Scripps Admits It Got Paramedics’ Call : Hospital Officials Acknowledge Call in Accident Case Was Received, Referred

Carlsbad paramedics caring for a 14-year-old youth fatally injured while skateboarding in February did contact Scripps Memorial Hospital in La Jolla by radio as required under county trauma system procedures, the hospital acknowledged Friday.

The announcement by the hospital’s chief of trauma reverses statements made by Scripps doctors earlier this week that, contrary to county trauma procedures policy, they received no call and that the incident showed the county needs to crack down on Tri-City Hospital of Oceanside--where the youth eventually died of his injuries--for trying to act as a designated trauma center at the expense of Scripps.

The admission came after a story in The Times quoting the two paramedics who handled the Feb. 8 incident on the details of their radio contact with Scripps. The paramedics said they called Scripps as required and were told that it was overloaded with calls and to contact another hospital. The boy was taken to Tri-City, where he died Feb. 23 of heart and lung failure.

The case became controversial Wednesday when the Board of Supervisors, acting on a story in the San Diego Union, ordered a staff investigation into why John William Dement was taken to Tri-City by ambulance instead of to Scripps by Life Flight helicopter. That story quoted Scripps’ Dr. Robert J. Eggold as saying there was no call to the hospital, and he implied that the paramedics consciously decided to take the patient to Tri-City in violation of procedures.

A. Brent Eastman, Scripps’ chief of trauma, said Friday that the hospital had no written notation of paramedics calling. However, he said a review of tape communications shows a call at the approximate time of the Dement incident.

Eastman said, “At that time, Scripps Memorial communications circuits, both radio and telephone, were very active and the following response to the unidentified caller is recorded: ‘Scripps ER (emergency room) 16:47 (4:47 p.m.) I have two other calls going, could you please try another base station (hospital).’

“These are the words of Scripps Memorial’s communications nurse.”

Eastman said that because of heavy telephone traffic at the time, recording equipment was unable to tape incoming radio communications, which would normally include the words of the paramedics (That is why the caller was unidentified.).

“It is quite possible that this comment (from the nurse) was directed to a paramedic calling in on the Dement incident,” Eastman said. “I want to emphasize that Scripps Memorial is in no way disputing the paramedics’ statement that they contacted Scripps.”

A Scripps spokesman said Friday that the hospital is conducting a complete review of its communications procedures. The spokesman said that Eggold was not available for comment on his previous allegations concerning Tri-City.

The Carlsbad paramedics said Thursday that they contacted Tri-City after the radio message from Scripps, because Tri-City is the only other base station hospital in radio contact with their area, despite its non-trauma designation. The paramedics--one of whom works part-time for Life Flight --also said that the helicopter was not asked to land at the accident scene because the Dement boy was highly combative and therefore a danger to the helicopter pilot.

“We followed all county procedures to the letter,” paramedic Sonny Hilliard said.

Carlsbad fire division chief Jim Page, who supervises paramedics, told The Times Thursday that the furor over the handling of the accident was politically motivated, adding that he would not allow his paramedics to be made scapegoats in a dispute between doctors and hospitals.

Scripps is the designated trauma center for the north coast area under the county system set up Aug. 1. It has complained--along with four other hospitals in the system--about Tri-City acting as a de facto trauma facility and handling severely injured patients. Those hospitals last week threatened to withdraw from the system if county supervisors agreed to consider Tri-City for future designation as a trauma center.

Tri-City on Thursday withdrew its request for designation through the county administrative process, saying that the process had become politicized. The hospital will now pursue trauma center status through a lawsuit already filed against the county.

Tri-City officials on Friday also defended their hospital’s care of Dement after he was brought in. The question of whether the care was adequate was raised indirectly this week by several doctors connected with the county trauma network.

On Friday, Dr. Robert F. Andrews, the neurosurgeon who saw Dement in the Tri-City operating room, said in a statement, “Once asked to assume the medical responsibility, I utilized my best medical judgment in deciding against Life Flight transfer to Scripps trauma center as being an unacceptable medical risk, and not in the boy’s best interest.”