DENVER — A year-long Denver7 Investigates investigation has uncovered a potentially dangerous culture inside Denver Health’s paramedics division.
The concerns have come to light after interviews with a half dozen former paramedics, a review of internal emails and public information about recent emergency responses by Denver Health ambulances.
Former Denver Health paramedics tell Denver7 that for years they worked in an environment where they were pressured by managers to bypass other qualified hospitals and transport seriously injured patients back to Denver Health.
Denver Health paramedics have a national reputation as some of the most qualified and skilled in the country. Those that elected to speak out stressed that the criticism raised in this report must focus on the culture they claim exists at Denver Health and not decisions made by individual paramedics.
“We have failed. The system is failing,” said one paramedic.
“They are not in it for what’s right for the patient,” another paramedic added.
The two paramedics spoke to Denver7 Investigates on a condition of anonymity because they fear retaliation.
“They are in it for the ego and the money,” one paramedic said, referring to Denver Health. “It’s like this is our county, you can’t tell us what to do.”
One paramedic said the job was “destroying me as a person.” Two of the six paramedics who spoke with Denver7 Investigates agreed to share their information in on-camera interviews. Combined, the two have more than three decades of experience as paramedics for Denver Health.
Both said they were questioned about decisions to bring serious trauma patients to a closer hospital instead of Denver Health. Their claims were supported by other former paramedics who spoke with Denver7.
“There’s two types of paramedics who work at Denver Health: The ones that take all level-one trauma patients back to Denver Health and former Denver Health paramedics,” the paramedic said.
He and others claim that the hospital will find ways to end the employment of non-conforming paramedics.
In paramedic terminology, a Code-10 trauma patient is the most seriously injured patient and requires the fastest route to an emergency room. Denver7 Investigates also uncovered examples where Denver Health paramedics made decisions to bypass closer hospitals to bring patients to Denver Health.
Multiple sources point to a call for a paramedic unit on May 11. On that day, two men walked into an emergency room in Green Valley Ranch on Denver’s eastern side. Both were victims of gunshot wounds. A doctor inside recognized that injuries to one of the victims was too serious to be treated at that facility. He called 911 and when a Denver Health ambulance arrived, sources tell Denver7 that the doctor requested the paramedic take the gunshot wound victim the UCHealth. It was the closest hospital and just 7 miles from the emergency room in Green Valley Ranch. Instead, the paramedic elected to take the patient to Denver Health more than 19 miles away.
“I believe the paramedic who made that decision was instructed, encouraged, trained and bullied into going to Denver Health,” said one of the paramedics talking to Denver7.
“For that casem there was concern over where that patient was transported,” said Dr. Danny Willner, an Emergency Room doctor at UCHealth.
UCHealth filed a formal complaint with Denver Health, questioning the decision to bypass UCHealth’s hospital in Aurora.
“This is a patient safety issue,” Dr. Willner said. “We know that time is important for trauma patients. We know the further you transport someone, the less likely they are going to have a good outcome from a traumatic injury.”
Using the state’s open records laws, Denver7 Investigates reviewed documents showing UCHealth has questioned more than a dozen transport decisions for level one trauma patients by Denver Health during the past nine months.
One of the paramedics speaking to Denver7 said that medics take patients to Denver Health because they won’t be second guessed, regardless of the outcome.
The doctor in charge of the paramedic division at Denver Health has a different perspective and denied any wrongdoing.
“No paramedic has ever faced discipline for not bringing a trauma patient to Denver,” Dr. Kevin McVaney said. “I’ve done nothing wrong. I take care of patients. I would not change a thing about how we equip and take care of our trauma patients.”
McVaney did admit a mistake with the decision to transport the gunshot wound victim to Denver Health on May 11.
In an internal email obtained by Denver7 Investigates, McVaney writes, “My reply to [UCHealth] on this one was that it was not the best destination. We should discuss and prep if we think this is going to go to media."
Denver7 Investigates also obtained an internal email authored by McVaney that may expose the mounting tensions between Denver Health and UCHealth.
"I don’t want to over emphasize these," the email stated in reference to the multiple complaints filed by UCHealth, “because I don’t want [UCHealth] to set our agenda," McVaney wrote.
McVaney said he meant that outside emails don’t dictate the care at Denver Health.
“I don’t want any outside force dictating how we care for patients in Denver,” he said.
However, one of the paramedics said that Denver Health plays by its own rules. The other said that McVaney should step out of the political nature patient care and do what’s best for the patient.
Ultimately, the disconnect lands in a difference in philosophy, according to Wilner, who directs the ER at UCHealth. He said every minute counts for victims of major trauma.
McVaney said that time alone has never been a measure of quality.
In September, the Mile High Regional Emergency Medical and Trauma Advisory Council adopted a new guideline for transporting level one trauma patients in the Denver metro area. It directs paramedics to take patients to “the most rapidly accessible appropriate” facility. It does not say the closest or the nearest, a fact Denver Health uses to support its recent decisions.
If you have a tip for Denver7 Investigates or want to share your thoughts with Chief Investigative Reporter Tony Kovaleski you can email him at tony@thedenverchannel.com.
