Las Vegas trauma center closes

LAS VEGAS — Critically injured patients in a four-state region were going to local emergency rooms for medical attention yesterday after the only trauma center in Las Vegas closed its doors.

The top-level trauma center serving southern Nevada and parts of three neighboring states shut its doors Wednesday after private surgeons at the county-operated medical center refused to return unless Nevada lawmakers cap soaring medical-malpractice awards.

"You're looking at a dead trauma center," said Dr. John Fildes, trauma-center director at University Medical Center (UMC) in Las Vegas.

The closure came after orthopedic surgeons took themselves off their normal rotations, citing rising insurance premiums for high-risk trauma duties. It had an almost immediate effect in Las Vegas, a city of almost 1.5 million residents where officials expected 260,000 Independence Day weekend visitors. With no Level I treatment center for car-crash, gunshot or other life-threatening injuries, patients were being taken to hospital emergency rooms.

"We're going to help. We're going to take them to the closest hospital," Tim Szymanski, Las Vegas Fire Department spokesman, said yesterday. Officials said critically ill patients would be stabilized at emergency rooms and, if necessary, flown more than an hour by medical helicopter to trauma units in California, Arizona or Utah for specialized treatment.

Nevada's only other trauma center is Washoe Medical Center, 450 miles away in Reno.

A Level I trauma center staffs specialists and surgeons round-the-clock, while emergency rooms have doctors on call. Nevada Gov. Kenny Guinn stuck Wednesday to a plan to call a special session of the Nevada Legislature after July 26 to deal with medical malpractice issues.

In April, the Republican governor created a state-underwritten insurance fund to help surgeons, obstetrician-gynecologists and other physicians in high-risk fields who face skyrocketing insurance premiums. The crisis came after the largest carrier in the state, the St. Paul Insurance Cos. of Minnesota, pulled out in December.

Nevada Assembly Speaker Richard Perkins, D-Henderson, called the center's closure a strike.

Perkins said he hoped the trauma-center surgeons would return to work while legislators and a panel of medical, legal and insurance representatives work on a solution.

Fildes said the county-run UMC Trauma Center was rated as the third-busiest among 67 surveyed nationwide last year by the Chicago-based American College of Surgeons' National Trauma Data Bank. Its 11,439 patients last year had a 95 percent survival rate, he said.

Dr. Donald Palmisano, president-elect of the American Medical Association, issued a statement Wednesday calling for Nevada to model medical-malpractice tort changes on California's 25-year-old Medical Injury Compensation Reform Act. It limits attorney fees and caps jury awards at $250,000 for pain and suffering in medical cases.