Missing Tape Sought in Christmas Death : Recording Would Reveal Information on How Victim of Gunshot Was Treated

Officials at Grossmont Hospital said Saturday they are trying to locate a missing tape recording of the radio transmissions between the hospital’s emergency staff and paramedics involving the handling of a gunshot patient who died.

State medical authorities are investigating the death of the man, who spent 36 minutes at Grossmont on Christmas Day without benefit of a trauma surgeon before being transported to the UC San Diego Medical Center, where he died.

At the time of the incident, Grossmont was East County’s designated trauma center. The hospital ceased being a trauma center Thursday, and East County’s most critically injured patients are now taken to Sharp Memorial Hospital.

Grossmont Administrator Ron Dahlgren said Saturday that the cassette tape recording of conversations between the hospital’s mobile intensive care nurse and paramedics involved in the incident has been missing since Dec. 28, but he said the tape is not critical to the investigation into the death of Nickey Trevino, a chief petty officer in the Navy.

Trevino, who was in El Cajon when he was shot, was taken at 12:29 p.m. to Grossmont Hospital, where he was treated before being transferred UCSD Medical Center by a Life Flight helicopter. Trevino arrived at UCSD at 1:12 p.m. He was pronounced dead at 2:44 p.m.

Doctors Made Decision

Dahlgren said Saturday that the hospital emergency room physician contacted the hospital’s trauma surgeon by telephone while Trevino was en route to Grossmont, and that the two men decided Trevino should be taken to UCSD Medical Center after first being stabilized at Grossmont.

Dahlgren said the decision to call Life Flight came after the emergency room staff requested, on the hospital’s public address system, for any available surgeon in the hospital to report to the emergency room, and none responded.

He said that according to the hospital’s contract with the county, a trauma surgeon does not need to be present in the emergency room when a trauma patient arrives, if there was insufficient advance time to notify the surgeon.

The contract also says that if there was not enough time to get the surgeon to the hospital before the patient arrives, the emergency department physician should start the evaluation and resuscitation of the patient.

The hospital’s own medical review committee is reviewing “the judgment call” that was made by the emergency room physician and the trauma surgeon in deciding to transfer the patient to UCSD Medical Center, Dahlgren said.

But, he said, the tape would not necessarily aid that investigation.

“It is not a formal part of the record in terms of what happened in that case,” he said. “The pre-hospital report form and the base station patient assessment sheet are the legal forms that are utilized in (determining) the disposition of the patient.

The tapes are made and later replayed so the hospital staff can critique the handling of paramedic operations, Dahlgren said. Such tapes are stored in the same envelope as other, written records of the same incident. In this case, he said, while the tape is missing from the envelope, the balance of the written reports are preserved.

Dahlgren said he wasn’t aware himself that the tape was missing until Friday evening, when contacted by a San Diego Tribune reporter.

Asked whether the tape may have been taken by someone, Dahlgren said, “I don’t know. I know that it is missing from where we would expect it to be, and the staff has been searching for it since Dec. 28. As an administrator and the person responsible for the operation of the hospital, it certainly concerns me that any record would not be there when we need it. But it does not, in my opinion, present a material lack of information as to the dispensation of that particular case.”

Dahlgren said he would not speculate as to whether someone on the hospital’s staff stood to gain by the tape’s disappearance.