Tri-City Calls Halt to Fight to Be Named Trauma Unit

Tri-City Hospital officials, smarting from a recent court setback, agreed Thursday to drop their long-running legal battle to become a part of San Diego County’s network of trauma centers.

Hospital officials filed suit against the county more than a year ago in an effort to gain entry into the trauma system, but a Superior Court judge ruled against them May 15.

The hospital district’s board of directors voted unanimously not to appeal Judge J. David Hennigan’s decision, but stressed that they remain confident that the hospital will ultimately be granted trauma center status.

Lucas Bonagura, a physician and hospital district director, said San Diego County officials will eventually recognize the need for a trauma center along the county’s northern coast and “will be begging for us to join.”

Bonagura said the struggle over the trauma issue had drained the hospital of “much of its soul and a lot of its pocket book.” He said county officials had chosen to put politics and money ahead of lives, maintaining that patients were being treated “like carcasses of meat to be taken elsewhere.”

Director Margret Merlock agreed, predicting that Tri-City Hospital would be designated a center for critically injured or ill trauma victims after gaps in the existing network become obvious.

“Eventually, down the road, we’ll get it by default,” Merlock said.

County trauma officials could not be reached for comment on the board’s action.

Under the system set up by the county in August, 1984, severely injured patients are transported to hospitals designated for trauma care. Although an ordinary hospital emergency room might be closer to the scene of an accident, the patient’s chances of surviving are said to be better at a trauma center.

Initially, six hospitals in the San Diego area were named as part of the trauma network. Later, when Grossmont Hospital dropped out of the system, Palomar Hospital in Escondido was added by the county Board of Supervisors.

Tri-City Hospital officials were miffed that they were slighted in the selection process, saying that their facility was excluded so San Diego hospitals could treat enough patients to make the trauma service financially worthwhile.

The hospital’s leaders also argued that trauma victims along the North County coast would be better served at Tri-City than at the more-distant trauma facilities.

County officials, however, have countered that the distance patients have to travel is outweighed by the superior care provided at the specially equipped trauma centers. In addition, they contend that a system with too many trauma centers reduces the number of critically injured patients each hospital treats and consequently dilutes the level of care.

After Grossmont dropped out of the trauma network, the Board of Supervisors agreed to give Palomar and Tri-City a chance. During a review by a medical team, completed in October, 1984, Palomar edged Tri-City, garnering 90.4 out of a possible 100 points to Tri-City’s 90.1.

Subsequently, the board selected Palomar, despite Supervisor Paul Eckert’s argument that the North County needed two hospitals designated as trauma centers because of the area’s rapid growth.

After that setback, Tri-City officials at first sought to win admission to the trauma network by working through the county’s administrative process, but failed to make any headway. In early 1985, the hospital filed its lawsuit against the county.

Hospital officials argued in part that the medical review conducted as part of the selection process was flawed because 1.2 points were deducted from Tri-City’s score. That penalty came because the average home-to-hospital response times of neurosurgeons were not included in the application. Officials, however, said the county had never requested the information.

Amid the legal fireworks, a flap erupted during the summer of 1985 over the transporting of patients to the trauma centers.

Oceanside officials ordered their paramedics to stop taking accident victims to Palomar or Scripps, complaining that it was leaving the city unprotected for too long should another emergency occur. That conflict was eventually eased by an agreement that Life Flight helicopters would be used to augment the paramedic services on trauma cases.

Meanwhile, Tri-City scored early victories in its legal fight against the county, winning a decision earlier this year to make the medical selection panel’s records public.

Nonetheless, that decision was later nullified when Hennigan, a Riverside County Superior Court judge called in to hear the politically sensitive case in San Diego, ruled on May 15 against the hospital’s effort to be a trauma facility.

Faced with the prospect of pushing the case to the state appeals court, the hospital’s district directors decided to drop the matter because of the cost to continue the legal struggle.