Countywide : Victim Turned Away From UC Hospital

Orange County officials are questioning a decision by administrators at UCI Medical Center to declare its trauma center full on Sunday and turn away a badly injured bicyclist.

Greg Bales, who went through the windshield after colliding with a car Sunday morning, was taken by ambulance from the accident scene less than a mile from the medical center in Orange to Mission Hospital Regional Medical Center in Mission Viejo, about 25 miles away.

Bales, 18, was reported in good condition Monday with multiple facial lacerations and a concussion.

Dr. Robert Bade, medical director of the county’s Emergency Medical Services agency, said Monday that he believed that “it would have been appropriate for the patient to go (to UCI Medical Center), at least for stabilization.”

But Dr. Kenneth Waxman, the medical center’s trauma director, said it was impossible to admit Bales because both the hospital’s emergency facilities and intensive care units were full.

Bales was driven past a second trauma center because it, too, was full.

Waxman, other trauma experts and several county fire chiefs said the incident demonstrates that Orange County’s emergency network is overloaded.

“The trauma system essentially failed that patient,” Waxman said. “But there may be other examples where patients may die.”

He blamed county supervisors and Health Care Agency Director Tom Uram for failing to reimburse hospitals fairly for indigent care.

Health-care advocates have been concerned about the quality of trauma care since one of the first emergency centers, at Fountain Valley Regional Hospital and Medical Center, closed Dec. 27, leaving Orange County’s 2.2 million residents with only three of the lifesaving centers--UCI, Western Medical Center-Santa Ana and Mission.

Bade and Emergency Medical Services Director Betty O’Rourke have been recruiting a fourth trauma center to cover the northwest part of the county and reportedly are talking with Los Alamitos Medical Center and Humana Hospital-Westminster.

Meanwhile, EMS officials contend that Bales’ long-distance, 25-minute ambulance ride was unusual. In January, trauma patients spent an average of 10.5 minutes en route to a center and only five patients took longer than the system’s goal of 20 minutes, Bade said, while adding that he believes that the system still works well. Though Waxman disagreed, officials at two other trauma centers agreed with Bade.

“We have not had any prolonged transportations that I’m aware of,” said Linda Baldwin, trauma coordinator at Western Medical Center-Santa Ana. In January, her trauma center received about 15 trauma patients more than the 100 for which it budgeted. “Right now, we’re doing fine,” Baldwin said.