Fresno doctor slams ‘reckless’ hospital as some trauma services lapse amid Creek Fire
Community Regional Medical Center suspended neurosurgical trauma services to new patients over the weekend, after critical contract negotiations broke down once again.
“Right now, what happens is that if a patient needs neurosurgical care, Community Medical Center cannot provide them, and those patients are transferred to a location that can provide that care,” said Lauren Nickerson, communications director for Central California Faculty Medical Group.
Craig Castro, president and CEO of Community Medical Centers, confirmed neurosurgical trauma coverage was still unavailable at the hospital as of Monday.
“While we had hoped that by now an agreement could be reached with CCFMG for neurosurgical trauma coverage, we also have worked simultaneously over the weekend to seek alternate coverage,” Castro said Monday in a written statement to The Bee. “Either way, we expect to have neurosurgical trauma coverage restored in a day or two.“
CRMC was still treating almost all patients at the Fresno hospital over the weekend. However, patients requiring neurosurgical trauma services, such as treatment for major head injuries, were transferred to other hospitals across the state.
Stalled negotiations left six neurosurgeons without a contract as of Wednesday. Nickerson said the six surgeons continued to work over the weekend anyway, with pay, but were only able to tend to existing patients. She said negotiations for a temporary contract for those six doctors also failed.
Castro, however, said CRMC offered multiple proposals during weekend negotiations, “including one (on Sunday) around 6:30 p.m. that we believe meets all CCFMG’s demands.”
He said they remain unsure if CCFMG leaders have seen or reviewed this proposal.
News of the latest setback in the hospital’s contract standoff comes as the Creek Fire torches thousands of acres in eastern Fresno and Madera counties, leaving dozens of people injured, with hundreds forced to evacuate their homes and businesses.
Burning since Friday evening, the Creek Fire has consumed around 80,000 acres as of Monday afternoon. The blaze continued to burn on both sides of the San Joaquin River near Mammoth Pool, Shaver Lake, Big Creek, and Huntington Lake.
The cause of the fire remains under investigation. Nearly 1,000 firefighters were battling the out-of-control blaze on Monday.
Tensions mount amid CRMC contract standoff
In total, 28 providers are in negotiations for new contracts, but only those six provide immediate trauma services that are crucial during an emergency, Nickerson said. Trauma care is of particular importance during the wildfires, she added.
“When disasters happen, it’s not just the injuries you would expect,” Nickerson said. “There were reported injuries where there was also car accidents, or a car accident of people trying to flee the Castle Fire. You could absolutely have head trauma.”
Nickerson was unable to say whether any Fresno-area patients required treatment for head injuries over Labor Day weekend. It also wasn’t immediately clear which hospital would take those patients, though Fresno is the only Level I Trauma Center between Sacramento and Los Angeles.
“We are deeply disappointed that when given a clear opportunity to solve the immediate neurosurgical trauma coverage crisis, senior hospital leadership refuses to finalize any sort of bridge funding agreement,” James Davis, MD, FACS, Chief of Trauma at CRMC and Chief of Surgery at UCSF Fresno, said in a news release.
“Allowing coverage to lapse during the busy holiday weekend is detrimental and reckless,” he added. “CMC said they would solve this crisis by bringing in locum physicians from outside of the area. However, bringing in neurosurgeons from outside of the region instead of negotiating with your long-term partners and the neurosurgeons who are already providing the care for Valley patients is baffling.”
Tensions between the two sides have been mounting since last week.
Late last week, Castro criticized the doctors’ group of conveying “misinformation” in the media, which he described as “shocking.”
Castro has said CCFMG neurosurgeons of “unilaterally terminated a call agreement” that interrupted services as of midnight on Wednesday.
“CMC has been working on these complicated changes since May and from the beginning has sought to be transparent and to earn the full cooperation of CCFMG,” Castro wrote. “Though CMC has in earnest proposed solutions to every concern, the initial agreements we presented in July have yet to be completed as a result of CCFMG’s lack of full cooperation.”
Is CRMC’s Level I Trauma Center status in jeopardy?
A Level I Trauma Center means that all services related to trauma are immediately available, in-house, 24 hours a day, seven days a week.
The Fresno hospital is the only Level I center between Sacramento and Los Angeles.
As of Friday, CRMC’s elite status remained intact on paper. Castro has said the status isn’t in jeopardy
The county’s Emergency Medical Services agency is responsible for overseeing the Level I Trauma Center status of CRMC.
Dan Lynch, Fresno County’s EMS director, confirmed the crucial designation wasn’t immediately vulnerable on Friday.
“As long as they have a plan to correct this deficiency in a short period of time, we will try to work with them in maintaining their designation as a Level I,” he said. “We are waiting for an update... but I feel pretty good that they have a good plan to get the services back, we are not taking any action right now to remove their status.”
Lynch could not immediately be reached for comment before print deadline Monday.
This story was originally published September 7, 2020 at 11:00 AM.