Lack of capability, poor decisions led to hospital ship seeing few patients in Puerto Rico


Staffed with 800 personnel and costing $180,000 a day, the ship received an average of 36 people a day as outpatients or inpatients. […]

But the ship did not leave Virginia until Sept. 29, arriving in Puerto Rico on Oct. 3.

Problems quickly emerged. For starters, the Comfort lacked critical capacities, including the ability to treat premature babies and patients with common antibiotic-resistant infections, head trauma and strokes requiring neurosurgery, or heart conditions needing bypass surgery. One doctor was heard complaining about receiving so-called “social cases”— patients who would be difficult to discharge because they lost their homes or lacked caregivers.

The problems were not just limited to the ship itself. Local government officials in Puerto Rico decided shortly after the ship’s arrival that it should move around the island in order to give care “wherever the needs were at the time.” In theory, this sounds like a good idea. Except, it turned out not to be. The local government also required that doctors needed to vet patients through the Puerto Rico Medical Services Administration. Once a patient was vetted and it was deemed that their local hospital was already full, only then could they be referred to the Comfort.

Of course, the Puerto Rico Medical Services Administration, a large, public hospital in San Juan, was completely overwhelmed post-hurricane. As a result, this move dramatically decreased the amount of patients referred to the ship.

Patient flow slowed to a trickle. According to the Navy, only 137 patients were delivered over a period of three weeks.

The first phone numbers provided by the public hospital did not work, and others had to be established. Callers overwhelmed the cellphone of the emergency department director after his number was posted on Facebook.

In areas without working cellphones, land lines or satellite phones, and with only ambulance radios to communicate, “referring patients to the Comfort was impossible,” said Dr. Rene Purcell-Jordan, an emergency room physician in Yauco, in southwest Puerto Rico.

While some patients in need were treated on the ship, this was an overwhelming failure across the board. The federal government seemed not to know (or care) how to do this right and the local government made misstep after misstep that made it almost impossible for doctors to refer patients. Add to that patients who didn’t want to be far from their homes and families and doctors who lacked information about what kind of patients the ship could treat. And then there’s this inexplicable move: “On Nov. 15 the Comfort left the dock, with a spokesman saying the ship planned to restock at sea and then resume treating patients. On Nov. 17, the ship was ordered home, for good, without warning.”

Does anyone know what the hell is going on in Puerto Rico? Does anyone in charge actually care? Because 77 days after Hurricane Maria, it’s very clear that human error and negligence are making conditions even worse. This is a growing disaster by the day, and there are a lot of people who are responsible for it and need to be held accountable. 


USA News


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