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With No Doctor in the House, Patient Diverted; S. Shore Hospital Cleared in Case of Heart Attack

Posted on: Monday, 12 September 2005, 21:00 CDT

The Patriot Ledger

WEYMOUTH - South Shore Hospital, which wants state approval to treat more heart patients, had to transfer a heart attack victim to Boston for emergency artery-clearing treatment because its own unit had closed for the day.

An ambulance took the unidentified patient to the Weymouth hospital after calling ahead to the ER.

But when it arrived, the only doctor on duty who could perform an angioplasty had left.

The patient was sent through rush hour traffic to a Boston hospital, where he underwent the life-saving procedure.

The man recovered, but he or his family filed a complaint about the delay in his treatment. State investigators concluded the Weymouth hospital did nothing wrong.

"They're not required to provide (emergency) angioplasty 24-7," said Paul Dreyer, chief of the state Division of Health Care Quality.

Current guidelines say patients with cardiac symptoms should go to the nearest hospital. Dreyer said he did not know whether it was best for the patient to have gone to South Shore Hospital first instead of straight into Boston.

Dr. Marvin Lipschutz, senior vice president for clinical affairs, said the hospital plans to offer around-the-clock service by November, but not because of this case.

"The compelling fact is that they said we did the right thing," Lipschutz said.

South Shore is among a handful of community hospitals allowed to perform emergency angioplasty. The hospital won state approval in 2001.

None of the community hospitals approved to provide the emergency treatment operates 24 hours a day, Dreyer said.

In an angioplasty, a doctor threads a balloon-tipped wire into coronary arteries to clear clots that starve the heart muscle and cause heart attacks.

South Shore has also waged a long battle to offer open heart surgery and has applied to the state to provide non-emergency angioplasty. Hospital officials have argued that allowing South Shore to provide more advanced treatment will save lives by avoiding time-consuming transfers to Boston.

South Shore has performed more emergency angioplasties than any other approved community hospital: 211 since April 2001, a spokeswoman said. South Shore also opens patients' arteries in less than 60 minutes, compared with the national average of 100 minutes.

The incident involving the patient who was transferred to Boston occurred on an undisclosed afternoon in December, according to a report by investigators from the Department of Public Health.

A paramedic told investigators that the South Shore's emergency room advised him to bring the patient in after he reported the man's condition. The ambulance arrived at 4:12 p.m.

The angioplasty unit is normally staffed from 6:30 a.m. to 5:30 p.m. weekdays for scheduled diagnostic procedures and for emergency angioplasties. On that day, however, one of two doctors who performed angioplasties was on vacation and the other had left the hospital.

The man was taken by ambulance to an unidentified hospital in Boston. Doctors there began the procedure at 6:03 p.m., almost two hours after the man arrived at South Shore Hospital and two hours and 15 minutes after he called for help.

Brockton Hospital, the other local hospital that offers emergency angioplasties, has hours from 7:30 a.m. to 3:30 p.m. on weekdays, with more times possible depending on staff availability, spokesman Rich Copp said.

The hospital had longer hours in the past. Copp did not respond to a message asking for comment.

Lipshutz said South Shore Hospital does not have enough interventional cardiologists to perform emergency angioplasties around the clock.

"We're working with Brigham and Women's Hospital (South Shore's clinical partner) to recruit more cardiologists," Lipschutz said. "It's going to be available in the fall."

Sue Reinert may be reached at sreinert@ledger.com.

Source: Patriot Ledger, The; Quincy, Mass.

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