Teen’s death fuels trauma care debate

Molly Ball, Cy Ryan and Dan Kulin

Monday, Aug. 30, 2004 | 11:02 a.m.

When 17-year-old Lee Masangkay was beaten in the Boulevard mall, suffering injuries that later turned out to be fatal, the ambulance didn't take him to Sunrise Hospital, even though it is located next door to the shopping plaza on Maryland Parkway.

Instead, he was taken to University Medical Center three miles away, where trauma specialists were waiting, equipped with specialized knowledge to deal with severe injuries.

There is no evidence that Lee, who died of his injuries three days after the Aug. 21 beating at the hands of gang members, would have survived if he had gotten to a hospital sooner. But health officials are getting angry phone calls about the incident, highlighting the contentious debate over trauma care in the Las Vegas Valley.

Dr. Joey Villaflor, chairman of the state Health Board, told board members about the phone calls at Friday's meeting and used the case to illustrate his view that patients would benefit from Sunrise's proposed addition of a trauma center.

Lee wasn't taken to Sunrise because it would have been against the law. By state statute, all trauma patients within 30 minutes of a certified trauma center must be taken there first.

The story showed, Villaflor said, that "we need to expand the system, and we should do it right away."

He added, "If I get shot in front of Sunrise, I want to go to Sunrise."

But opponents of Sunrise's plan said arguments like Villaflor's missed the point. They don't deny that more trauma care is needed, but they say it ought to be implemented carefully and with local input.

Debate at Friday's meeting, held in Carson City with Las Vegas participating via teleconference, was heated, pitting members of the state Health Board against each other, Clark County representatives and hospital administrators.

The county Health Board was unanimously outraged when State Health Administrator Alex Haartz gave Sunrise the go-ahead to apply for a provisional license to open a trauma center -- just days before a county group was scheduled to return recommendations for planning the region's trauma system as a whole.

"What the report says is, you should not create another trauma center until you have a trauma system," said state AFL-CIO Executive Secretary-Treasurer Danny Thompson, who served on the citizens task force, whose suggestions were set aside.

Thompson said Haartz acted illegally by allowing Sunrise to apply for the provisional license. Instead, he said, Sunrise should have asked the health board for a variance -- an exception to the regulations, granted when unusual circumstances are present.

But as Regional Chief Deputy Attorney General Randal Munn explained at the meeting, the law does not allow for Sunrise to do that. In fact, he said, there is a Catch-22: For the state to designate a trauma center, it must be approved by the American College of Surgeons; for the college to approve it, it must be up and running, but it cannot operate without state designation.

Munn argued that Haartz's approval was within legal bounds, but some disagreed.

"Trauma care in Southern Nevada has been done a disservice by the recent action of the staff (Haartz)," board member Dr. Jerry Reeves of Las Vegas said at the meeting.

No action was taken on the contentious issue at the state meeting. On Thursday, the county board voted to allow County Health Officer Dr. Donald Kwalick to hire a private consulting firm to help develop a trauma system and draw a map to determine where patients should be taken.

The consultant's work is expected to cost about $90,000. Kwalick said he hoped UMC, Sunrise and St. Rose Dominican Hospital -- which is seeking lower-level trauma designation at its Siena Campus in Henderson -- would contribute to the cost.

In calling for a consultant, the county is showing that it will not let an administrator in Carson City dictate the shape of health care in Las Vegas, said Dan Musgrove, the county's director of intergovernmental relations.

"The (county) Health District took a stand that they're going to develop a system, and that's the way to go," he said. "We don't gain a lot as a valley if we just put things in willy-nilly."

Blain Claypool, UMC's chief operating officer, said trauma service is most needed in the southern part of the valley. "That's where the system is being stretched," he said -- not right down the road from UMC's facility.

Musgrove also argued that, while the valley's growth will eventually require more trauma services, the situation is not yet acute. "There is no emergency, no reason to rush," he said.

But Ann Lynch, Sunrise's vice president for community affairs, rejected that argument. "That's like saying the roof's got some split tiles, I think it's going to leak -- but we're not due for rain for six months, so let's not fix it," she said.