- The Washington Times - Wednesday, October 15, 2003

D.C. paramedics have filed official complaints that George Washington University Hospital is discouraging emergency crews from bringing in patients from low-income neighborhoods.

According to memos sent this week to senior fire and emergency medical services (EMS) officials, paramedics said Dr. Robert Shesser, director of the hospital’s emergency medicine department, has discouraged them several times from delivering patients from Southeast and even has tried to close the hospital’s doors to them.

In an incident Saturday night, one emergency medical technician (EMT) said he notified Dr. Shesser by radio that his ambulance was transporting a critically ill patient to the hospital. The doctor asked where the crew was coming from and was told it was Southeast. Dr. Shesser then said he had just closed the hospital’s emergency room. The ambulance continued to the hospital.

The patient — an elderly woman in diabetic shock — died after waiting 30 minutes to be admitted to the hospital, according to city and EMS officials.

“We are currently conducting an internal investigation of that incident,” said Dr. Fernando Daniels III, medical director of the D.C. Fire and EMS Department.

The incident is noted in an Oct. 13 memo to Jerome Stack, assistant director of EMS operations, written by the EMT responding to the medical call. The Washington Times has obtained a copy of the memo and of a transcript of the radio call to GWU hospital.

Hospital Chief Executive Officer Dan McLean said in a written statement that the incident resulted from the deterioration of the D.C. Healthcare Alliance, the $80 million public-private partnership that provides medical care for the city’s poor.

“Ambulance bypass is all too common because the District’s health care delivery system is on the brink of collapse,” Mr. McLean said.

He said the hospital’s emergency department was on “ambulance bypass” Saturday, meaning that the emergency room was full. But Mr. McLean added that the hospital’s policy is to “not withhold treatment” from any patient in “distress” when it is the closest facility.

The Times reported last month that Mr. McLean, also the chairman of the D.C. Hospital Association, had threatened to pull his hospital out of the D.C. Healthcare Alliance.

According to Gregory Blalock, director of EMS operations, the authority to close a hospital’s emergency room rests with EMS supervisors, not hospital staff.

“There is a policy in place,” Mr. Blalock said of the incident. “Evidently during the time of this event, that procedure had not been followed. That’s why we allowed Ambulance 18 to continue to the hospital.”

Mr. Blalock said emergency room directors are required to contact a staffing specialist in the EMS office, which is staffed at all times, to notify supervisors if they need to close. He said GWU hospital made no such notification Saturday night.

“Everything was done appropriately by our EMTs,” Mr. Blalock said. “The way they announced their closure status, that’s not done that way.”

D.C. Council member Kevin P. Chavous said he was “disgusted” by what he had heard on the tape.

“My position is clear: This is outrageous, and Dr. Shesser should be relieved of his duties immediately,” said Mr. Chavous, Ward 7 Democrat. “From what we’re hearing, the admittance incidents have a racial overtone.”

Dr. Shesser could not be reached for comment.

Two other memos, dated Oct. 12 and Oct. 13 and sent to Mr. Stack and D.C. Fire Chief Adrian H. Thompson, state that Dr. Shesser on other occasions has approached the emergency crews and asked them about where patients are coming from.

Kenneth Lyons, president of the American Federation of Government Employees Local 3721, which represents the city’s medics, said he had received more than 15 complaints from medics about such conduct at the hospital since this summer. He said he had encouraged the medics to put their complaints in writing after the Saturday incident.

“I think they have reached the point of frustration,” Mr. Lyons said. “I think it’s less of a racial issue than a financial issue. That’s what it comes down to in this city — who can pay.”

In a press release, Mr. Chavous said he has sent a letter to Chief Thompson and city Health Director James Buford seeking an investigation into racial profiling at the hospital.

In July, the hospital began asking medics who transported patients to the emergency room to fill out a questionnaire, asking where they were transporting patients from. Fire officials said they had not been notified of the purpose of the survey and had instructed medics not to comply.

“We told them to dismiss that because it wasn’t done through the proper channels,” Mr. Blalock said.

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