District of Columbia fire department ambulances should no longer take critically ill or injured persons to Capitol Hill Hospital, the city's Emergency Medical Services Advisory Committee recommended yesterday.
According to sources on the committee, the group, an advisory body to the Department of Human Resources, recommended that the passby remain in effect for as long as the hospital's emergency room license remains on "provisional" status.
That license was downgraded to "provisional" by DHR inspectors after an auto accident victim died of severe internal injuries 55 minutes after being discharged from Capitol Hill, where he was diagnosed only as having fractures of three ribs.
Committee chairman Vincent J. Roux, medical director of Howard University Hospital, refused to discuss the recommendation until after it is considered by DHR director Albert P. Russo.
Sources said, however, that the proposal was one of several considered, and had been brought to the committee by Dr. William Washington, Russo's adviser for health affairs.
There were three basic proposals, the sources said: "There was the suggestion that it be voluntary; if they don't do it, then we zap them. And there were suggestions, not accepted, that we cut off all ambulance service."
"The idea of closing down the emergency room was not thought to be a good one," a source said, "because that would cause a serious dislocation of emergency medical services in the community and probably punish the hospital more than it needs to be.
"I think this is a clear signal to this hospital and any hospital, that medical care had better be of good quality."
Members of the committee acknowledged that assessment of whether individual cases are life threatening will be made by city ambulance personnel, some of whom are not trained to make such decisions.
The auto accident victim, Howard Smith, undoubtedly would have been taken to Capitol Hill under this system, because his injuries did not appear to be life threatening, sources said.
Since the Smith case, which occured March 3, became known 10 days later, two other cases have come to light in which questionable medical judgments in the hospital's emergency room were followed by the patients' deaths a short time later at another hospital, D.C. General.
District Mayor Marion Barry said at a press conference two weeks ago that if the EMS advisory committee recommended taking Capital Hill off the ambulance list, he would act on the recommendation.
Capitol Hill administrator Ray V. Terry, declined to comment on the committee's action last night, saying he had not been informed of the decision. Terry said that within the next week to 10 days he expects to receive a report on the hospital's emergency room prepared by a group of outside experts called in by the hospital.