EMERGENCY CARE TMH removes Level 3 trauma label

Humility of Mary Health Partners doubted the designation was valid.
By WILLIAM K. ALCORN
VINDICATOR HEALTH WRITER
WARREN -- Trumbull Memorial Hospital, acting on a recommendation from the Ohio Department of Health, has voluntarily withdrawn its self-designation as a provisional Level 3 trauma center.
Trauma centers -- ranging from the highest, Level 1, to the lowest, Level 3 -- provide higher levels of medical care for trauma patients than regular emergency departments.
A Level 1 center is a regional facility that can provide care for every aspect of injury, according to St. Elizabeth Health Center in Youngstown, a Level 1 trauma center.
Level 2 centers provide most types of trauma care, but may not have all the surgical specialties available to handle severely injured patients.
Level 3 centers provide basic trauma care, but need to transport severely injured patients, including those that require highly specialized surgery because of head injury, amputation or other significant injury, to their designated Level 1 trauma center, St. Elizabeth officials said.
Inspection
TMH, after an inspection by an American College of Surgeons trauma team in mid-March, faxed a copy of the transcript of the ACS exit report to ODH and was told by Dr. Virginia A. Haller that it appeared TMH has met the requirements for acting as a provisional Level 3 trauma center.
As a result, TMH declared that it was a Level 3 trauma hospital.
At a press conference last week, however, Humility of Mary Health Partners officials, whose St. Joseph Health Center in Warren also is seeking Level 3 trauma center status, doubted the validity of TMH's claim of Level 3 status because of the speed with which it was achieved, and asked ODH to look further into the matter.
As a result, Dr. Haller wrote a letter to Kevin M. Spiegel, TMH chief operating officer, saying that she gave her opinion that TMH appeared to meet Level 3 requirements "under the assumption that TMH had already received a written consultative report from the American College of Surgeons."
The document that TMH sent to the state health department and Dr. Haller was a written transcript of the exit discussion that TMH had with the ACS team. To achieve provisional status, Dr. Haller wrote in her letter to Spiegel, Ohio requires that a hospital have a written report of the ACS team's final report.
Misunderstanding
Dr. Haller said she did not understand at the time that TMH's action was based on an exit interview. Further, she said ODH has no authority to approve or disapprove the provisional trauma center status of a hospital.
Because TMH does not have an official written report from ACS, and given that Ohio law is based on ACS criteria, Dr. Haller recommended that TMH reconsider its declaration of trauma center status.
Spiegel said when TMH does receive the final written consultative report from the ACS, the matter will again be taken to the hospital's trauma committee and its board of directors for a vote to declare TMH a provisional Level 3 trauma center.
"While we believe what we did was in the best interests of the residents of Trumbull County, it does not fit into the technical guidelines of the law," Spiegel said.
Practicing
"TMH has been acting internally [practicing] as a Level 3 trauma center since Jan. 1, 2004. We believed we meet the guidelines, and declaring ourselves a Level 3 trauma center seemed the reasonable thing to do," he said.
Spiegel said he does not believe the events over the past week will hold up its effort to become a Level 3 trauma center.
"I don't think it was a misunderstanding on our part. We acted on the advice of ODH and the state Emergency Medical Services. We believed that as long as we developed a corrective action plan, it was acceptable," Spiegel said.