The Washington Hospital Center announced yesterday that it has begun construction of a new helicopter pad and an admission and treatment area for patients suffering from life threatening injuries or illness.
The new Medical-Shock-Trauma Acute Resuscitation Unit (MEDSTAR), scheduled for completion in February, will give the Hospital Center physical facilities even better arranged than those at the renowned Shock Trauma Unit located at University Hospital in Baltimore.
The Hospital Center unit's landing pad will be 70 feet from the door of the unit, rather than the several blocks that separate the Baltimore unit from its helicopter pad.
The new unit, located on the ground floor of the Hospital Center's present intensive care tower will include six resuscitation bays, a trauma room, X-ray facilities and an operating room.
It is not clear yet what effect the construction of the new facilities, which will be manned by teams of specialists, will have on the long-festering dispute between Maryland and the District over the treatment of Washington area trauma patients.
The feud between the medical offices has centered on th e question of where patients injured in Maryland should be transported.
There have been several instances of patients, severely injured within blocks of the District's border with Maryland being carried in Maryland State Police helicopters across the city and the Hospital Center to Baltimore for treatment.
Maryland officials have conceded that persons injured inside the city should not be transported to Baltimore, but they concede little else.
The position of those responsible for Maryland's nationally admired emergency medical system is, in effect, that no matter where the critically injured patient is, as long as he is in Maryland, treatment at the established Baltimore unit is preferable to treatment at any D.C. facility.
"Once they are here, they will have a better chance of surviving," says Marianna Herschel, spokeswoman for the Baltimore Shock Trauma Unit.
"The patient who is bleeding to death shouldn't be flown to Baltimore," counters Dr. Vincent Roux, chairman of the District advisory committee on emergency medical services.
The feud is pictured by those involved as a dispute over which jurisdiction offers of the best care in life-threatening emergencies. But others say the problem also involves financially based fears of empty hospital beds and an alleged personal antagonism between the head of the Maryland system, Dr. Adams Cowley, and the chief of the Hospital Center's trauma service, Dr. Howard Chamberpior., former protege of Cowley's.
"The disagreements between the two groups are basically based on the personalities of two men," said Roux. "It has been a battle between Cowley and Champion, with each man leaking stuff in the press and which . . . I have been trying to mediate for six months to a year."
Cowley refused to comment directly on the alleged feud between he and Champion, stating through a spokeswoman that he has "no problems" with Champion.
Champion said yesterday that "there are no hard feelings between us. We have a most cordial relationship."
The new unit at the Hospital Center will be very different from the Baltimore unit in some respects, and extremely similar in others.
In the way it will handle trauma victims - those injured in auto accidents shootings, industrial accidents, etc, the new Wasington unit will, in effect, be a copy of the facility in Baltimore.
It differs, however, in that it will also handle nontrauma medical emergencies, such as severe heart attacks, patients with respiratory failure and patients with internal bleeding caused by disease, rather than by accidents tr add five
The Baltimore unit handles only emergency surgical cases.
Officials of the Maryland emergency, medical system have been contending that it is up to the District of Columbia to designate one trauma facility for the city before Maryland officials agree to send any Maryland patients into Washington.
In the meantime, however, the Maryland system has agreed to include an eye trauma service at Georgetown University Medical Center as part of the Maryland system, and some Maryland patients are flown to the burn unit at the Hospital Center.
Herschel said yesterday that the development of the new facility at the Hospital Center will mean that Maryland officials will have to reconsider whether there is a need to include a D.C. facility in the Maryland system.
Sixty-five of the 250 patients treated by the Hospital Center's shock trauma team between January and September of this year were flown to the Hospital by U.S. Park Police helicopters, which do carry Maryland residents into the city.
The dispute between the jurisdictions has reached the point where Park Police officers tell storeis of victims being airlifted from the WOodrow WIlson Bridge, on the D.C. line, to be flown past the Hospital Center to Baltimore.
"We're talking about a 22-minute flight bo Baltimore versus a one-minute flight to the Washington Hospital Center. As far as we are concerned, it's playing games with people's lives," said one Park Police officer.
And there are other acconts of Maryland's refusal to even lend its helicopter assistance to transport patients from Maryland hospitals to District hospitals.
Last March, for example, D.C. neurosurgeon Bernard Stopak wanted a 9-year-old patient at Montgomery General Hospital, who was "dying on the spot" from a bullet wound in the head, transported to Children's Hospital National Medical Center, in the District, for a brain scan.
When Maryland police refused to helicopter Stopak and his patient to Children's rather than Baltimore, the neurosurgeon requested help from the Park Police. It took the Park Police seven minutes to airlift the child since recovered - to Children's.
"The kid was dying, in extremis, and I needed something that was absolutely vital," Stopak said recently. "It was unreasonable to make me go to Baltimore where I have no privileges just so they could go to the shock trauma center (where) I would have had to give up the patient."
Pediatric trauma patients in Maryland are, in fact, taken to Johns Hospital University Hospital, rather than to the Shock Trauma Unit.