Wednesday, January 21, 2004

Investigators examining charges that a George Washington University Hospital physician in October tried to redirect medics transporting an elderly Southeast woman did not interview key witnesses to the incident, according to the woman’s family and the medics’ union leader.

However, investigators have exonerated the hospital in the Oct. 11 incident, according to the medical center’s provost, John F. Williams, who issued a statement Monday that the U.S. Department of Health and Human Services (HHS) had found “no evidence of wrongdoing” on the hospital’s part.

“I am appalled,” said Tina Britt, the elderly woman’s cousin who had placed the 911 call for the ambulance and followed it to the hospital. “No one has talked to me about anything that happened that night.”

The president of the union that represents the city’s medics said his members also were not interviewed.

“They didn’t speak with the paramedics at all,” said Kenneth Lyons, president of the American Federation of Government Employees Local 3721. “All we ever asked was there be a thorough investigation, and we just haven’t seen any indication of that — at least not yet.”

A spokeswoman for the HHS’ Centers for Medicare and Medicaid Services said the department had requested an investigation, which was conducted by the D.C. Department of Health. The probe found no evidence of violations.

Officials from the D.C. Department of Health did not return calls seeking details about the investigation.

The Washington Times first reported that city paramedics had filed official complaints that GW hospital was discouraging emergency crews from delivering patients from low-income neighborhoods.

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

In the Oct. 11 incident, an emergency medical technician (EMT) said he notified Dr. Shesser by radio that he was transporting a critically ill patient. 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, but the ambulance continued to the hospital.

The woman, whose identity has not been publicized, was suffering from congestive heart failure and was admitted to the hospital. A dementia patient, she is in a nursing home, Miss Britt said.

In a preliminary report in October, the D.C. Fire and EMS Department’s medical director faulted Dr. Shesser in the incident.

“Based on the facts, GW Hospital was not on closure at the time Ambulance 18 initiated contact with them,” Dr. Fernando Daniels III wrote in a memo to Fire Chief Adrian H. Thompson. “There is no documentation in the EMS log that GW had requested closure or diversion six hours prior to the alleged incident.”

GW hospital issued a report in October clearing Dr. Shesser of any wrongdoing. The report did not say that the hospital had asked EMS officials to be placed on closure, but it said Dr. Shesser “knew, better than EMS command-and-control or the paramedics, whether he could care for additional patients without jeopardizing the safety of the patients already in his care.”

In a written statement, hospital Chief Executive Officer Dan McLean said 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. At that time, the hospital was negotiating its contract with the alliance.

Mayor Anthony A. Williams announced Nov. 7 that GW hospital had renewed its contract with the alliance.

University medical center officials and Dr. Daniels would not comment yesterday, but a fire department spokesman said he was unaware of any report exonerating the hospital.

“We do know there is an official investigation going on and we wouldn’t have any comment until we saw that final report,” said spokesman Alan Etter.

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