MARCO ISLAND — Marco Island officials are requesting a state investigation after an 80-year-old man waited nearly an hour for an ambulance earlier this month and later died.
A 65-page report from the Marco Island Fire Rescue Department, which was sent to the Florida Bureau of Emergency Medical Services, concludes that the NCH Healthcare System may have violated promises to the county to have an ambulance crew ready to transport patients between hospitals and that Collier County EMS failed in its duties to promptly respond to 911 calls.
Mike Murphy, the Marco Island fire chief, filed a complaint this week with the state's EMS bureau. He asked them to investigate a lapse in medical care when Paul Anderson, 80, of Marco Island, died after it took health providers 54 minutes to get an ambulance to him at NCH Marco Island Healthcare Center — an urgent care center. He suffered a stroke, and friend had taken him to the urgent care center.
"It's just a tragic situation that could have been avoided," Murphy said.
The report also makes recommendations to Marco Island City Council, the Collier County Commission and the health providers involved in the call on how to address concerns raised from the call.
"The overall conclusion of our report is that the system failed to meet the needs of our residents and did not meet the expectations that our residents and businesses should expect," Murphy wrote.
In its conclusion, the report states that NCH did not "live up" to the requirements of its certificate from the county. It recommends that the Collier Commission hold a hearing on potential county violations by NCH and review its transport certificate.
According to the Marco fire department report, patient transport from the NCH Marco Island Healthcare Center has been problematic in the past, but was supposed to have been resolved months before Anderson's emergency.
In March, when NCH was reissued a "certificate of public convenience and necessity," given by the Collier Commission to qualified patient transport providers, the hospital system agreed to transport patients during all hours of occupation, the report said. However, documents show that while the healthcare center opened at 8 a.m., transport paramedics were not scheduled to come in on the day of Anderson's stroke until 9 a.m. — and they arrived late.
Anderson was ultimately taken to NCH Downtown Naples Hospital by the hospital's ambulance. He died the next day.
Murphy said it's unclear if a quicker response would have saved Anderson, "but you'd like to give the person every possible chance you can."
The report also questioned if Collier EMS met its state obligations to respond to 911 calls.
A county directive to NCH requiring the hospital, not the county, to provide all transport between facilities, stemmed from a billing dispute between the healthcare system and Collier EMS. The new policy, which went into effect the day before Anderson's delayed transport, was the result of an outstanding balance of $178,742 for transport services that the county says NCH owes.
Although the county was late in its response, the report said EMS first responders made "every effort to assist, but (were) denied by their supervisors."
"The field people — the paramedics that ride in the firetruck and are on the ambulances — they did their job," Murphy said. "They did what they were told to do."
County spokesman John Torre said EMS interim Chief Walter Kopka twice confirmed that NCH personnel would take the patient to the hospital, according to Collier County spokesman John Torre. Kopka spoke to the NCH transport manager once and “reconfirmed” it a second time by text messaging, wrote Torre in an email to the Daily News.
Collier EMS has since said it would send paramedics to Marco Island Healthcare Center to check on patients in emergencies to avoid similar delays.
Beyond the roles NCH and Collier EMS played in responding to Anderson, the report also addressed other issues raised during the call.
The report notes that NCH's transport vehicles do not keep some emergency medications that are on Collier EMS ambulances. Some of those medications were needed by the NCH medic in this call, but minutes were lost retrieving them from the medical center first.
With Collier Emergency Medical Director Dr. Robert Tober responsible for what drugs go into emergency response vehicles, the report said Tober should review a policy that has potentially live-saving drugs in EMS ambulances, but not NCH transport vehicles.
Although the report was sent as part of an official complaint to the state, Murphy said the fire department was not trying to point fingers at any particular party in the Anderson's emergency.
Given that Marco Island firefighters also responded to this call, Murphy said it was necessary to have an outside agency independently investigate what happened and recommend fixes.