COUNTYWIDE : Doctors Fear for Trauma Systems

As one of Orange County’s four trauma centers prepares to close permanently, California’s top emergency physicians warned Thursday that if the emergency system does not work in a wealthy county such as this one, it may not work anywhere.

Dr. Bruce Haynes, director of the state Emergency Services Authority, said, “If it can’t work here, they’re going to have trouble making it work anywhere else in the state.”

Haynes made his remarks at a public forum on trauma care at United Western Medical Center-Santa Ana that was sponsored by California Health Decisions, a nonprofit group based in Orange.

Also Thursday, some of Orange County’s leading trauma doctors accused county supervisors of “abrogating their responsibility” and causing the life-saving emergency network to fail by refusing to reimburse hospitals fairly for their treatment of indigent patients.

Said Dr. William Thompson, “I’m thinking about supervisors’ not providing any money at all out of their own pockets, and this is ridiculous.”

Herbert Rosenzweig, county director of medical services, countered: “There’s a limited amount of discretionary funds. It has to do with Proposition 13.”

Trauma centers, with high-tech equipment and with specialists on call 24 hours a day, offer more sophisticated care than a regular emergency room. When the system works, paramedics get critically ill or severely injured person to a center in less than an hour, thereby saving people who might otherwise have died.

The Orange County trauma care network was a national model when it began in 1980 with five hospitals. The number was later reduced to four--UCI Medical Center in Orange, Mission Hospital Regional Medical Center in Mission Viejo, United Western Medical Center-Santa Ana and Fountain Valley Regional Hospital and Medical Center.

But directors of Fountain Valley have decided to close their center, effective Dec. 27. They cited $1 million in losses from treating uninsured patients last year as the reason.

Trauma surgeons and some civic leaders have warned that without Fountain Valley, the Orange County trauma network will collapse. As more people must be taken farther to be treated, trauma advocates say, more will not receive care quickly enough, leading to more deaths. Advocates have asked the county supervisors to start putting funds into the trauma system to keep it functioning.

Acting on a recommendation by 45 member organizations, the United Way board of directors on Thursday urged the supervisors to “make immediate emergency allocations to save the trauma system” as it existed on July 1--that is, with Fountain Valley.