John Robbins wrote in Niagara This Week, Dec.6, 2011:
Unlike many remote parts of Ontario, Niagara has the benefit of being located close to a well-equipped trauma centre just across the river in Buffalo.
But despite that fact, it seems few patients are actually transported directly from the scene of an accident by land ambulance to Erie County Medical Center.
In his more than 14 years serving as a paramedic in Welland, Niagara Falls, Fort Erie and Port Colborne, Timothy Harrold has never taken a patient directly to ECMC, regardless of the extent of the person’s injuries.
And part of reason for it has to do with the rules governing cross-border patient transfers, Harrold told a coroner’s inquest in Welland on Monday.
“We can’t cross into the United States without permission,” said Harrold, the Niagara Emergency Medical Services acting supervisor on the night of Dec. 26, 2009 when 18-year-old Reilly Anzovino was critically injured in a car accident on Highway 3 near Nigh Road in Fort Erie.
Harrold was in Niagara Falls at the time the dispatch call was received, but he immediately asked to be assigned to the call given the seriousness of the accident and the fact there were multiple patients involved.
Arriving around midnight, Harrold took command of the accident scene and set about determining which patients should be transported to which hospitals.
Having spoken with the paramedic caring for Anzovino, who was by this time already in an ambulance, Harrold decided the most logical place for Anzovino to be transported was the nearest Canadian emergency department, located at Welland County General Hospital to the north-west of the accident scene.
While he briefly considered sending Anzovino to the trauma centre at ECMC, he soon ruled out a cross-border transfer.
The inquest has heard previously an air ambulance had been requested, but was grounded due to poor weather conditions.
Harrold testfied before sending Anzovino to ECMC he would have had to obtain permission from a emergency physician at the base hospital in Hamilton and the doctor evaluating the request would have required a “head-to-toe assessment” of the patient’s condition before granting the request.
Given the length of time the ambulance had already been on location at the scene of the crash and the foggy and icy conditions he figured were likely worse closer to Buffalo, Harrold said it was agreed the best place to transport Anzovino was Welland County General.
Although Port Colborne General hospital and Fort Erie’s Douglas Memorial hospital were closer than Welland, emergency departments at those two facilities had been converted to urgent care centres months prior to the accident as part of a larger restructuring of hospital services in Niagara.
One of the main issues the five-member inquest jury has been asked to consider is whether the closure of the ERs in Fort Erie and Port Colborne played a role in Anzovino’s death.
Even if those ERs hadn’t been shuttered, in Harrold’s opinion a patient suffering from life-threatening internal injuries, as Anzovino was, would still have been better off going to Welland County General hospital, where emergency surgery can be performed and doctors have access to advanced diagnostic imaging equipment, such as a CT scanner.
Dr. Jack Stanborough, the regional coroner who is presiding over the inquest, seemed surprised to hear that Harrold had never taken an accident victim directly to a ECMC during his career.
“I don’t get the sense Niagara trauma patients are ending up at trauma centres,” Stanborough said."
So, then: where are Niagara's trauma patients "ending up"??
Somehow, Helen Harris, a former St.Catharines city hall employee, did end up in a Buffalo hospital (and not in any Ontario hospital); she died.
How and why did that happen? No one knows.
There was no inquiry: it might have led to embarrassing questions about the shortage of medical facilities in Niagara courtesy of McGuinty's Liberal single-payer health monopoly.
Jim Bradley won't say anything about the American health system, except, of course, being the proud Liberal he is, to smugly demonize and denigrate it - while Ontarians are heading to the States for health care.
Is the issue here about cross-border medical co-operation, so that Ontarians from McGuinty's single-payer health-care nirvava can access American health care facilities, or is the issue about how McGuinty's ideological, rigid Liberal single-payer health-care monopolism has harmed the ability of Ontarians to have the best care here at home?
The problem is not Buffalo; the problem is McGuinty's disastrous Liberal bait-and-switch health-care monopolism.