PALM BEACH, Florida (9 July 2007) -- A scathing editorial and several hard-hitting articles by Palm Beach Post staff writer Phil Galewitz have put St. Mary's Medical Center on notice that the Palm Beach community will not tolerate the company's cold-blooded, cost-cutting and allegedly illegal scheme to discontinue emergency hyperbaric treatment. While St. Mary's begs poverty as its rationale for closing the chamber -- the hospital lost millions last year -- Galewitz argues that Tenet Healthcare Corporation, which now owns St. Mary's, promised to maintain emergency services as part of its agreement to buy the hospital in 2001. Palm Beach Post editorial (2007-07-08) "For a period of ten (10) years after the sale transaction closing, Purchaser shall keep both Hospitals open as acute care hospitals, maintaining the following core services at each Hospital: (a) medical/surgical services, (b) emergency services, including trauma services at St. Mary's Hospital for the period it is awarded the trauma contract from Palm Beach County, (c) pediatric services, (d) orthopedic services and (e) OB/GYN services at the St. Mary's Hospital campus." That is the service Tenet Healthcare Corp. committed to provide when it purchased St. Mary's and Good Samaritan hospitals in 2001. So - at least until 2011 - St. Mary's obviously should continue providing emergency hyperbaric services for divers with decompression sickness. The hospital stopped providing the service a week ago, saying that it treats fewer than 50 emergency hyperbaric patients a year and it is hard to staff 24 hours a day. On Thursday, that forced paramedics to fly a diver who became ill off Boca Raton to Mercy Hospital in Miami. The shutdown endangers patients whose decompression sickness can be worsened by flying and who face a limited window for treatment. St. Mary's was the only Palm Beach County hospital that offered hyperbaric services for emergencies. Scuba divers benefit from the oxygen immersion treatment, as do individuals with carbon monoxide poisoning. That St. Mary's will continue offering hyperbaric services for wound treatment but not emergencies belies the pledge of Tenet Chief Operating Officer Stephen Newman. Last month, after The Post reported a $6 million decline in profits for St. Mary's, and members of the Town of Palm Beach Medical Commission said they wanted Tenet to sell Good Sam and St. Mary's to a not-for-profit entity, Mr. Newman told Post reporter Phil Galewitz: "We are comfortable over time with the financial viability of St. Mary's and Good Samaritan. We're here for the long run." At the request of Palm Beach County Health Department Director Jean Malecki, Attorney General Bill McCollum is investigating whether the hospital's purchase agreement prevents it from ending emergency hyperbaric services. Mr. McCollum can remind Tenet of its 2001 legal settlement - and force the company to abide by it. Tenet can start acting like it's really "here for the long run" by immediately restoring emergency hyperbaric treatment. Palm Beach Post article by Phil Galewitz (2007-07-10) St. Mary's Medical Center's recent decision to drop emergency hyperbaric services follows a growing - some argue dangerous - trend. With one of Florida's biggest scuba diving events scheduled this month and the peak of hurricane season approaching, Palm Beach County and the Treasure Coast join Tampa Bay as the most populated areas of the state lacking the lifesaving procedure for divers with decompression sickness and victims of carbon monoxide poisoning. There are dozens of hyperbaric oxygen chambers available at hospitals around the state. But only six hospitals provide 24-hour emergency hyperbaric care, including just three south of Orlando, according to an informal canvassing of Florida hospitals by The Palm Beach Post. Those hospitals are Lee Memorial Health System in Fort Myers, Mercy Hospital in Miami and Mariners Hospital in Tavernier. The trend among hospitals, including Miami's Jackson Memorial and Melbourne's Wuesthoff Medical Center, has been to drop the emergency service. The reason is simple: money. Hyperbaric chambers make money helping patients, mainly diabetics, with wound healing. Emergency cases are typically money losers because hospitals must pay staff and doctors to be on call 24 hours a day, and hospital officials argue that too many emergency patients are uninsured. For the past three years, St. Mary's paid doctors to be on call for hyperbaric care. But last month, the hospital decided that handling fewer than 50 emergency cases a year - mostly divers suffering decompression sickness or "the bends" - wasn't enough to justify the expense. | | Hyperbaric chambers are used to treat scuba diving injuries on an emergency basis as well as non-diving injuries usually on an out-patient basis. That decision is under investigation by Florida Attorney General Bill McCollum because Tenet Healthcare Corp. promised to maintain emergency services as part of its agreement to buy St. Mary's and Good Samaritan medical centers in 2001. In response, St. Mary's released a statement Monday. "We sought and received clarity from the attorney general's local representative prior to taking this step," it said. Three other hospitals in Palm Beach County provide hyperbaric services: Wellington Regional Medical Center, Boca Raton Community Hospital and Bethesda Memorial Hospital in Boynton Beach. But St. Mary's was the only one handling emergencies. As a result, shutting down the service has sparked controversy. "I didn't like the decision," said Dr. Michael Chidester, one of two hyperbaric medicine physicians at St. Mary's. "Certainly the risk of significant complications goes up the longer the delay between diagnosis and treatment, and having someone go to Miami or Orlando is going to increase the risk of permanent disabilities and problems." Last week, a diver with decompression sickness had to be taken to Mercy Hospital in Miami from Boca Raton. That incident has heightened concern for local divers heading into Florida's mini-lobster season July 25-26. On Monday, Boca Raton fire-rescue officials visited Mercy to assess its capabilities and work on coordinating transfers. Marc Kaiser, director of Mercy's hyperbaric center, said the hospital treats about 50 to 60 emergency patients annually in the hyperbaric chamber and can handle more. He said the number of divers needing emergency care has dropped in recent years because of better equipment and better diver education. But as the state moves closer to the height of the hurricane season, more attention is being paid to the potential for carbon monoxide poisoning from homeowners' improper use of generators. After Hurricane Charley in 2004, Lee Memorial's hyperbaric chamber in Fort Myers treated 27 carbon monoxide poisoning cases in 48 hours. Carbon monoxide gas kills more Americans - about 1,500 a year - than any other poison. As with decompression sickness, the longer treatment is delayed, the greater the risk to the patient. The Healthcare Emergency Response Coalition of Palm Beach County - a group of hospital administrators, emergency medical officials and doctors - will discuss the St. Mary's decision at its next meeting this month. Two hyperbaric medicine doctors at Lee Memorial cover emergencies even though they are not paid by the hospital. The hospital typically handles fewer than 50 cases a year but has no plans to discontinue the service. "This is a community service," said Gail Wilkinson, director of hyperbaric medicine and wound care. "This is the right thing to do." Ken Locklear, president of West Palm Beach-based American Baromedical Corp. and a former Navy diver who manages hyperbaric facilities at two Detroit-area hospitals, said St. Mary's decision will put lives at risk. "The bottom line is patients who need this service are going to die or lose limbs without it," said Locklear, who also publishes Hyperbaric Medicine Today magazine. SOURCE - Palm Beach PostSCUBA FORUMDISCUSS THIS TOPIC - Dive in and have your say at Scuba Forum |
