- The Washington Times - Thursday, October 16, 2003

D.C. Mayor Anthony A. Williams yesterday ordered an investigation into reports that a George Washington University Hospital doctor told an ambulance crew carrying a critically ill patient that the emergency room was closed after the crew said it was coming from Southeast.

“We need to know what happened, why it happened and who is responsible,” the mayor said in a written statement. “District residents and visitors to our city need to have a level of confidence in the emergency medical operations we have in place. Arbitrary and unauthorized closures of emergency room operations will not be tolerated.”

Mr. Williams has ordered D.C. Health Department Director James A. Buford and Dr. Fernando Daniels III, medical director of the D.C. Fire and Emergency Medical Services (EMS) Department, to investigate.

The Washington Times first reported yesterday that D.C. paramedics had filed complaints that Dr. Robert Shesser, director of the emergency medicine department at the GWU hospital, had discouraged emergency crews from delivering patients from low-income neighborhoods.

According to an official memo about a Saturday night incident, an emergency medical technician (EMT) said he had notified Dr. Shesser that his ambulance was transporting a critically ill patient to the hospital. After the crew told Dr. Shesser that it was coming from Southeast, he said he had just closed the hospital’s emergency room.

EMS personnel, however, told the crew that the emergency room had not been closed, and the ambulance continued to the hospital. The authority to close a hospital’s emergency room rests with EMS supervisors, not hospital staff, fire and EMS officials said.

There was some confusion yesterday among city and hospital officials about the patient’s status.

City officials and EMTs initially told The Times that the patient — a 97-year-old woman in diabetic shock — had died while in the hospital’s care Saturday.

“The patient that came in on Oct. 11 was received by the hospital, is doing well and is prepared for release today,” hospital Chief Executive Officer Dan McLean said yesterday.

Hospital officials would not confirm the patient’s identity or status when The Times contacted them Wednesday.

Two other recent memos to D.C. Fire Chief Adrian H. Thompson and Jerome Stack, assistant director of EMS operations, state that Dr. Shesser has approached emergency crews on other occasions and asked them about where patients are coming from, The Times reported yesterday.

Mr. McLean said yesterday that Dr. Shesser remains on the job. Mr. McLean said he cannot explain the apparent communication breakdown between the hospital and EMS officials. He said the hospital had asked to be closed Saturday but had not received confirmation from EMS personnel.

In a written statement, Mr. McLean said the incident had 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.

Mr. Williams termed as “reprehensible” Mr. McLean’s efforts to portray the incident as a failure of the alliance.

“This troubling incident should prompt those in charge of the hospital to conduct their own internal review,” Mr. Williams said. “The response should not be to point the finger at others and disparage a successful and large-scale effort to bring quality health care to the District’s poorest residents.”

In a written statement yesterday, the city’s health director said the incident should not “be linked to the District’s Healthcare Alliance program.

“The Alliance is providing quality health care to District residents who otherwise would not have access to health care at all,” Mr. Buford said in the statement. “Our goal is to provide quality health care to all residents of the District.”

At a press conference yesterday, Mr. McLean , chairman of the D.C. Hospital Association, reiterated his displeasure with the alliance.

“We have not backed away from our commitment to the alliance…. But we are concerned with the way it is running,” he said. “The alliance needs a hard look from all of us because it is not running the way it was originally intended.”

Mr. McLean said the services being provided by Greater Southeast Community Hospital have been inadequate. Greater Southeast is undergoing its third bankruptcy in five years.

Mr. McLean also rebuffed any notion that GWU hospital had engaged in racial profiling.

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

D.C. Council member Kevin P. Chavous said the hospital’s practice of inquiring where a patient is coming from had “a racist overtone.”

One paramedic in a memo to Chief Thompson said Dr. Shesser appeared to be particularly interested in where black patients were transported from. “I have never had Dr. Shesser ask where a white patient was transported from. He always seems to only ask when an African-American patient is brought into the emergency room,” the paramedic said in the memo.

The Ward 7 Democrat raised the issue during a D.C. Council Judiciary Committee hearing.

“We don’t want to jump to conclusions, but there’s one heck of a smoking gun out there,” Mr. Chavous said. “We need to build a new hospital, but while we’re going through this process, the thing we can’t have is the suggestion that one of the few hospitals that will serve our citizens can pick and choose which citizens they will serve.”

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