Lewis Gale Medical Center (Salem, Virginia) is part of the Hospital Corporation of America (HCA) which operates 186 hospitals nationwide. The hospital (LGMC) is one of two hospitals on the Roanoke Valley. LGMC was recently recognized by the Virginia Department of Health as a Level II trauma center. According to the hospital’s press release, the designation recognizes the hospital’s commitment to providing optimal care for sudden, life-threatening injuries.
Let me share a story with you and then you decide whether LGMC is committed “to providing optimal care for sudden, life-threatening injuries.
A middle-age man contacted our office with the following story. He recently began experiencing back pain and went to the new Lewis Gale ED at Blue Hills. He was examined and diagnosed with a lumbar strain and sent home. Within hours the pain became unbearable and he returned to the Blue Hill ED with his wife. His wife was told that he would remain in the Blue Hills ED overnight for observation. The next morning his back pain was no better, he had lost control of his bladder, and both of his legs were so weak he could not walk. Correctly, he was promptly transferred to the Emergency Department of LGMC where more highly skilled care could be provided.
The loss of bowel or bladder control in a patient with back pain can be a medical emergency. The most feared and dangerous diagnosis from these types of symptoms is called “cauda equina syndrome (CES).” This syndrome occurs when the nerve roots in the lumbar spine are compressed, cutting off sensation and movement. The loss of sensation, bladder and bowel incontinence, and lower extremity paralysis can become permanent if the pressure on the spinal cord is not released as soon as possible.
What happened to this middle-age man? He arrived in the Emergency Department at LGMC at 9:34 AM. A Magnetic Resonance Imaging study (MRI) was correctly ordered upon his arrival. This study could (and did) confirm the working diagnosis of CES and the precise location of the spinal cord compression. The MRI study was not completed for another 6 hours and that is not the worst part of the story. Despite having confirmation of the presence and location of the compressed spinal cord, and not having an available neurosurgeon to undertake emergent surgery, the Emergency Department at LGMC did not call for an ambulance to transfer the patient across town to Carilion Roanoke Memorial Hospital until 5:33 PM – two hours after having confirmation of a surgical emergency. It gets worse…the ambulance to transfer the patient to Carilion Roanoke Memorial Hospital did not arrive at LGMC until 7:30 PM – another delay of two hours. The patient was transferred to the Operating Room at Carilion upon arrival but the decompression surgery, provided way too late, was not successful and the patient continues to have urinary incontinence and cannot walk.
My Question: Does this sound like a Level II trauma center to you?