Trauma centers warn lives could be at risk

Orlando Sentinal ^ | 2/28/03 | Greg Groeller and Jerry W. Jackson

[friendly]

Trauma centers across Central and North Florida warned Thursday that they may be unable to take up the slack when Orlando Regional Medical Center, barring a "miracle," shuts its Level 1 trauma unit April 1.

Hospital officials and emergency-services personnel said they expect the shutdown will cost some people their lives.

Orlando Regional became the first hospital in Florida history to seek the closing of its Level 1 trauma center. It blamed Florida's skyrocketing malpractice-insurance premiums, saying they have made it too hard to recruit needed trauma specialists.

[friendly]

I track the effects of the corrupt legal industry carefully nationwide. Hospital trauma centers and ERs are being forced out of business this week on an essentially daily basis at this point. The time is long past due for massive tort reform.

[Dick Vomer]

Hopefully a couple of lawyers kids will need surgery and when they get the chaplain, waiting room and stale coffee with the little talk.... "Well, we had to transport to the level 1 cause none of our neurosurgeons would risk the liability of caring for your kid. Sorry he/she died in route but it was all we could do or HAD to do ...... legally." If you think this is BS, it's already happened to a friend of mine's son.

The bad news is that people are gonna die.... the good news is that at least some of them will be lawyers.

[visagoth]

The time is long past due for massive tort reform.

You got that right. I have quite a few friends in the field of trauma medicine. Each has a story about being sued for malpractice, and each has had their insurance company settle out of court because they fear how much more it would cost to go to a jury trial.

The worst of these suits is when a trauma victim arrives at the emergency department essentially dead from injuries, latter dies and the family then sues the attending physician for malpractice for 'not doing enough' to save the patients life.

A classic quote one of the lawyers gave defending this physician in the case: "There is only one God, and the doctor is not he."

[friendly]

Unlike lawyers, medical professionals have ethics. That is the whole problem with the legal industry. It is de facto unregulated, unlike any other business.

And the liability insurance scam is nauseating: It is merely a lawyer tax, with 70% of the premium payouts going to the defenses and plaintiff lawyers.

[friendly]

Good points. And a new "legal theory" (lawyer lie allowed by corrupt judges) is to sue docs for doing TOO MUCH to save a person.

[RWG]

First part of that would be to send all the illegals home. That would probably fix most of the problem. How do illegals get heart lung transplants and surgeries to seperate twins? Who pays for those costs? Before you deny taxpayers the right to hold incompetence responsible, get rid of the illegal burden and then we'll sit down and talk about reform.

[Trust but Verify]

WE had the unfortunate experience of our 14 year-old son neing struck by a car while on his bicycle. We got a phone call telling us to meet him at the only Level 1 trauma center in our region, which happens to be on the other side of the county we live in.

We were sure that the reason they were bringing him there instead of a nearer hospital was because his injuries were grave.

When we arrived at the hospital, we saw our name scrawled on a piece of paper at the reception desk. A social worker wa standing by to accompany us to a private waiting room where we would be kept isolated and minded. This scared the daylights out of us. When they finally had a doctor come and give us some information, it was that Kyle had fractured his jaw and his collarbone and had been badly burned on his arm and leg by the exhaust from the car as it rested atop him. (some wonderful passersby lifted the car off of him and pulled him out. We never did find out who they were.) Serious injuries, but nothing that would require a trip to the trauma center and certainly not the scare they gave us thinking the worst.

At the end of the day, I think a lot of people are needlessly taken to trauma centers. If you've seen the shows on TV, there are always a couple who didn't need to be there to start with. Maybe that's why these places are being over-run.

[demkicker]

I expect the outcry will be louder than usual on this particular hospital. Afterall, it's in Florida and will be the fault of the Bush brothers. < /sarcasm>

[FreeperinRATcage]

Yup, you're probably right..a lot of people end up at trauma centers, then their injuries are determined to be not worth it.

Why? Well, its simple...Paramedics and EMTs do not have x-ray machines. They do not have CAT scans or MRI's either. They do have the knowledge that, based on how an injury occured, a person may have a good chance of having a critical injury that just isn't obvious.

Would you take the chance?

[Trust but Verify]

No, I would not want to take the chance, but in my son's case, he was alert and was even able to give his vital information, name, address, DOB, telephone and his SS#! That tells me the boy did not have a serious head injury.

[FreeperinRATcage]

Well..I wasn't there, but I do have some knowledge in this area. I've been a Paramedic for 20 years, the last 15 in a major city.

Your son was probably transported there due to "mechanism of injury", otherwise known as "kinematics". Basically, this says that a patient who has had sufficient force applied to their body to potentially cause serious injury must be taken to a trauma center. It does result in a lot of transports that eventually don't need the services of a trauma center, but it also can reveal the presence of hidden injuries that can kill you if you are not in a place where appropriate surgery can be performed immediately.

The theory is currently in dispute in some areas of the country, precisely because of the reasons you mentioned. What it comes down to is a cost/benefit analysis...what is the cost of having many unecessary patients taken to a trauma center as opposed to the liability of not taking someone who needs it because the injury is not obvious?

By the way..I'm very glad your son ended up not needing trauma services...it means he's OK :).

[chiya]

my husband was also alert, able to give all vital information, after being flown to our nearest trauma center, after the mri's he was then flown to a larger trauma center 4 hours away, because he had a severe spinal cord injury. Out in the field you just cannot diagnose some things, and his life was too precious to take the chance,

[Teacher317]

Indiana and many other states have statutory limits in place to prevent this kind of thing.

IN Code 34-18-14-3 limits medical malpractice damages to $1.25M.
IN Code 34-18-18-1 limits lawyer's fees to 15% of any recovery from the patients compensation fund.
I can't find the Code numbers, but I know that pain-and-suffering and other non-economic damages are limited to $50,000 or 3 times the actual economic costs (whichever is greater), and that 75% of these awards go to a state victim's fund, and not to the plaintiff (discouraging the public from looking for the big payday).

Let's hope these ideas get spread around the country.

[Mamzelle]

The ERs *must* shut down. Nothing less will bring us back to reality. Who knows, that probably won't work, either.

[Trust but Verify]

Yes, he was OK. We are forver grateful for that. Other than a surgical scar under his chin and the scars from the burns on his leg, you'd never know. He refuses to talk about it, though.

[Mamzelle]

re: Serious injuries, but nothing that would require a trip to the trauma center and certainly not the scare they gave us thinking the worst.)))

You're wrong. Vital blood vessels could have been injured by broken bones or internal injuries, and they don't know that until investigated. Then, it's *mighty* nice to have that vascular surgeon waiting uptstairs to keep him from bleeding to death. That's what the higher levels are all about--those surgeons waiting...it's great they were not necessary. What if they had been.

[Teacher317]

Since the list is getting longer, we should start keeping track.

In November, a significant percentage of Oregon's doctor's were planning on moving or quitting the business if the single-payer system was voted in. (It didn't, by about a 80-20 margin)
NJ, FL, PA, and IL have all had doctors go on either symbolic or real strikes since then.
Now FL trauma centers are closing down.

Add to this the developing nurse shortage (less qualified people are going in, since they are being found financially liable more often and can't afford the same attorneys as the doctors, nor can they afford to lose the cases), Congress has decided that the insurers are better at deciding who our doctors should be than we are (HMO's), and the Congressional stupidity of the "take one, take all" Medicare system (which forces many doctors to go to either exclusively poor or exclusively wealthy patients).

Am I missing anything? The FDA's poor management of promising new drugs? The beatings that the drug manufacturers take from the law lobby and liberals?

[Mamzelle]

What an oasis of good sense in a sea of chaos! Your state must attract a lot of good physicians, giving patients a lot to choose from when selecting. Because the insurance companies know they work in some conditions of reasonable expectations, they can issue policies and compete and keep costs down, and those costs are paid by patients as well.

[Mamzelle]

Dying in transit...that's then a COBRA problem. You can then sue (and there are criminal penalties as well) for transporting while unstable, even if the patient's only hope was in being moved from one hospital to another. However, if that hospital shuts down its ER entirely, and offers no ER/ET services whatsoever, it will not be in violation of COBRA.

[friendly]

Illegal aliens are bankrupting the hospital system, and ESPECIALLY the collapsing-while-we-speak ER/trauma care.

Your personal medical care when you need it most (car accidents, MI, etc) has been destroyed by corrupt immigration lawyers, democrats, and bureaucrats.