Bishop Jenky's Response to Tribunal---November 17, 2003

Most Rev, Daniel.R.Jenky,. C.S.C.
OFFICE OF THE BISHOP
DIOCESE OF PEORIA

November 17,2003
Dr. John Carroll 2727 W. Heading Avenue
West Peoria IL 61604

Dear Dr. Carroll:

I am responding to your email of November 11, 2003, in which you asked that our Diocese constitute a Tribunal against what you term are "certain secular leaders at OSF."

Because the leaders are employed at what is termed a "public juridic person" sponsored by an exempt Pontifical Religious community, the Diocesan Bishop is not competent to receive such a petition. The proper forum to address these concerns would be either the Congregation for Religious at the Holy See or the Apostolic Signatura. They would be able to give specific direction in this matter.

Respectfully yours in Christ,

Most Reverend Daniel R. Jenky, C.S.C.
BISHOP OF PEORIA

(Bishop Jenky was referring me to Rome and Pope John Paul II regarding problems at OSF that are occuring six blocks from his office.)

I filed several other petitions for a Catholic Tribunal court with Bishop Jenky. I believed there was a dangerous monopoly of ambulances and transport of sick patients controlled by OSF and Advanced Medical Transport in Peoria and filed for a petition. Monsignor Rohlfs sent me this response:



OFFICE OF THE VICAR GENERAL
412 N. E. Madison Avenue Peoria, Illinois 61603-3720
Telephone 309-671-1550 FAX 309-671-1558
December 15, 2003


DIOCESE OF PEORIA

Dear Doctor Carroll:

Bishop Jenky is in receipt of your fourth petition regarding OSF St. Francis and the alleged monopoly carried on by the Advanced Medical Transport Company at OSF St. Francis.

After taking canonical counsel on the matter he wishes to state once again that any such issue involving the Third Order of St. Francis would have to be taken up by Rome itself rather than the diocese, as it is an "Exempt Religious Congregation of Pontifical Jurisdiction". It is the considered opinion of our canonists that the Bishop would have no jurisdiction over the issues which you have presented.
I know that this will come as a disappointment to you but it is truly futile to continue asking for a diocesan tribunal against a congregation of pontifical jurisdiction.

With warmest personal regards, I remain

Sincerely in Christ,

Monsignor Steven P. Rohlfs, S.T.D.
Vicar General-Chancellor

SPRJps

So by the end of 2003, the Catholic Diocese of Peoria had threatened me, abandoned sick Haitian children, and refused a Catholic Tribunal court stating they wouldn't judge against OSF. In the next couple of years Haitian Hearts patients would be refused access to care at OSF, and at least one would tragically die. When the Peoria Firefigters were disciplined for trying to give life saving care at the scene, the problems moved much closer to home.

Please see forum articles written below over the next one and one-half years regarding Emergency Medical Services in Peoria. I shouldn't have been referred to Pope John Paul II in Rome for these local problems, largely due to the power and control of our Catholic hospital--OSF, by Monsignor Rohlfs and Bishop Jenky.


City needs independent study of ambulance service

January 10, 2004

Peoria's new city manager, Randy Oliver, is organizing a commission to study emergency medical services (EMS) in Peoria. The editorial board of the Journal Star pleads for a fiscally responsible decision regarding these services. Local physicians need to insist that both fiscally and medically responsible choices are made for pre-hospital patients.

The EMS services in Peoria are provided by two agencies. Advanced Medical Transport (AMT) provides the only advanced life support service and transport of patients. This company is supported by Peoria's three hospitals and governing boards. AMT grosses over $7 million per year and desires a 10-year contract to remain the only paramedic and transport agency in Peoria. The second agency is the Peoria Fire Department. Firefighters arrive quickly at the scene, but can provide only basic life support and are not permitted to transport patients.

The Peoria Medical Society needs to consider the following questions: Who will compile and interpret the statistics regarding local EMS care? What EMS issues will be analyzed? What is the response time for the Peoria Fire Department versus AMT to an emergency? How much time elapses from the 911 dispatch call until the electrical shock is administered to a patient in full cardiac arrest?
When AMT arrives at the scene and begins its advanced life support, have the patients waited longer than necessary? What percentage of Peorians survive and walk out of the hospital after suffering a cardiac arrest? Are Peoria's trauma patients transported quickly and efficiently with the "scoop and treat" philosophy? How does Peoria compare to other cities in the U.S. and Canada that have state-of-the-art EMS? Might it not be responsible and medically important to allow Peoria firefighters to advance their skills (such as improved airway control and IV medication administration) to improve patient outcome?

The most important question is: Can Peoria's EMS system be studied in an independent and unbiased fashion? The same doctors, administrators and boards of directors that made questionable decisions 10 years ago are still in absolute control today.

Thus, the Peoria Medical Society needs to do exactly what the first sentence of its mission statement professes: To promote the health and general welfare of the Peoria public. Peoria's pre-hospital patients have never been in a more perilous situation. Encourage Oliver's study to ask the correct questions and answer them using scientific rigor. Then and only then will fiscal and medically appropriate decisions be made regarding EMS in Peoria.

Dr. John Carroll
Peoria





Let fire department transport critically ill patients

February 28, 2004

The Peoria Fire Department purchased one or two ambulances recently. A Feb. 3 Journal Star editorial asked, " ... what good is a fire department ambulance if it can't transport patients to the hospital?" Good question. Perhaps a better question is, "Why can't the fire department transport patients in the first place?"

Fire department personnel, many of whom are trained paramedics, are the first responders to emergency medical calls every day. However, the fire department is not allowed to transport patients to a hospital and cannot provide advanced medical care at the scene. Trauma patients must wait for paramedics from Advanced Medical Transport, a private ambulance company, to arrive. Since patient survival improves with faster response, the firefighters should be allowed to use their skills.

Control of ambulances and emergency medical services lies in the hands of the project medical director. The OSF-employed physician who held this post for nine of the last 12 years, Dr. George Hevesy, was paid a salary by AMT. Freedom of Information documents from the state of Illinois reveal that OSF administrators knew and approved of this arrangement. There is an immense conflict of interest when a project medical director accepts money from a private ambulance company. Small wonder the fire department is not competing with AMT in the paramedic and transport business.

OSF should not allow an employee to accept money from an ambulance company he or she regulates. OSF also needs to explain why corporate profits have been given greater importance than fast emergency response times. City Manager Randy Oliver's commission on emergency services must address this conflict of interest.

The present project medical director, Dr. Rick Miller, needs to assure Peoria that the Peoria Fire Department will be adequately trained and allowed to transport patients in their new ambulances and that financial gain will not be allowed to override the public's right to the fastest and most efficient medical care possible.

Tom Carroll

Peoria


Peoria's medical mafia limiting emergency care

July 27, 2004

Re. July 16 editorial, "Send corrupt health facilities planning board to morgue":
The Journal Star states that in Illinois, "Any board with this much authority over this much money becomes a trough of corruption." Truer words could not have been written. For 30 years lobbyists, attorneys and politically connected people have influenced the decisions made by this nine-member board regarding construction of new hospitals and expansion of existing ones in Illinois.

Unfortunately, similar conflicts of interest and cronyism are currently occurring in Peoria. The stakes are very high here with lives and money on the line.

In Peoria we have one paramedic transport company, Advanced Medical Transport (AMT). Its medical director is Dr. George Hevesy, who happens to be the medical director of OSF-St. Francis' emergency department. Dr. Hevesy is salaried by both OSF-St. Francis and AMT. OSF is the main supporter of AMT and is also the base station for all emergency medical services in central Illinois.

The AMT board of directors, composed of prominent Peorians, has the support of the OSF-St. Francis board of directors. Dr. Hevesy's relationship with the Illinois Department of Public Health in Springfield, which regulates paramedics and ambulances in the state, is well known in emergency medicine circles throughout Illinois. And finally, the Peoria City Council, which will decide if AMT remains in total control of paramedic care and transport in Peoria for the next decade, will consider the findings and recommendations of a California-based consulting firm.

Some members of the council suspect a pre-existing relationship between AMT and this California firm. One needs a scorecard to keep track of this local health care travesty.

In the meantime, the Peoria Fire Department continues to respond to medical emergencies, can only provide basic life support (not paramedic care) and cannot transport patients, even with its one ambulance. The PFD obviously does not enjoy the support of the above¬named individuals, boards and state agencies.
The real loss, of course, is for Peorians who suffer an out-of-hospltal medical emergency. State-of-the-art, pre-hospital emergency care is not offered in Peoria, not because we can't, but because our medical mafia will not allow it.

Dr. John Carroll
Peoria

Should Peoria Fire Department sell its only ambulance?
Sunday, December 12, 2004

What will the city do with the one Peoria Fire Department ambulance that sits alone and unused? Will It be sold for somethl ng more Important than saving people's lives?

In September, the Matrix Consulting Group evaluated Peoria's emergency medical services. Matrix reported that the fire department's average response time to life-
threatening emergencies was almost two minutes faster than Advanced Medical
Transport's. Since the fire department can only provide basic life support, patients frequently walt until AMT arrives for paramedic intervention.

One plan formulated by the consulting firm to improve service was to target certain areas with four non-transport fire department engines. These vehicles would be staffed by firefighter/paramedics who would provide advanced life support. The fire department has paramedics who could provide their expertise for these engines.

The problem is the two physicians who have controlled ambulances in Peoria for the last two decades don't support the fire department's advancing from basic life support service to advanced life support. Unfortunately, Peoria firefighter/paramedics are not allowed to use their paramedic skills at emergencies.

Matrix noted the fire department has applied to the physician in charge of ambulances to outfit its only engine with various basic and advanced life support medications and equipment. That request was denied.

The boards of directors of our local"health-care Industry," and the doctors who have been responsible for ambulances in Peoria, need to disclose their private interests and explain why seiling the one and only fire department ambulance Is beneficial to sick and Injured pre-hospital patients In Peoria.

Dr. John Carroll
Peoria



Wednesday, February 23, 2005

Let Peoria Fire Department Operate its Ambulance


On Feb. 1 the Peoria City Counci voted to sell the only fire department ambulance, which has been sitting idle in a garage. It was never allowed to respond to 911 calls. Numerous firefighters who are certified paramedics are not allowed to use their skills. They have been wasted.

To help rectify this situation, I will purchase the PFD's ambulance at its present market value and donate it back to the PFD if these conditions are met:

1. This ambulance will be used for sick or injured Peorians and staffed by PFD firefighters/paramedics allowed to use their advanced life support skills in Peoria.

2. Doctors George Hevesey and Rick Miller have been directors of the Emergency Department at OSF for the past 15 years. They have controlled all ambulances in the area. Both physicians need to publicly declare any fees, stipends, salaries or other benefits they've received from their relationship with Advanced Medical Transport, the only company allowed to operate in Peoria.

3. OSF's Emergency Medical Services Department needs to provide health-care data for the past decade to the city manager and City Council revealing how Peoria's pre-hospital patients did when cared for and transported by AMT. This data was conspicuously absent in the 149-page consultant's report that evaluated fire and emergency medical services in Peoria last year.

The medical ambulance debacle in Peoria, plagued by conflicts of interest, needs to end.


Dr. John Carroll
--------------------------


In 2005, a man collapsed at a Peoria restaurant in a full cardaic arrest. The PFD paramedic on the scene was not allowed to put the airway tube in the patient and the patient eventually died. The paramedic firefighter was afraid of being suspended as another firefighter had been several weeks earlier for putting a tube in a patient. I presented this tragic situation to the Peoria City Council at the Citizens forum and the following excerpts from an article that appeared in the Journal Star two days later follow:

BY JENNIFER DAVIS AND DAYNA R. BROWN
OF THE JOURNAL STAR
PEORIA - Criticism of the city's private ambulance service by a former emergency room physician is being downplayed but could still lead to discussion on how to improve the system.

Dr. John Carroll, who worked for 21 years at OSF Saint Francis Medical Center before he was fired in 2001, told the City Council on Tuesday of a recent incident in which a man at a Peoria restaurant went into full cardiac arrest and later died while a Peoria firefighter/paramedic on the scene wasn't allowed to try to help save him.
"Just think if that was your family member," Carroll told the council. "Valuable minutes really shouldn't be wasted at the scene" waiting for the city's ambulance service to arrive.

Carroll has been critical of Advanced Medical Transport, the city's only ambulance provider, since at least 2002, but some question whether his accusations are personally motivated by his firing.

"Dr. Carroll has been critical of our operations for some time now. I don't recall ever having the chance to speak with him personally," said Andrew Rand, AMT's executive director. "It's regrettable that these sort of anecdotal references are made that are unsubstantiated."

Rand noted that the AMT was recently given its second perfect score from the Commission on Accreditation of Ambulance Services, making it the only private provider in Illinois thus recognized.

"We have an excellent system," said Dr. Rick Miller, Emergency Medical Services Medical director. An employee of St. Francis, Miller has the responsibility of certifying people as paramedics and EMTs and overseeing their education. If there are any problems and someone has to be reprimanded, he is also involved.

"To say (firefighters) are standing around is inflammatory and an insult to the fire department," Miller added.

Firefighters can perform CPR, control a patient's airway, ventilate a
patient, give oxygen and administer several medications. They can
also use a defibrillator, which could be the most important tool for
a cardiac patient, Miller said.

Those firefighters who are also system-certified paramedics can
also use their skills to assist AMT paramedics if they request help -
a relatively new change allowed by Miller.

It's also an example of what appears to be a sea change in the
relationship between the fire department and AMT. Just a couple years ago, the fire department wanted to get into the ambulance transport business over AMT's objections. But now both sides say they are working together like never before.


My comments:

This article and Rand and Millers statements are very misleading. If the above "anecdote" did not happen, I am quite sure that OSF and AMT would have let everyone know at the Journal Star. The firefighter felt terrible that he was not allowed to insert the breathing tube as the family watched. (The firefighter had already shocked the patient and he had a heart beat and needed a secure airway.)

The "new change" referred to in the article by Dr. Miller is very difficult to understand. Quite simply, it means that Miller caved in and if AMT ASKS the PFD paramedic to insert the tube into the patients airway, the PFD paramedic can now do it, thanks to the "largesse" of Dr. Miller. What if AMT is not on scene and the patient needs the tube"? Under, Miller's "new change", the patient has to wait. This is unbelieveable. The brain cannot go without oxygen for very long. Also, remember, that the PFD paramedics cannot provide advanced life support at the scene like AMT can and does. (By the way, the same PFD paramedics frequently work outside of the Peoria Fire Department and can insert the tube when needed and can provide advanced life support. Why can't they provide the same in Peoria?)

I do think that the PFD firefighters and the AMT paramedics work well at the scene. But the real problem is behind the scene by the officials and doctors making policy.

And finally, the second "perfect score" by AMT, referenced by the Journal Star, was probably paid for too, as was their first "perfect score".