Tag Archives: injuries

‘Trauma Centers’ Huge Fees to Treat Minor Injuries and Send Home

The care was ordinary. A hospital in Modesto, California, treated a 30-year-old man for shoulder and back pain after a car accident. He went home in less than three hours.

The bill was extraordinary. Sutter Health Memorial Medical Center charged $ 44,914 including an $ 8,928 “trauma alert” fee, billed for summoning the hospital’s top surgical specialists and usually associated with the most severely injured patients.

The case, buried in the records of a 2017 trial, is a rare example of a courtroom challenge to something billing consultants say is increasingly common at U.S. hospitals.

Tens of thousands of times a year, hospitals charge enormously expensive trauma alert fees for injuries so minor the patient is never admitted.

In Florida alone, where the number of trauma centers has exploded, hospitals charged such fees more than 13,000 times in 2019 even though the patient went home the same day, according to a KHN analysis of state data provided by Etienne Pracht, an economist at the University of South Florida. Those cases accounted for more than a quarter of all the state’s trauma team activations that year and were more than double the number of similar cases in 2014, according to an all-payer database of hospital claims kept by Florida’s Agency for Health Care Administration.

While false alarms are to be expected, such frequent charges for little if any treatment suggest some hospitals see the alerts as much as a money spigot as a clinical emergency tool, claims consultants say.

“Some hospitals are using it as a revenue generator,” Tami Rockholt, a registered nurse and medical claims consultant who appeared as an expert witness in the Sutter Health car-accident trial, said in an interview. “It’s being taken advantage of” and such cases are “way more numerous” than a few years ago, she said.

Hospitals can charge trauma activation fees when a crack squad of doctors and nurses assembles after an ambulance crew says it’s approaching with a patient who needs trauma care. The idea is that life-threatening injuries need immediate attention and that designated trauma centers should be able to recoup the cost of having a team ready — even if it never swings into action.

Those fees, which can exceed $ 50,000 per patient, are billed on top of what hospitals charge for emergency medical care.

“We do see quite a bit of non-appropriate trauma charges — more than you’d see five years ago,” said Pat Palmer, co-founder of Beacon Healthcare Costs Illuminated, which analyzes thousands of bills for insurers and patients. Recently “we saw a trauma activation fee where the patient walked into the ER” and walked out soon afterward, she said.

The portion of Florida trauma activation cases without an admission rose from 22% in 2012 to 27% last year, according to the data. At one Florida facility, Broward Health Medical Center, there were 1,285 trauma activation cases in 2019 with no admission — almost equal to the number that led to admissions.

'Trauma Centers' Huge Fees to Treat Minor Injuries and Send Home

Broward Health Medical Center in Fort Lauderdale, Florida.

“Trauma alerts are activated by EMS [first responders with emergency medical services], not hospitals, and we respond accordingly when EMS activates a trauma alert from the field,” said Jennifer Smith, a Broward Health spokesperson.

Florida regulations allow hospitals themselves to declare an “in-hospital trauma alert” for “patients not identified as a trauma alert” in the field, according to standards published by the Florida Department of Health.

At some hospitals, few patients whose cases generate trauma alerts are treated and released the same day.

At Regions Hospital, a Level I trauma center in St. Paul, Minnesota, patients who are not admitted after a trauma team alert are “very rare” — 42 of 828 cases last year, or about 5%, said Dr. Michael McGonigal, the center’s director, who blogs at “The Trauma Pro.”

“If you’re charging an activation fee for all these people who go home, ultimately that’s going to be a red flag” for Medicare and insurers, he said.

In the Sutter case in Modesto, the patient sued a driver who struck his vehicle, seeking damages from the driver and her insurer. Patient “looks good,” an emergency doctor wrote in the records, which were part of the trial evidence. He prescribed Tylenol with hydrocodone for pain.

“If someone is not going to bleed out, or their heart is not going to stop, or they’re not going to quit breathing in the next 30 minutes, they probably do not need a trauma team,” Rockholt said in her testimony.

Like other California hospitals with trauma center designations, Sutter Health Memorial Medical Center follows “county-designated criteria” for calling an activation, said Sutter spokesperson Liz Madison: “The goal is to remain in position to address trauma cases at all times — even in the events where a patient is determined healthy enough to be treated and released on the same day.”

'Trauma Centers' Huge Fees to Treat Minor Injuries and Send Home

Sutter Health Memorial Medical Center in Modesto, California.

Trauma centers regularly review and revise their rules for trauma team activation, said Dr. Martin Schreiber, trauma chief at Oregon Health & Science University and board chair at the Trauma Center Association of America, an industry group.

“It is not my impression that trauma centers are using activations to make money,” he said. “Activating patients unnecessarily is not considered acceptable in the trauma community.”

Hospitals began billing trauma team fees to insurers of all kinds after Medicare authorized them starting in 2008 for cases in which hospitals are notified of severe injuries before a patient arrives. Instead of leaving trauma team alerts to the paramedics, hospitals often call trauma activations themselves based on information from the field, trauma surgeons say.

Reimbursement for trauma activations is complicated. Insurers don’t always pay a hospital’s trauma fee. Under rules established by Medicare and a committee of insurers and health care providers, emergency departments must give 30 minutes of critical care after a trauma alert to be paid for activating the team. For inpatients, the trauma team fee is sometimes folded into other charges, billing consultants say.

But, on the whole, the increase in the size and frequency of trauma team activation fees, including those for non-admitted patients, has helped turn trauma operations, often formerly a financial drain, into profit centers. In recent years, hundreds of hospitals have sought trauma center designation, which is necessary to bill a trauma activation fee.

“There must have been a consultant that ran around the country and said, ‘Hey hospitals, why don’t you start charging this, because you can,'” said Marc Chapman, founder of Chapman Consulting, which challenges large hospital bills for auto insurers and other payers. “In many of those cases, the patients are never admitted.”

The national number of Level I and Level II trauma centers, able to treat the most badly hurt patients, grew from 305 in 2008 to 567 last year, according to the American College of Surgeons. Hundreds of other hospitals have Level III or Level IV trauma centers, which can treat less severe injuries and also bill for trauma team activation, although often at lower rates.

'Trauma Centers' Huge Fees to Treat Minor Injuries and Send Home

Emergency surgeons say they walk a narrow path between being too cautious and activating a team unnecessarily (known as “overtriage”) and endangering patients by failing to call a team when severe injuries are not obvious.

Often “we don’t know if patients are seriously injured in the field,” said Dr. Craig Newgard, a professor of emergency medicine at Oregon Health & Science University. “The EMS providers are using the best information they have.”

Too many badly hurt patients still don’t get the care they need from trauma centers and teams, Newgard argues.

“We’re trying to do the greatest good for the greatest number of people from a system perspective, recognizing that it’s basically impossible to get triage right every time,” he said. “You’re going to take some patients to major trauma centers who don’t really end up having serious injury. And it’s going to be a bit more expensive. But the trade-off is optimizing survival.”

At Oregon Health & Science, 24% of patients treated under trauma alerts over 12 months ending this spring were not admitted, Schreiber said.

“If this number gets much lower, you could put patients who need activation at risk if they are not activated,” he said.

On the other hand, rising numbers of trauma centers and fees boost health care costs. The charges are passed on through higher insurance premiums and expenses paid not just by health insurers but also auto insurers, who often are first in line to pay for the care of a crash victim.

Audits are uncommon and often the system is geared to paying claims with little or no scrutiny, billing specialists say. Legal challenges like the one in the Sutter case are extremely rare.

“Most of these insurers, especially auto insurance, do not look at the bill,” said Beth Morgan, CEO of Medical Bill Detectives, a consulting firm that helps insurers challenge hospital charges. “They automatically pay it.”

And trauma activation charges also can hit patients directly.

“Sometimes the insurance companies will not pay for them. So people could get stuck with that bill,” Morgan said.

A few years ago, Zuckerberg San Francisco General Hospital charged a $ 15,666 trauma response fee to the family of a toddler who had fallen off a hotel bed. He was fine. Treatment was a bottle of formula and a nap. The hospital waived the fee after KHN and Vox wrote about it.

Trauma alert fatigue can add up to a nonfinancial cost for the trauma team itself, McGonigal said.

“Every time that pager goes off, you’re peeling a lot of people away from their jobs only to see [patients] go home an hour or two later,” he said.

“Some trauma centers are running into problems because they run themselves ragged. And there is probably unneeded expense in all the resources that are needed to evaluate and manage those patients.”

Read more
This post originally posted here Medscape Medical News

25-year-old dies from injuries after mass shooting on Austin's 6th Street, police said

AUSTIN, Texas — A victim has reportedly died after the mass shooting that occurred in the early hours of Saturday morning in Austin on 6th Street, according to police.

Officials identified the victim as 25-year-old Douglas John Kantor and said he succumbed to his injuries at a local hospital on Sunday afternoon.

25-year-old dies from injuries after mass shooting on Austin's 6th Street, police said

One suspect has been arrested in connection to the shooting that killed Kantor and wounded 13 others, authorities said.

Investigators continued looking for the second suspect involved on Sunday and were working to find out what led to the violence.

“This does appear to be an isolated incident between the two parties,” Chacon said.

Most, if not all of the victims were believed to be innocent bystanders, but investigators continued to review surveillance video of the area.

The gunfire erupted just before 1:30 a.m. along 6th Street, a popular area filled with bars and restaurants.

At the time, the street was barricaded to keep out vehicle traffic, Chacon said.

THE MORNING AFTER: 6th Street’s calm after overnight mass shooting

“Our officers responded very quickly,” Austin Police Department’s interim chief said. “They were able to immediately begin life-saving measures for many of these patients, including applications of tourniquets; applications of chest seals.”

Some officers drove patients to the hospital because of how chaotic the shooting scene was. Chacon said it became hard to contain the crowd and get ambulances to the wounded.

Travis Young was inside his apartment building on on 6th Street when he heard the gunshots.

“By the second gunshot, I was already on the floor,” Young said. “Popped up about 30 to 40 seconds later, and you saw bodies everywhere. People were screaming. People in pain.”

Houston resident Fred Plummer said he’s in Austin for an annual bike rally and returned to the scene of the shooting Saturday afternoon.

Plummer said he had left just moments before gunfire erupted earlier in the day.

“People were texting me asking if I was okay because they knew I was in the area,” Plummer said. “I had to say my prayers again. I was really grateful that whatever it was, moved me to leave. Its, you know, its sad.”

Follow Roxie Bustamante on Twitter, Facebook and Instagram

Copyright © 2021 by The Associated Press. All Rights Reserved.

Author: AP

This post originally appeared on ABC13 RSS Feed

Memorial Day weekend water safety: Officials warn of boat crashes, injuries and even drownings

Memorial Day weekend water safety: Officials warn of boat crashes, injuries and even drownings

AUSTIN (KXAN) — Leading into Memorial Day — as always — lakes and rivers are expected to be busier. 

“Enjoying the weather, a little wake-surf, a little partying, mingling, having a good time,” one lake-goer said.

Out in Devil’s Cove on Lake Travis, dozens flooded in and out Sunday as they took advantage of the holiday weekend.

With more people on the water, those who are familiar with popular areas for boating and tubing are warning safety should always be a priority.

“You get a lot of boat traffic that’s becoming unsafe — people cutting each other off, personal water crafts getting too close to boaters,” Owner of Lake Travis Scuba, Robert Weiss said.

Weiss explained that as the lake changes, some aren’t aware of deep or more shallow areas. He said this can lead to boat-scathed surfaces, and creates a risk for drowning if people aren’t paying attention to their surroundings.

Weiss urges if you’re out drinking, you should pace yourself as drownings become a concern.

“They’re not thinking about some of the possible dangers of being out on a lake,” Weiss said.

Taking a splash into some weekend fun — crowds of thousands are also showing up to the Guadalupe River in New Braunfels, officials said. They’re pleading with everyone to plan ahead before taking a float. 

Memorial Day weekend water safety: Officials warn of boat crashes, injuries and even drownings

“This is not a swimming pool, or a ride, or attraction,” River Operations Manager for the City of New Braunfels, Amy Niles said. “If you’re not a strong swimmer, we encourage you to find some other form of water recreation. We would like all guests to use a life jacket.”

You will catch police out patrolling Lake Travis, stopping boaters when necessary.

Something else to be mindful of, is making sure you leave your valuables behind when going out on the water. 

Weiss said he and his team have found thousands of dollars worth of expensive items this Memorial Day Weekend, including a $ 30,000 watch.

Author: Jala Washington
This post originally appeared on KXAN Austin

LIVE: Multiple injuries in 'active scene' shooting in San Jose, Calif., officials say

LIVE: Multiple injuries in 'active scene' shooting in San Jose, Calif., officials say
SAN JOSE, Calif. — Police are responding to an “active scene” shooting in San Jose, California, Wednesday morning.The shooting happened at the VTA rail yard, where light rail cars are stored.

Multiple people have been injured, VTA spokesperson Brandi Childress told KGO. She wasn’t able to confirm the number of those shot or the extent of their injuries.

Mayor Sam Liccardo said the shooting “left several people being treated,” but also didn’t elaborate.

San Jose Police Department tweeted the “shooter is down.”

The VTA building is not open to the public, so the shooter would have needed employee access or to have broken in, Childress said.

“We ask for people’s prayers,” Childress said.

Police asked that “everyone stay out of the area while we conduct our investigation.”The incident started at 6:50 a.m. PT. A witness told our sister station KGO they heard gunshots.

Santa Clara County sheriff’s deputies are planning to hold a briefing. We’ll be streaming the press conference live.

This is a breaking news report. Check back here for new developments.

Copyright © 2021 KTRK-TV. All Rights Reserved.

Author: KTRK

This post originally appeared on ABC13 RSS Feed

London stabbing: Teenager found with injuries in Havering dies – arrests made

London stabbing: Teenager found with injuries in Havering dies - arrests made
Officers were to Church Road in Havering at 6.41pm where they found one of the victims, believed to be in his mid-teens, had been wounded. They provided first aid with a member of the public and an air ambulance attended, but he was pronounced dead at 7.07pm.
The Met Police are in the process of tracing next of kin and formal identification has not yet taken place. A post-mortem examination will be held in due course.

They were also called at 6.51pm to reports of a male stabbed on Retford Road, one mile away.

They found a second boy, also aged in his mid-teens, suffering from a stab wound.

He was taken to an east London hospital. There are no updates on his condition as yet.

Homicide detectives from the Specialist Crime Command have been informed.

Three people have been arrested in connection with the investigation and a number of crime scenes remain in place, the force said.

Anyone with information is asked to call police via 101 quoting reference Cad 6572/07May. Alternatively, to remain anonymous contact Crimestoppers on 0800 555 111.

This post originally appeared on Daily Express :: UK Feed

Halal Bros on UT Drag burns Friday, no injuries reported

Author: Billy Gates
This post originally appeared on KXAN Austin

Halal Bros on UT Drag burns Friday, no injuries reported

AUSTIN (KXAN) — The fire is now out at a popular restaurant on Guadalupe Street near the University of Texas at Austin campus, the Austin Fire Department said Friday afternoon. No one was hurt, and firefighters say the cause was accidental.

The fire at Halal Bros eatery just north of West 27th Street sparked around 10:30 a.m. Friday.

“Fire started in wall and extended to into the attic,” the Austin Fire Department tweeted. “The building was built in 1920 and the construction features made it difficult to access the fire.”

The fire continued to burn for about an hour before firefighters were able to put it out.

At least four fire trucks and dozens of firefighters quickly responded to the fire.

Halal Bros is a family-owned business with three brick-and-mortar locations in Austin, plus a food truck. Their business started in 2010, serving Halal and Middle Eastern food.

2 people with potentially serious injuries in hospital after multi-car crash in northwest Austin

2 people with potentially serious injuries in hospital after multi-car crash in northwest Austin

AUSTIN (KXAN) — Two people were taken to the hospital with potentially serious injuries after a multi-vehicle crash Wednesday in far northwest Austin, medics say.

Austin-Travis County EMS tweeted updates on the crash starting at 7:01 a.m. saying multiple vehicles were involved in a crash and one person was trapped inside a vehicle at the intersection of Farm-to-Market Road 2222 and Farm-to-Market Road 620. That’s in the Four Points area.

They later revised it to two people trapped and both were cut out of the vehicle and an additional ambulance responded to the scene.

Both people were declared trauma alerts and were taken to St. David’s Round Rock hospital. Along with ATCEMS, the Austin Fire Department, Austin Police Department and Lake Travis Fire and Rescue all responded to the scene.

FM 2222 is closed near River Place Boulevard as crews clear the crash. Avoid the area and try to find an alternate route if possible.

Billy Gates

Man shot multiple times in north Austin, in hospital with life-threatening injuries

Man shot multiple times in north Austin, in hospital with life-threatening injuries

AUSTIN (KXAN) — A man is in the hospital with life-threatening injuries after he was shot multiple times at the north Austin apartment complex, the Austin Police Department says.

APD responded to the Marquis Parkside Apartments, located at 12820 N. Lamar Blvd., just after 12 a.m. Monday to reports of gunshots and people screaming. The complex is near Parmer Lane.

The victim, a 24-year-old man, was the one who called police and said he was shot multiple times.

It’s unclear what led up to the shooting, APD says, and they don’t have anyone in custody and the incident is under investigation.

We are working to get more information on the incident and once we do, we’ll update this story.

Man shot multiple times in north Austin, in hospital with life-threatening injuries
A man is in the hospital with life-threatening injuries after he was shot multiple times at a north Austin apartment complex early Monday morning. (KXAN photo/Richie Bowes)

Billy Gates

Taylor Dee dead: Country music star dies at 33 after suffering injuries in car crash

Taylor Dee dead: Country music star dies at 33 after suffering injuries in car crash
Country music singer Taylor Dee has died aged 33. A Texas Country Music Association spokeswoman confirmed the sad news of the rising star’s death.
It has been revealed Taylor died last week after sustaining injuries from a car crash in Texas, which took place earlier this month.

Linda Wilson told a local CBS affiliate: “Taylor Dee was the real deal – a true talent with a heart and passion not only for her music but for people.

“In every performance, her talent was evident, but more importantly she allowed her fans to know her heart. She will be missed tremendously.”

Taylor’s friends and family members are also said to have confirmed she was the victim of the car crash, which occurred while she was driving in her SUV late at night.

READ MORE… Alex Beresford calls out Nigel Farage on BLM claim amid Bristol riots

“I thought it would be a great song to come out with first to radio. 

“I thought a lot of people would be able to relate to it, because I know I can!”

The star previously shared that artists including Christina Aguilera, Jewel, and Shania Twain had been huge inspirations for her musically.

Taylor began singing when she was young before deciding to pursue her talents as a career when she was in middle school.


Newlywed suffers life-changing injuries in freak fall on TUI holiday in Tenerife

Newlywed suffers life-changing injuries in freak fall on TUI holiday in Tenerife
Wendy Brown, 57, plunged ten feet from the unguarded staircase at the La Palma and Teneguia Princess Hotel in Tenerife three days into a break with husband Gary. The mum-of-two sustained serious brain and spinal injuries and was placed in an induced coma in hospital on the island, reports Cheshire Live.
The couple remained in Tenerife while Wendy underwent brain and spinal surgery, before she was taken by air ambulance back to the UK.

She spent time at a hospital in Manchester and a rehabilitation centre, before being discharged home and her injuries mean she has had to give up her job as an administrator.

Gary, who had only wed Wendy six months before the horror accident, said: “It has been an incredibly stressful three years and I am still finding it difficult to come to terms with what my wife has gone through and what the future means for us all.

“We had only been married six months when we went on holiday to Tenerife, and we returned home with our lives in pieces.”

Gary has since called serious injury experts at Irwin Mitchell to investigate what happened during the holiday, which was booked with TUI UK Limited, and to help Wendy access the specialist rehabilitation required to support her ongoing needs.

Following legal discussions, an agreement regarding liability has now been reached between TUI and the family’s legal team.

The agreement has been approved by the High Court paving the way for mum Wendy to access funds which will ensure she can continue with the rehabilitation process.

“All we want is for Wendy to receive the best possible care she can to make the most of life. It’s such a relief that this agreement has been reached and we can now look at getting Wendy the support she needs,” Gary added.

The fall happened in January 2018 and, since then, Wendy’s injuries have changed her life significantly.

Gary, who lives with Wendy in Bollington, Cheshire, said: “We hope this agreement means we can now start to look to the future a little bit more.

“We now call on TUI to work with us and our legal team so we can get all the care and support Wendy needs in place as quickly as possible.”

Cheryl Palmer-Hughes, the specialist international serious injury lawyers at Irwin Mitchell representing Wendy and Gary, said after the hearing: “This is a devastating case, with Wendy’s family still struggling to come to terms with her life-changing injuries.

“What was meant to be an enjoyable holiday turned into a complete nightmare, and while nothing can change what happened, we are pleased to have successfully reached this agreement.

“Our focus will now turn to ensuring Wendy has access to the expert treatment she now requires to maximise her recovery and help her live as independently as possible.

“It’s also vital that tour operators learn lessons from what happened to Wendy to improve safety for tourists.”

A TUI spokesman said: “We remain very sorry to hear of Ms Brown’s experience on her holiday in Tenerife. As this is now an ongoing legal matter, it would be inappropriate for us to comment further.”


  1. ^ Cheshire Live (www.cheshire-live.co.uk)