By Gary Pinnell
Highlands Today
SEBRING, Fla. — Four months ago, when her husband had a stroke and seizures, Becky Crivello asked the emergency medical technician to call Aeromed. She wanted her husband flown to Tampa General.
EMS took him to a local hospital instead. On Tuesday, she complained to the Highlands County commissioners.
“This happened Feb. 22,” Crivello said. “About 5 p.m., my husband suffered a stroke and seizure. We immediately called 911. He was breathing. He had fallen. He was not conscious or aware of what was going on.”
When EMS arrived, she relayed the information to the EMT. “My husband had already been to Tampa General. They had a surgeon at Tampa General on staff. He needs Aeromed. We have a place for it to land. It’s just a quarter of a mile from my home. I kept explaining it to them, over and over again, that we needed to get to Tampa.
“While a paramedic worked on my husband. I kept getting more and more vocal. I wasn’t as nice with the person I was speaking with. My husband needed to be in Tampa, he did not need to be at a hospital here. There was no one to care for him here, at our facility,” Crivello said. “If he had not been unconscious, if he had not been breathing, I would have put him in my car and driven him, because I’ve done that before.”
“I know they’re concerned about the expense,” Crivello said. Flights typically cost about $12,000. “I told them that I was aware of the cost. I would empty my checkbook, I would empty my retirement account, I needed to get my husband to the doctor to get the care that he needed.”
Crivello has EMT training, she said. “I lost my battle. We went to Florida Hospital instead, where he had another seizure. He was brought into the emergency room.”
Although a nurse, a nurse in training and a phlebotomist treated her husband, no one asked her for information about her husband, she said. “I have a notebook this thick – she held two fingers about six inches apart – full of medical information,” she said. “He’s had a heart valve, he’s had Hodgkin’s Disease, he’s had major surgery. Apparently, his name was in the computer, so they were able to pull it up.”
Her husband had two more seizures, she said. “No one else came in. No nurse came in. No doctor came in. There’s a doctor on the bill, but he never walked into his room.”
Then the emergency room doctor, Cary Pigman, walked by. “I said, thank God. I said, ‘Dr. Pigman, I think we need to be in Tampa,’ and he said, ‘Yes you do. Let me make a call.’ He returned within a few minutes and said Aeromed is on its way.”
Aeromed said her husband had another seizure on the way to Tampa, she told commissioners. “Unfortunately, we spent four or five hours in limbo. His memory is still affected by these events, and we wonder if he had received the medical care we had asked for, would his memory be more intact?”
She was told the county commission was the place to file a complaint. “So here I am. I stand before you to ask you to readdress how Aeromed is used in our county.”
She held up stickers that said, “Please take me to Tampa General in an emergency.”
“I will have this tattooed on him if it will get the help that we need,” she said.
EMS Director Harvey Craven told her that if she brought a letter to him stating there were no doctors in Highlands County who could provide the proper medical care, he would make an exception for her husband.
“That’s awesome, but it helps no one else in this room,” Crivello said. “I have one from Dr. Pigman that says we have no neurosurgeon.”
“I did make sure that Mr. Craven called you and spoke to you about the whole issue, and he did check the protocol, about how the EMT handled your case, and the medical director said everything was handled according to your protocol,” County Commission Chairman Ron Handley said.
Craven said he called EMS Medical Director Dr. Donald Geldart, who is on staff at Florida Hospital Heartland. “EMS makes use of helicopters mainly for trauma,” Craven said. “We do (fly) strokes that meet certain criteria. And that’s according to the stroke center, which is Florida Hospital Heartland. Their neurologist, who is Dr. (Bridglal) Ramkissoon, has set up criteria which follows along national standards of the American Heart Association, on where these people need to go, stroke wise. And it’s time sensitive. That’s where our transport protocols come in.”
Use of the helicopter is reserved for time-critical circumstances, Craven said. “For example, trauma alert. This needs to get to a state trauma center quickly.
“My thought was, if he was continuing to have seizures, he needed to go to the closest facility for stabilization. They would transfer him out to Tampa General,” Craven said.
State laws also govern where trauma patients and other patients are transported by ambulances, Craven said. “But it all falls on Dr. Geldart and the national standards.”
“If this issue arises again, then you will know this specific case, and handle it accordingly?” Handley asked.
“Exactly, that’s not a problem,” Craven said.
“How will you know, if that happens again?” Commissioner Greg Harris asked. “You’ll put it in the system?”
“Yes,” Craven said.
“That’s not true,” Crivello said. “Because I have a letter on file at EMS. I have a tonsil that, if it gets infected, could very well block my airway. And I am a patient of the head (ear nose and throat doctor) at Tampa General. And I have brought pictures and filled out a form. I’m supposed to be sent straight to Tampa General. And (Craven) had no knowledge of that whatsoever. So if he doesn’t know, the paramedics and the EMTs certainly aren’t going to know.”
“The sheriff just informed me that once we get the letter, we’ll input it into her dispatch,” Craven said. He also agreed to search for letters that have already been received so they could also be put in the 911 system.
“We sympathize with your story,” Handley said, “but our EMT did what he was supposed to do.”
“We take stroke alerts to Florida Hospital,” Craven said. “Because we can’t determine if they are a blockage or a bleed, in the field.”
“We do get letters, occasionally, from Tampa General and other hospitals occasionally. And we do spread that to our people to that they know that this address, this person, needs this care, and he’s going to be taken where. Now, if he’s in cardiac arrest, he’s going to a local hospital. The helicopter doesn’t take cardiac arrests.”
“Protocols are guidelines,” Crivello argued. “It all depends on the situation… He needed to be where his doctors were. He was in Florida Hospital and never once, never once saw a neurologist.”
“These are medical issues,” County Attorney Ross Macbeth advised. “This board is uniquely unqualified to be making decisions on matters like this.”
———
©2015 the Highlands Today (Sebring, Fla.)