Newest liability victims: West Virginia emergency patients

Hospitals nationwide are scrambling to find the subspecialists needed to keep emergency departments running 24/7.

By Tanya Albert, AMNews staff. Sept. 16, 2002.

A West Virginia hospital that struggled over the past year to keep its Level I trauma center adequately staffed has lost its fight.

The West Virginia Emergency Medical Services office in August downgraded the Charleston Area Medical Center to a Level III trauma center, down from a Level I center equipped to handle serious injuries 24 hours a day, seven days a week.

CAMC didn't have enough orthopedic surgeons to cover the hospital. Sky-high medical liability rates and physicians' inability to find affordable insurance helped lead to the shortage.

The hospital -- which also had been struggling to keep its neurosurgeons and plastic surgeons -- saw the number of orthopedic surgeons available for call shrink to five, less than half the number covering the emergency department two years ago.

"We already know that people will have poorer outcomes," said David Kappel, MD, state chair for West Virginia's committee on trauma for the American College of Surgeons.

An estimated 800 to 1,000 patients -- about 40% of the people who came into the emergency department every year -- are expected to go elsewhere, according to a CAMC spokesman.

But hospitals that can treat severe trauma patients are few and far between in West Virginia. The downgrade leaves just one Level I trauma center in the state -- about three hours north in Morgantown -- and only one Level II center in Huntington, about 45 minutes west of Charleston.

"This is a major, major blow to the patients of this state," said Ahmed D. Faheem, MD, past president of the West Virginia State Medical Assn. [...]