NCH will no longer transport patients between hospitals after Marco man's wait, death

Paul Anderson

Paul Anderson

Sunday Oct. 2

8 a.m. Friend takes Paul Anderson, 80, to Marco Urgent Care Center.

8:30 a.m. Approximate time Anderson arrives at urgent care center.

8:45 a.m. Friend walks into nearby Marco fire station for help at urgent care center.

8:48 a.m. Collier County Medic Rescue 50 ambulance dispatched to urgent care center.

8:54 a.m. Battalion Chief advises to hold call. Medic Rescue 50 placed on standby in station.

9:02 a.m. Medic Rescue 50 canceled.

9:03 a.m. Battalion Chief says NCH ambulance will transport Anderson.

9:18 a.m. Second 911 call comes in of an 80-year-old male having difficulty breathing, high blood pressure at Marco Urgent Care Center. Collier County Medic Rescue 90 ambulance dispatched.

9:19 a.m. Collier County Tower 50 firefighter/paramedic unit dispatched to Marco Urgent Care Center.

9:21 a.m. Medic Rescue 90 arrives, placed on standby.

9:22 a.m. Anderson’s friend says NCH ambulance driver arrives for 9 a.m. shift.

9:26 a.m. Confusion about a second patient

9:32 a.m. Medflight is requested.

9:36 a.m. Medflight is put on standby. Tower 50 assists with loading Anderson in NCH transport ambulance. Paramedic rides with NCH unit.

9:40 a.m. Medic Rescue 90 advises that there was only one patient and he was transported to NCH.

Monday, Oct. 3

Paul Anderson dies.

— NCH Healthcare Systems is getting out of the patient transportation business after a mishandled emergency call on Marco Island earlier this month ended with the death of an 80-year-old man.

NCH and Collier County EMS have been under fire since reports surfaced it took 54 minutes to get an ambulance to Paul Anderson, who had suffered a stroke and was at the NCH Marco Island Healthcare Center — an urgent care clinic.

There was confusion over whether NCH’s transport crew or a Collier EMS ambulance would transport Anderson to NCH Downtown Naples Hospital, reports said.

On Friday, NCH Healthcare Systems relinquished its certificate to transport patients, effective immediately, with a letter to Collier County Manager Leo Ochs. The letter was signed by Dr. Allen Weiss, NCH president and CEO.

“We have found that NCH having its own transportation service may have led to varying interpretations as to who is responsible for transport,” NCH said in a prepared statement.

With NCH backing out, emergency patient transport between hospitals will fall solely on Collier EMS ambulance crews.

NCH’s decision to drop its transport service came as a shock to Collier EMS. The day before Anderson suffered a stroke, EMS announced it would no longer transport patients between NCH facilities due to a billing dispute. Earlier this week, EMS agreed to once again assist NCH with emergency patients without an EMS chief first discussing the transport with NCH.

“We got zero advanced notice on it,” Ochs said of NCH’s decision to stop transports.

Ochs said he advised EMS officials to “do what is operationally necessary to meet the demand in the field” for now.

EMS officials told Marco Island Fire Chief Mike Murphy additional emergency crews would be available nearby to pick up any slack, Murphy said. It will ultimately be up to the Collier County Commission to decide a more permanent solution, Ochs said.

The NCH statement went on to say they would focus on “care to patients in our hospitals and outpatient facilities,” and that patient transportation is “best coordinated” by providers specifically focused on the service.

Employees affected by the termination of NCH’s transport service can reapply for open positions with the hospital system, according to the statement.

The controversy over patient transport started after Anderson suffered a stroke the morning of Oct. 2. After he complained of dizziness, a friend rushed him to NCH Marco Island Healthcare Center.

Anderson’s condition was too severe for the urgent care clinic, reports say, but there was confusion over whether NCH or Collier EMS would take Anderson to the hospital.

Because of a billing dispute between Collier EMS and NCH, a county directive stated NCH would be required to provide all transport between its facilities, except for trauma alerts. NCH owes the county $178,742 for previous hospital-to-hospital transports. The hospital system argues that the county should be billing the patients.

On Oct. 2, NCH’s transport crew was initially unavailable to transport Anderson, reports say.

Collier EMS has been criticized for not arriving on the scene after urgent care clinic staff called 911 for assistance. County officials have said they were informed by NCH supervisors that they would transport Anderson.

The Marco Island Fire Rescue Department, which also responded to the call, has requested a state investigation into the matter.

Patient transport from the NCH Marco Island Healthcare Center has been a problem in the past, according to a Marco Island Fire Rescue Department report.

Those issues came up this spring during the renewal of NCH’s certificate of public convenience and necessity, a document distributed by the Collier Commission to qualified providers. According to Marco fire reports, NCH agreed to transport patients during all hours of occupation, the report said.

However, documents reveal that while the urgent care clinic opened at 8 a.m. the day of Anderson’s stroke, transport paramedics were not scheduled to come in until 9 a.m. — and they arrived late.

© 2011 marconews.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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