The Register-Herald, Beckley, West Virginia

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May 18, 2013

Details still ‘sketchy’ concerning shutdown of cardiac stent procedures at RGH

BECKLEY —  The four-day suspension of heart stent procedures at Raleigh General Hospital due to an “unexpected availability of physician coverage” and without further explanation has left more questions than answers, answers that, according to hospital spokesman and Director of Marketing Kevin McGraw, will not be available until at least Monday.

McGraw said Friday that RGH CEO David Darden is out of town and unavailable for further comment. In the meantime, at least one other local hospital has changed protocol to accommodate patients who may require urgent cardiac catheterization by transferring them to Charleston as a result of the announcement.

Coronary angioplasty (or PCI) and stenting are procedures used to open clogged coronary arteries, the arteries supplying the heart, and are “life and death services” to patients experiencing an elevated ST segment myocardial infarction, says Beckley Appalachian Regional Hospital lead Emergency Room physician assistant Farrah Zahir. A STEMI, as it is also known, is the more severe type of heart attack, and patients experiencing it have a matter of minutes for their occlusion to be medically addressed before heart muscle begins to die, seriously threatening the health of the heart and the life of the patient.

At least for this weekend, indicates Zahir, STEMI patients coming to BARH who may have been appropriate transports to nearby Raleigh General Hospital will be given the appropriate oral medications and clot-busting drugs, if indicated, then transported instead to Charleston Area Medical Center, 45 minutes away. BARH had been taking advantage of the cardiac catheterization services available at Raleigh General Hospital since the unit’s opening in 2009. The availability of emergency catheterization services only five minutes away, especially for patients for whom time is of the essence, is not something to take for granted, explains Zahir.

“When a patient comes in with chest pain, an EKG (electrocardiogram) is done and within two minutes, that patient is brought into the hands of the attending physician here. If the patient has an ST-elevation MI, oral thrombolytics (anti-clotting agents) are given and they are literally out of here in 20 minutes.”

Now that services have been suspended until Monday, the BARH ER team has made arrangements with an interventional cardiologist in Charleston who will be on call for the weekend to receive STEMI patients presenting to BARH. “We have a good working relationship with CAMC. Getting these patients to a facility that has a cardiac catheterization department is imperative. As always, we will implement the appropriate treatment protocol until we can get them to the interventionalist in Charleston, if needed.” Despite what may be happening at Raleigh General Hospital, indicates Zahir, “people will still be in good hands when they come here.”

According to Phillip Bolt, director of the Beckley Regional Command Center, all is “business as usual.”

“We will continue to follow the protocols (for patient transport and treatment) that guide the Command Center, whether it is a cardiac emergency, or other, like an orthopedic emergency. We deal with these types of situations on a daily basis, where we’ll have to divert patients to another facility because a hospital is overwhelmed with a lot of patients or if there isn’t an orthopedic physician on call, for instance. There is emergency protocol in place that directs how we address patients on a case by case basis.”

Mike Darby, chairman of the Board of Directors for Raleigh General Hospital, said, “The only thing I can say is that David Darden and Kevin McGraw, I know, understand this is important to the public and I am sure they will share more information as soon as they are able.”

The Register-Herald attempted to contact several additional board members, but no one else offered formal comment or explanation as to the cessation of services.

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