Sunday, December 1, 2013

Did Waves of Hospital Closings Impact Metro-North Derailment Passenger Emergency Trauma Treatment ?

From the Demand A Hospital list serve :


From:  Demand A Hospital <demandahospital@gmail.com>
Subject:  Corrected : Metro-North Derailment Injured Skip Nearer Level 1 Trauma Center
Date:  1 décembre 2013 20:19:14 UTC-05:00
To:  Demand A Hospital <demandahospital@gmail.com>

Corrected : 

Due to corrupt HTML code from the Newsday Web site, we are transmitting our prior e-mail in unformatted text.  Plus, we clarified the subject line.  

We apologize for the confusion.


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Dear All :

Today was a sad day, following the tragic Metro-North train derailment in the Bronx.

For unexplained reasons, the Metro-North passengers injured today were dispersed amongst far-flung city hospitals, including Elmhurst Hospital Center, a Level I trauma center 13 miles away in Queens, even though St. Luke's/Roosevelt Hospital in Morningside Heights in Manhattan is less than 7 miles away.  

Following the wave of hospital closings under the Berger Commission, the Medicaid Redesign Team, and Superstorm Sandy, the capacity of New York City hospitals to handle mass trauma events remains in question.  

The following news report from Newsday indicates that some passengers have already been discharged after receiving emergency medical treatment, but many others remain hospitalized in critical condition.  Because time is of the essence when treating trauma patients, it's not yet known why some passengers were transported over longer distances, unnecessarily extending the time until some passengers received trauma care.

As we mourn the passengers, who died today, and as we wish those injured a speedy recovery, let's hope that city and state health officials recommit to the need to maintain capacity in our city and state hospital system for emergencies and accidents, especially mass events like this derailment.

Tonight, our thoughts are with the Metro-North passengers and their friends and families.  We owe it to each other to have a hospital system that maintains the necessary capacity and specialized medical staff to timely provide specialized Level I trauma care.



List of Level I Trauma Centers : http://www.health.ny.gov/professionals/ems/trauma2.htm

Newsday article link :  http://www.newsday.com/news/new-york/ntsb-on-scene-to-probe-fatal-metro-north-derailment-1.6521318


NTSB on scene to probe fatal Metro-North derailment
Originally published: December 1, 2013 8:32 AM
Updated: December 1, 2013 7:06 PM

By JENNIFER BARRIOS, EMILY NGO AND ALFONSO A. CASTILLO jennifer.barrios@newsday.com,emily.ngo@newsday.com,alfonso.castillo@newsday.com

Investigators are trying to determine what caused a Metro-North passenger train to jump off the rails on Sunday morning, killing four people, while on an area of track that New York's governor called "dangerous."

The National Transportation Safety Board began its investigation Sunday at the scene of the derailment, about 100 feet north of the Spuyten Duyvil station on the Hudson Line.

More than 100 passengers were on the train, and FDNY reported at least 67 victims, including four killed, 11 critically injured and six with serious injuries. Five NYPD officers on the train commuting to work were among the injured, sources said.

A source in law enforcement said the train operator told first responders that he had applied the brakes but that they did not work. However, authorities have not corroborated that as of yet.

However, Russ Quimby, a rail safety consultant and former member of the National Transportation Safety Board, said train brakes are usually designed with a failsafe and if they malfunction, the train is designed to come to a stop.

The law enforcement source also said speed may have been a factor.

The seven-car train derailed at about 7:20 a.m., according to MTA spokesman Aaron Donovan.

Three men and one woman were killed, the MTA said.

Crews will use a crane to lift up the overturned cars Sunday night to search "for any further fatalities" and to avoid further fuel spills, National Transportation Safety Board member Earl Weener said during a briefing at the scene. Gov. Andrew M. Cuomo had said earlier he believed all passengers had been accounted for on Sunday.

Weener said a "multidisciplinary team" will meet Sunday night to form sub-teams to examine the point of derailment, the train signal system, mechanical equipment, data from event recorders, maintenance and personnel records and survival factors.

Weener said the team will document the condition of all the cars before turning the equipment back over to Metro-North. It also will interview the derailed train's personnel.

"Our mission is to understand not just what happened but why it happened, with the intent of preventing it from happening again," Weener said.

He said the NTSB already had downloaded information from the train's data recorder, which contains information about the train's operation at the time of the derailment.

Cuomo said track repairs will only begin after the NTSB finishes its investigation, which will take a week to 10 days.

"Tomorrow, I think it's fair to say, commuters should plan on a long commute," Cuomo said.

The derailed train, which was being pushed from the rear by a diesel locomotive, had been headed from Poughkeepsie to Grand Central Terminal in Manhattan when it tumbled from the tracks on a sharp curve near where the Hudson River meets the Harlem River.

"That's a dangerous area of the track, just by design," Cuomo told CNN on Sunday. "That's a difficult area of the track, but that doesn't explain the crash, either."

But he added later: "It can't just be the curve."

Trains are supposed to reduce their speed to 30 mph at that spot, according to the MTA. Before that point, trains can travel as fast as 70 mph.

Cuomo said people were ejected from the train because the front and rear doors opened.

As the trains slid along the ground on their sides, he said, the train cars "were picking up rocks and dirt, tree limbs, debris."

Late Sunday, emergency workers continued to work by floodlight among the cars, which still lay on their sides or listed dangerously along the river, as emergency boats floated in the water and emergency vehicles sat with lights flashing.

Bodies of the dead and the injured had been carried out on stretchers, and no passengers remained aboard late Sunday, but a ladder used to access the train was left leaning against the second car.

Dozens of uniformed police officers, firefighters and other first responders were still on the scene, some directing car traffic away from the area.

Maria Herbert was aboard the derailed train, working as an assistant trainman, said her husband, William Herbert, 53, of upstate Wallkill.

Herbert said his wife called him minutes after the event, injured and sounding like she couldn't breathe.

"Thank God she's alive," he said. "If that train went into the water, it would have been worse. I think God stopped the train."

Herbert, who said he worked in the maintenance department of the MTA for 25 years, said he and his wife had often discussed maintenance issues on the curve where the train derailed on Sunday.

"She had been fearful about that area," Herbert said. "That curve is very sharp and that rail wears away."

FDNY Chief of Department Edward Kilduff said that three of the four people who died were found by first responders outside the train, and one was inside. All of the fatalities were from cars that had flipped onto their sides. Most of those injured had suffered blunt trauma, Kilduff said.

Rescuers had to cut open cars and use air bags to lift them off one or two people who were trapped underneath, Kilduff said.

Kilduff said the terrain posed a challenge to rescuers, some of whom had to carry their equipment to the area. "The stability of the cars was also a serious challenge," he said.

NYPD Commissioner Ray Kelly said the train's engineer was at a hospital in stable condition. "He's banged up, but conscious and alert," Kelly said at a news conference.

Media reports indicated the engineer was a 20-year veteran of the MTA and had made a statement to investigators.

Officials estimated more than 100 people were on the train -- much fewer than would have been riding during a workday.

If the train had been fully occupied, said FDNY Commissioner Salvatore J. Cassano, it would have been a tremendous disaster.

MTA board member Charles Moerdler described the scene as "dreadful, awful, chaotic."

"There were rail cars scattered all over the place, plus an engine, and hundreds of rescue workers -- fire, police and voluntary ambulance -- working feverishly together with canines," said Moerdler, who noted that the train came off the tracks along a "treacherous curve" and in an area where leaves are known to fall on tracks, making for dangerous, slippery rail conditions.

Quimby, a rail safety consultant who worked for 22 years as an NTSB crash investigator, said the curvature of the rail, and the speed at which the train traveled, would be among several factors examined in the NTSB probe.

He said curved rail can be susceptible to derailments because the centrifugal force of a train when it comes through a turn can, over time, gradually cause rails to separate from each other.

The group would likely be headed by a doctor of psychology who would examine any factors that could have taken the engineer's attention away from his job, including fatigue that could have caused him to "nod off," mobile devices, or drugs or alcohol. The engineer would give blood and urine samples for toxicological testing, he said.

Quimby said a type of event recorder that is standard on most commuter trains would likely provide answers to how fast it was moving when it derailed, and whether brakes were applied. He said he has never seen an instance of brake failure causing a commuter train to derail, because brake systems are generally designed with failsafes. If the brakes malfunction, a train automatically will come to a stop, he said.

Anthony Botallico, general chairman of the Association of Commuter Rail Employees -- the union representing Metro-North engineers and conductors -- said several train crew members were injured, as well as "extremely upset and traumatized."

"It's just a terrible tragedy, man," Botallico said. "My thoughts and prayers are going out to the family members and everybody who was killed. It's something that we're all feeling really hard right now."

The injured were taken to St. Barnabas Hospital, Montefiore Medical Center, Lincoln Medical and Mental Health Center and Jacobi Medical Center in the Bronx, New York-Presbyterian Hospital in Manhattan, and Elmhurst Hospital Center in Queens, authorities said.

Spokesman Steve Clark at St. Barnabas said 10 people were admitted to the hospital to stay overnight. So far, two have been officially discharged from the hospital. One is a 14-year-old boy who was traveling with his father and the other is a man in his mid 20s. Clark said many of the people who are staying are not critically injured except for two: a 43-year-old man with a spinal cord injury and a 21-year-old woman with a leg fracture.

A woman named Maria Ojito stopped by the hospital and told reporters she was a family friend of the 43 year-old man who suffered spinal cord injuries. She said his name is Samuel Rivera, Sr. and he had a son, also named Samuel Rivera, who was the 14 year-old boy who was released earlier, both from Ossining, NY. She said the two were headed into the city but she is not sure for what and the father was undergoing surgery right now and had been for ten hours as of 6 p.m. She said the elder Rivera worked for MTA but not sure doing what but that he was not in duty.

She said the family is "devastated" by the news.

New York-Presbyterian received a total of 17 patients, 14 of which were received at the emergency department, according to a release. Of the 14, four were critical and 10 were noncritical, the release said.

Jacobi Medical Center received 13 patients, all in stable condition. Several have since been discharged, according to a statement released by the hospital.

Kelly was scheduled to visit the five injured officers in the hospital. At least one -- a female officer who suffered fractured ribs and other injuries -- was at St. Barnabas Hospital.

Officials said at news conferences they don't believe any of those passengers who were seriously injured will die.

Those looking to check on the status of family members were asked to call the city's 311 information line, while those outside of New York City could access the city's 311 system by calling 212-639-9675.

A family center staffed by Red Cross and officials from the MTA was set up at John F. Kennedy High School in the Bronx.

Unlike air disasters, where authorities have complete passenger lists, there was no such list of who was on the Metro-North commuter train.

Politicians issued statements on the tragedy, including Mayor-elect Bill de Blasio, who said he was in contact with Kelly and was monitoring the situation.

A representative for Mayor Michael Bloomberg did not respond to a request for his whereabouts.

The White House issued a statement on Sunday, saying President Barack Obama had been briefed about the derailment and that his thoughts and prayers were with the friends and families of the victims.

Cuomo said Amtrak service between New York and Albany was resumed later Sunday.

Trains were moving through the derailment area at restricted speed, but service on the Hudson Line was suspended in both directions between Tarrytown and Grand Central on Sunday.

The Spuyten Duyvil station is off Edsall Avenue near Johnson Avenue in the Bronx, about 11 miles from Grand Central Terminal. The Henry Hudson Parkway passes over the area.

The derailment is the third major event to occur on Metro-North tracks in 2013 -- a year that has MTA officials have acknowledged has included a higher than normal number of safety-related incidents for its commuter railroads. In May, a Metro-North train derailed in Bridgeport, Conn, injuring 76 people. Less than two weeks later, a Metro-North train killed a track worker in West Haven, Conn.

And in July, a freight train derailed near the same location as Sunday's event.

With Maria Alvarez, Alfonso A. Castillo, Anthony M. DeStefano, Kevin Deutsch, Rita Deutsch, Tania Lopez, Ivan Pereira, David M. Schwartz, Nicholas Spangler, Andrei Berman and The Associated Press

-- 
Tell Gov. Andrew Cuomo to stop closing our hospitals :  1 (518) 474-8390

You can also tweet your concerns to Gov. Cuomo at :  @NYGovCuomo 

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