one of the worst economic dislocations our nation has ever experienced.”  

Quiz: How much do you know about mortgages?

A Securities and Exchange Commission complaint said Serageldin and his colleagues knew by the end of 2007 that the bond holdings were “grossly overvalued.” The bond traders were recorded discussing how “housing was going down the tubes,” the suit alleged, yet they didn't mark down the subprime mortgage bonds to reflect that reality.

A few days after Credit Suisse reported fourth-quarter earnings, senior managers detected abnormally high prices on some of the bonds. After investigation, the bank wrote down the value of various mortgage securities by $2.7 billion, including $540 million for the holdings Serageldin oversaw.

Serageldin, 39, appeared at Westminster Magistrates Court on Monday, where his extradition was ordered and the case sent to U.K. Home Secretary Theresa May for approval. Reports from London said May would approve the extradition.

Sean Casey, a New York attorney representing Serageldin, declined to comment.

ALSO:

New York sues Credit Suisse over mortgage-backed securities

JPMorgan Chase, Credit Suisse to pay $417 million in settlements

Surprising numbers of young homeowners have no mortgage debt

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Egyptian court orders new trial for Mubarak

CAIRO—

An Egyptian court granted an appeal by former President Hosni Mubarak and ordered a new trial into the killings of hundreds of protesters during the 2011 uprising, a move certain to inflame the political unrest that has upset the country’s democratic transition.

The ruling was a victory for the ailing Mubarak and his Interior minister, Habib Adli, who also won his appeal. Both men, who had been sentenced to life in prison, face other criminal charges and are likely to remain in detention until a new trial in the deaths by security forces of more than 800 protesters.

“The previous ruling was unfair and illegal,” said Yousry Abdelrazeg, one of Mubarak’s lawyers, who accused the judge in the first trial of political bias. “The case was just a mess and there was no evidence against Mubarak.”

No date has been set for the new trial.

The court’s decision comes amid turmoil over an Islamist-backed constitution and outrage over the expanded powers of Islamist President Mohamed Morsi. It means a bloody chapter in Egypt’s 2011 revolt will be revisited with the prospect that Mubarak, whose police state ruled for 30 years, may be absolved in a case that deepened the nation’s political differences and impassioned the Arab world.

Mubarak was convicted in June of not preventing the deaths of hundreds of protesters attacked by police and snipers during the uprising, which began on Jan. 25, 2011, and ended 18 days later when he stepped aside and the military seized power.

Mubarak argued that he had not ordered the crackdown and was unaware of the extent of the violence. A recently completed government-ordered investigation into the killings, however, reportedly found that Mubarak had monitored the deadly response by security forces in Tahrir Square via a live television feed.

The appeals court ruling came a day after prosecutors announced an investigation into allegations that Mubarak, 84, received about $1 million in illicit gifts from Al Ahram, the country’s leading state-owned newspaper. The former president has reportedly been in a military hospital since December after he fell in a prison bathroom and injured himself.

Last year’s trial riveted the nation with images of the aging Mubarak wheeled into the defendant’s cage on a stretcher, his arms crossed and his eyes hidden behind sunglasses.

jeffrey.fleishman@latimes.com  

(Special correspondent Reem Abdellatif contributed to this report)

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Oscar snubs leave Globes with also-ran nominees

BEVERLY HILLS, Calif. (AP) — Hollywood's junior prom for film honors features quite a different cast than the senior prom at next month's Academy Awards.

Sunday night's Golden Globes are in a rare place this season, coming after the Oscar nominations, which were announced earlier than usual and threw out some shockers that have left the Globes show a little less relevant.

Key Globe contenders lined up largely as expected, with Steven Spielberg's Civil War saga "Lincoln" leading with seven nominations and two CIA thrillers — Kathryn Bigelow's "Zero Dark Thirty" and Ben Affleck's "Argo" — also doing well.

All three films earned Globe nominations for best drama and director. Yet while "Lincoln," ''Argo" and "Zero Dark Thirty" grabbed best-picture slots at Thursday's Oscar nominations, Bigelow and Affleck were snubbed for directing honors after a season that had seen them in the running for almost every other major award.

The Globe and Oscar directing fields typically match up closely. This time, though, only Spielberg and "Life of Pi" director Ang Lee have nominations for both. Along with Spielberg, Lee, Bigelow and Affleck, Quentin Tarantino is nominated for directing at the Globes. At the Oscars, it's Spielberg, Lee, "Silver Linings Playbook" director David O. Russell and two surprise picks: veteran Austrian filmmaker Michael Haneke for "Amour" and first-time director Benh Zeitlin for "Beasts of the Southern Wild."

That forces some top-name filmmakers to put on brave faces for the Globes. And while a Globe might be a nice consolation prize, it could be a little awkward if Affleck, Bigelow or Tarantino won Sunday and had to make a cheery acceptance speech knowing they don't have seats at the grown-ups table for the Feb. 24 Oscars.

That could happen. While "Lincoln" has the most nominations, it's a purely American story that may not have as much appeal to Globe voters — about 90 reporters belonging to the Hollywood Foreign Press Association who cover entertainment for overseas outlets.

The Bigelow and Affleck films center on Americans, too, but they are international tales — "Zero Dark Thirty" chronicling the manhunt for Osama bin Laden and "Argo" recounting the rescue of six U.S. embassy workers trapped in Iran amid the 1979 hostage crisis.

Globe voters might want to make right on a snub to Bigelow three years ago, when they gave their best-drama and directing prize to ex-husband James Cameron's sci-fi blockbuster "Avatar" over her Iraq war tale "The Hurt Locker."

Bigelow made history a month later, becoming the first woman to win the directing Oscar for "The Hurt Locker," which also won best picture.

Globe voters like to be trend-setters, but they missed the boat on that one. Might they feel enough chagrin to hand Bigelow the directing trophy this time?

Spielberg already has won two best-director Globes, so that might be a further inducement for the foreign-press members to favor someone else this time.

Their votes were locked in before the Oscar nominations came out. Globe balloting closed Wednesday, the day before the Academy of Motion Picture Arts and Sciences announced its awards lineup.

The Globes feature two best-picture categories — one for drama and one for musical or comedy. Most of the Globe contenders also earned Oscar best-picture nominations, including all of the drama picks: "Argo," ''Lincoln," ''Life of Pi," ''Django Unchained" and "Zero Dark Thirty."

Yet only two of the Globe musical or comedy nominees — "Les Miserables" and "Silver Linings Playbook" — are in the running at the Oscars. That's not unusual, though, since Oscar voters tend to overlook comedy. The other Globe nominees for musical or comedy are "The Best Exotic Marigold Hotel," ''Moonrise Kingdom" and "Salmon Fishing in the Yemen."

Acting contenders include Daniel Day-Lewis, Sally Field and Tommy Lee Jones for "Lincoln"; Hugh Jackman and Anne Hathaway for "Les Miserables"; Joaquin Phoenix, Amy Adams and Philip Seymour Hoffman for "The Master"; Bradley Cooper and Jennifer Lawrence for "Silver Linings Playbook"; Leonardo DiCaprio and Christoph Waltz for "Django Unchained"; Alan Arkin for "Argo"; and Jessica Chastain for "Zero Dark Thirty."

Globe acting recipients usually are a good sneak peek for who will win at the Oscars. All four of last season's Oscar winners — Meryl Streep for "The Iron Lady," Jean Dujardin for "The Artist," Octavia Spencer for "The Help" and Christopher Plummer for "Beginners" — took home a Globe first.

Jodie Foster will receive the Globes' Cecil B. DeMille Award for lifetime achievement at the 70th Globes ceremony, airing live from 8-11 p.m. EST on NBC.

There will be a friendly rivalry between the hosts of the Globe ceremony, Tina Fey and Amy Poehler. The co-stars of the 2008 big-screen comedy "Baby Mama" both are nominated for best actress in a TV comedy or musical series, Fey for "30 Rock" and Poehler for "Parks and Recreation."

The Globes present 14 film awards and 11 television prizes.

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City Room: Cuomo Declares Public Health Emergency Over Flu Outbreak

With the nation in the grip of a severe influenza outbreak that has seen deaths reach epidemic levels, New York State declared a public health emergency on Saturday, making access to vaccines more easily available.

There have been nearly 20,000 cases of flu reported across the state so far this season, officials said. Last season, 4,400 positive laboratory tests were reported.

“We are experiencing the worst flu season since at least 2009, and influenza activity in New York State is widespread, with cases reported in all 57 counties and all five boroughs of New York City,” Gov. Andrew M. Cuomo said in a statement.

Under the order, pharmacists will be allowed to administer flu vaccinations to patients between 6 months and 18 years old, temporarily suspending a state law that prohibits pharmacists from administering immunizations to children.

While children and older people tend to be the most likely to become seriously ill from the flu, Mr. Cuomo urged all New Yorkers to get vaccinated.

On Friday, the Centers for Disease Control and Prevention in Atlanta said that deaths from the flu had reached epidemic levels, with at least 20 children having died nationwide. Officials cautioned that deaths from pneumonia and the flu typically reach epidemic levels for a week or two every year. The severity of the outbreak will be determined by how long the death toll remains high or if it climbs higher.

There was some evidence that caseloads may be peaking, federal officials said on Friday.

In New York City, public health officials announced on Thursday that flu-related illnesses had reached epidemic levels, and they joined the chorus of authorities urging people to get vaccinated.

“It’s a bad year,” the city’s health commissioner, Dr. Thomas A. Farley, told reporters on Thursday. “We’ve got lots of flu, it’s mainly type AH3N2, which tends to be a little more severe. So we’re seeing plenty of cases of flu and plenty of people sick with flu. Our message for any people who are listening to this is it’s still not too late to get your flu shot.”

There has been a spike in the number of people going to emergency rooms over the past two weeks with flulike symptoms – including fever, fatigue and coughing – Dr. Farley said.

Mayor Michael R. Bloomberg and Mr. Cuomo made a public display of getting shots this past week.

In a briefing with reporters on Friday, officials from the C.D.C. said that this year’s vaccine was effective in 62 percent of cases.

As officials have stepped up their efforts encouraging vaccinations, there have been scattered reports of shortages. But officials said plenty of the vaccine was available.

According to the C.D.C., makers of the flu vaccine produced about 135 million doses for this year. As of early this month, 128 million doses had been distributed. While that would not be enough for every American, only 37 percent of the population get a flu shot each year.

Federal health officials said they would be happy if that number rose to 50 percent, which would mean that there would be more than enough vaccine for anyone who wanted to be immunized.

Two other diseases – norovirus and whooping cough – are also widespread this winter and are contributing to the number of people getting sick.

The flu can resemble a cold, though the symptoms come on more rapidly and are more severe.

A version of this article appeared in print on 01/13/2013, on page A21 of the NewYork edition with the headline: New York Declares Health Emergency.

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How to keep up on product recalls

(AP / September 14, 2011)

By Scott J. Wilson, Los Angeles Times

January 13, 2013

Each year manufacturers announce more than 1,000 recalls of dangerous products, including toys, cars, medicine and food. But because there's no definitive way to inform consumers, many people remain unaware of these recalls and may continue to use an unsafe product. Here are some steps to take to keep yourself informed:

After buying a product, mail in the product registration card or, if it's an option, register online or by phone. Note that although some manufacturers take advantage of the registration process by asking for such things as your income, age or buying habits, you only have to give your contact information and the brand and model number of the product.

Sign up for email alerts with the Consumer Product Safety Commission at http://www.cpsc.gov/cpsclist.aspx. You can choose to receive all alerts or use the category options to be notified only for recalls of children's, household, outdoor or sports products.

For recalls related to cars, motorcycles, tires and vehicle child restraints, sign up for email notification from the National Highway Traffic Safety Administration at www-odi.nhtsa.dot.gov/subscriptions. You can select what products you want to monitor, including specific car models.

For food safety recalls, sign up for email alerts at http://www.foodsafety.gov/recalls/alerts, a website offered by the Department of Health and Human Services. The site also offers an app for smartphones and will feed recall notices to your Internet news reader.

For recalls of medical drugs and devices, go to the U.S. Food and Drug Administration website at http://www.fda.gov and select FDA Recall Email Alert. At the next page, you have several choices to be alerted to different kinds of recalls.

scott.wilson@latimes.com

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Connecticut group wants 'common sense' solutions to gun violence

A month after a gunman invaded Sandy Hook Elementary School, killing 20 children and six adults, a group of local residents are calling for efforts to make communities safer from gun violence.

A news conference is scheduled for Monday, the one-month anniversary of the shootings at the Connecticut school, a tragedy that has reignited the national debate on gun control.

A task force led by Vice President Joe Biden has been meeting this week with advocates on all sides of the thorny gun control issue and he has said he is hoping to have recommendations by next week.

Biden has offered to talk with any victims' families who would like to speak with him personally, a support group said Saturday, the Associated Press reported. 

“If you choose to wait a few weeks, or months, the offer is still there,” the group called Sandy Hook Promise wrote.

White House officials have said they are communicating with local groups and the families in Newtown, Conn.

“We remain in touch with families from Newtown and will present an opportunity for all of them to share their views before the president makes any decisions,” White House spokesman Matt Lehrich told the Associated Press.

Sandy Hook Promise is planning to “ask individuals across the country to make a promise to encourage and support common sense solutions that make their communities and our country safer from acts of violence like that which occurred at Sandy Hook Elementary School on Dec. 14,” according to the Hartford Courant. The group was formerly known as “Newtown United,” the newspaper said.

TIMELINE: U.S. mass shootings

The group was originally started to aid families of the children killed in the attack on the school by Adam Lanza, who first killed his mother at the home they shared. Adam Lanza killed himself after attacking the school.

Since the shooting, the group has broadened its focus, seeking a role in the national debate on gun violence. Founders of the group will be joined by victims' family members, survivors of the shooting, first responders and other community members, the newspaper reported.

Meanwhile, Newtown's schools superintendent is urging an indefinite police presence at the district's schools to allay fears among parents and children about gun violence, according to the Newtown News Times. Two officers are on duty at each of the district's six schools.

“I've told the police we need them,”  Supt. Janet Robinson told that newspaper this week.

The Sandy Hook Elementary School remains closed. Students and staff are using a school in neighboring Monroe.

School officials say they've received nearly 300 emails, many voicing concern about long-term security and a police presence.

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Mom carries gun into Philadelphia school, police say

EPA cites Shell Arctic drilling rigs for air emissions violations

Relatives of Erika Andiola, immigration activist detained in Arizona

michael.muskal@latimes com

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CBS welcoming actor Angus Jones back to comedy

PASADENA, Calif. (AP) — The teenage actor Angus T. Jones is expected back at "Two and a Half Men" next week, with CBS accepting his apology for calling the popular comedy "filth" and "very inappropriate."

"We move on," CBS Entertainment President Nina Tassler said on Saturday. After a break for the holidays, actors on "Two and a Half Men" are about to begin rehearsals for new episodes.

Jones, 19, plays the "half" in the popular comedy, portraying actor Jon Cryer's son.

Jones, who reportedly makes $350,000 an episode, later said he was sorry if his remarks in an interview with a religious organization showed an indifference to his colleagues or a lack of appreciation for his opportunity. He didn't publicly change his evaluation of the comedy, which is heavy on sexual jokes and innuendo.

Tassler indicated she was giving Jones some slack for his age, saying her own 24-year-old son said some things between 19 and 24 that she wished he hadn't.

"The bottom line is cooler heads prevailed," she said. "He has been a beloved member of that cast for years and years and years and he issued a public apology. At the end of the day, they want him to come back, he wants to come back."

Tassler also said CBS, show creator Chuck Lorre and the production company, Warner Bros., are all interested in seeing "Two and a Half Men" continue beyond this season. The actors are still not signed beyond this season.

She said CBS is nearing a deal to continue another one of its Monday night comedies, "How I Met Your Mother," for at least another season.

CBS is also basking in the success of its Thursday night comedy, "The Big Bang Theory," currently in its sixth season. Nielsen said the show had just under 20 million viewers last week, its biggest audience ever, breaking a record set one week earlier.

The show's reruns have become very popular on cable and in syndication, creating a sort of whiplash effect driving more interest in original episodes, Tassler said.

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‘Bodega Clinicas’ Draw Interest of Health Officials

HUNTINGTON PARK, Calif. — The “bodega clinicas” that line the bustling commercial streets of immigrant neighborhoods around Los Angeles are wedged between money order kiosks and pawnshops. These storefront offices, staffed with Spanish-speaking medical providers, treat ailments for cash: a doctor’s visit is $20 to $40; a cardiology exam is $120; and at one bustling clinic, a colonoscopy is advertised on an erasable board for $700.

County health officials describe the clinics as a parallel health care system, serving a vast number of uninsured Latino residents. Yet they say they have little understanding of who owns and operates them, how they are regulated and what quality of medical care they provide. Few of these low-rent corner clinics accept private insurance or participate in Medicaid managed care plans.

“Someone has to figure out if there’s a basic level of competence,” said Dr. Patrick Dowling, the chairman of the family medicine department at the David Geffen School of Medicine at the University of California, Los Angeles.

Not that researchers have not tried. Dr. Dowling, for one, has canvassed the clinics for years to document physician shortages as part of his research for the state. What he and others found was that the owners were reluctant to answer questions. Indeed, multiple attempts in recent weeks to interview owners and employees at a half-dozen of the clinics in Southern California proved fruitless.

What is certain, however, is that despite their name, many of these clinics are actually private doctor’s offices, not licensed clinics, which are required to report regularly to federal and state oversight bodies.

It is a distinction that deeply concerns Kimberly Wyard, the chief executive of the Northeast Valley Health Corporation, a nonprofit group that runs 13 accredited health clinics for low-income Southern Californians. “They are off the radar screen,” said Ms. Wyard of the bodega clinicas, “and it’s unclear what they’re doing.”

But with deadlines set by the federal Affordable Care Act quickly approaching, health officials in Los Angeles are vexed over whether to embrace the clinics and bring them — selectively and gingerly — into the network of tightly regulated public and nonprofit health centers that are driven more by mission than by profit to serve the uninsured.

Health officials see in the clinics an opportunity to fill persistent and profound gaps in the county’s strained safety net, including a chronic shortage of primary care physicians. By January 2014, up to two million uninsured Angelenos will need to enroll in Medicaid or buy insurance and find primary care.

And the clinics, public health officials point out, are already well established in the county’s poorest neighborhoods, where they are meeting the needs of Spanish-speaking residents. The clinics also could continue to serve a market that the Affordable Care Act does not touch: illegal immigrants who are prohibited from getting health insurance under the law.

Dr. Mark Ghaly, the deputy director of community health for the Los Angeles County Department of Health Services, said bodega clinicas — a term he seems to have coined — that agree to some scrutiny could be a good way of addressing the physician shortage in those neighborhoods.

“Where are we going to find those providers?” he said. “One logical place to consider looking is these clinics.”

Los Angeles is not the only city with a sizable Latino population where the clinics have become a part of the streetscape. Health care providers in Phoenix and Miami say there are clinics in many Latino neighborhoods.

But their presence in parts of the Los Angeles area can be striking, with dozens in certain areas. Visits to more than two dozen clinics in South Los Angeles and the San Fernando Valley found Latino women in brightly colored scrubs handing out cards and coupons that promised a range of services like pregnancy tests and endoscopies. Others advertised evening and weekend hours, and some were open around the clock.

Such all-hours access and upfront pricing are critical, Latino health experts say, to a population that often works around the clock for low wages.

Also important, officials say, is that new immigrants from Mexico and Central America are more accustomed to corner clinics, which are common in their home countries, than to the sprawling medical complexes or large community health centers found in the United States. And they can get the kind of medical treatments — including injections of hypertension drugs, intravenous vitamins and liberally dispensed antibiotics — that are frowned upon in traditional American medicine.

The waiting rooms at the clinics reflected the everyday maladies of peoples’ lives: a glassy-eyed child resting listlessly on his mother’s lap, a fit-looking young woman waiting with a bag of ice on her wrist, a pensive middle-aged man in work boots staring straight ahead.

For many ordinary complaints, the medical care at these clinics may be suitable, county health officials and medical experts say. But they say problems arise when an illness exceeds the boundaries of a physician’s skills or the patient’s ability to pay cash.

Dr. Raul Joaquin Bendana, who has been practicing general medicine in South Los Angeles for more than 20 years, said the clinics would refer patients to him when, for example, they had uncontrolled diabetes. “They refer to me because they don’t know how to handle the situation,” he said.

The clinic physicians by and large appear to have current medical licenses, a sample showed, but experts say they are unlikely to be board certified or have admitting privileges at area hospitals. That can mean that some clinics try to treat patients who face serious illness.

Olivia Cardenas, 40, a restaurant worker who lives in Woodland Hills, Calif., got a free Pap smear at a clinic that advertises “especialistas,” including in gynecology. The test came back abnormal, and the doctor told Ms. Cardenas that she had cervical cancer. “Come back in a week with $5,000 in cash, and I’ll operate on you,” Ms. Cardenas said the doctor told her. “Otherwise you could die.”

She declined to pay the $5,000. Instead, a family friend helped her apply for Medicaid, and she went to a hospital. The diagnosis, it turned out, was correct.

Health care experts say the clinics’ medical practices would come under greater scrutiny if they were brought closer into the fold.

But being connected would mean the clinics’ cash-only business model would need to change. Dr. Dowling said the lure of newly insured patients in 2014 might draw them in. “To the extent there are payments available,” he said, “the legitimate ones might step up to the plate.”

This article was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

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