Tri-City’s Staff Frustrated : Hospital Charges Politics Denied It Trauma Status

Tri-City Hospital officials, frustrated by what they say is the politicization of San Diego County’s trauma care system, charged Wednesday that interests other than medicine have played a role in keeping Tri-City out of the network of trauma care centers.

In a press conference Wednesday morning, three top Tri-City officials elaborated on their belief that a clique of medical professionals centered in San Diego has influenced the county’s decision-making from the start.

“We naively presumed that honesty, integrity, professionalism and facts would prevail, never imagining that behind-the-scenes politics plays such a dominant role in the county government’s decision-making process, even when peoples’ lives are at stake,” said Richard A. Hachten, the hospital’s chief executive officer.

Lucas Bonagura, a physician and hospital district director, was more blunt. “Downtown, they are determined that politics, money and power are more important than lives,” he said. “It seems our injured are like so many head of cattle--meat to be divided up among the downtown wolves.”

Bonagura said he believes the county has excluded Tri-City from the trauma care network so that San Diego hospitals--particularly Scripps Memorial in La Jolla--can treat enough patients to make the service financially worthwhile.

“The most important consideration has been that the hospitals downtown are not full, and they need to have our patients to break even,” he said.

Contacted later, Ben Clay, a lobbyist for the San Diego hospitals, declined to comment on Tri-City’s allegations.

Under the county system set up in August, severely injured patients known as trauma victims are transported--often past closer emergency rooms--to hospitals that have specially equipped and manned trauma care centers, where their chances of surviving are said to be better.

Although a recent county study said the system here is one of the nation’s best, the issue has been fraught with controversy over which hospitals would win the coveted designations.

Last year, the county named Scripps Memorial, Sharp Memorial, Mercy, Children’s and Grossmont hospitals and the UC San Diego Medical Center as the first trauma centers. Later, Grossmont dropped out of the system, and Palomar Hospital in Escondido was added by the county Board of Supervisors.

Last week, Tri-City abandoned its effort to win the designation through the county’s administrative process, deciding instead to pursue its case through the courts. The hospital has argued that trauma victims along the North County coast would be better served by going to Tri-City than by being transported by helicopter to Scripps.

The county has said that the distance patients have to travel to Scripps is outweighed by the superior care they receive once they arrive at the hospital.

At Wednesday’s news conference, Tri-City officials said they will continue to operate a non-designated trauma center, but will no longer have a trauma surgeon there at all hours. Instead, surgeons will be on call and, according to Hachten, should be able to reach the hospital before the the trauma patient does.

Hachten also said a second operating team that had been kept at the hospital during the night shift will be put on call instead. Together, the changes are expected to save the hospital $250,000 a year, enough to make Tri-City’s trauma program break even financially.