A Death in the Family : Health Care: Fountain Valley hospital trauma center closing leaves most of the staff sad, embittered--and enormously proud of its achievements.

Wearing armbands fashioned from black electrical tape, Fountain Valley Regional Hospital and Medical Center’s emergency room co-workers Wednesday mourned the final hours of its trauma center, which was scheduled to close at midnight.

“It’s the end of an era,” said nurse Kay Francis, who said she needed a second roll of tape to accommodate all those who wanted to wear armbands. “We’re all sad,” she said. “We’ve made a difference in this community.”

Roughly 75 of the 3,000 patients who came to the hospital’s emergency room each month were trauma patients--suffering from multiple, life-threatening injuries often caused by car or construction accidents or gunshots. For 10 years, they were treated immediately by surgeons, nurses and anesthesiologists trained to make quick decisions and work swiftly to save lives.

But continuing debt from treating the indigent and uninsured forced the hospital to announce recently that the team of specialists would no longer be available 24 hours a day, and that patients in need of immediate life-saving care would be sent to the county’s three remaining trauma centers--UCI Medical Center in Orange, Western Medical Center-Santa Ana and Mission Hospital Regional Medical Center in Mission Viejo.

Though time has blurred memories of thousands of saved lives, the trauma center staff remembered Wednesday a few of the against-the-odds survivors: the man who drove his car down Pacific Coast Highway into a lumber truck and wound up with a four-by-four through his chest; an elderly man with Alzheimer’s disease who stabbed himself three times; a man saved from a gunshot wound in the heart only to succumb to another gunshot wound within a year.

Judging by the scores of Christmas cards on display at the center, many Orange County residents clearly remember the trauma staff--and with gratitude.

One card was from the mother of a victim whose life was saved at the center. “I can’t ever thank you enough, there are just no words,” she wrote. “I hope you have as many Merry Christmases as this one you have given me.”

She signed it, “Motorcycle accident. Dec. 15. Around 10:30 p.m.”

Hospital administrator Richard E. Butler and others expressed regret Wednesday about the end of the center.

“Fountain Valley really is not blaming anyone. We don’t want to get out of the trauma business, but there is no alternative,” Butler said.

He said 47% of the 656 trauma patients treated in 1989 were either uninsured or under-insured, resulting in a projected $3-million loss for 1990. Following notice four months ago that the private, for-profit center would close, the only forthcoming aid was $600,000 in tobacco tax funds, he said.

Twenty-four-hour emergency services will continue at the hospital, but the dismantled trauma staff will be available only on call. Layoffs are not expected, Butler said.

Many hoped for an eleventh-hour reprieve from the county or state, but the reality of the situation sank in Wednesday as a workman removed the blue letters reading Regional Trauma Center on the outside of the hospital. Inside, the staff members had scant time for reflection as they hustled amid leftover Christmas tinsel and poinsettias to tend an unusually heavy load of regular emergency cases.

But they clearly were worried about the future--for the community and for themselves.

“The bottom line is, we saved lives that otherwise wouldn’t have been saved,” said Carol Hedenberg, an emergency room nurse for 13 years. “No one in ER is happy about it,” she said.

Although some, like nurse Phil Pruden, predicted the lack of trauma patients would make it easier to give full attention to the emergency patients, others worried that their emergency skills, no longer honed by the daily trauma cases, might become rusty.

Some had come to work at Fountain Valley just for the challenge of working at the trauma center where, at its height, four patients a day were treated. “We have to see if we lose personnel,” said Dr. Peter Anderson, director of emergency services.

Many, including Anderson, complained bitterly about the lack of state and county support to save the center.

“There’s a crisis in Orange County when the county government is refusing to acknowledge its duty to the poor and is shifting the burden of health care to private doctors and hospitals who are not able to take care of it,” he said.

“They’re betting the system will survive,” Anderson said. “I hope it does.” However, the strain on the other hospitals may lead to the collapse of their trauma centers as well, he said.

If the other centers close, mortality rates could rise above those before 1980, when the four-hospital trauma system began, said Dr. Peter LePort, head of the trauma center.

Added Pruden: “It’s a shame that one of the wealthiest counties in the state is not able to provide state-of-the-art trauma care for patients.”