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Tampa General's plan to stay put 'touchy'

A significant storm surge would flood and isolate the hospital, but doctors say evacuation would kill the frail.

By LISA GREENE
Published September 24, 2005

TAMPA - With its 875 beds, transplant and burn programs, and Level 1 trauma center, Tampa General Hospital is the best hope for many Tampa Bay area residents who are desperately ill.

But in a hurricane, being at Tampa General may make those same patients even more vulnerable.

Built in 1927, Tampa General sits on the water on the edge of Davis Islands. It is in a primary evacuation zone, where everyone is supposed to evacuate for even a Category 1 hurricane.

But that's not what Tampa General plans to do.

Instead, hospital officials say that in most situations, they plan to stay put. They believe keeping the patients in the hospital, even in a vulnerable location, will be safer than moving them.

That plan is being criticized in the wake of Hurricane Katrina, as horrific tales emerge of patients in New Orleans being ventilated by hand and dead bodies being stacked in hallways. Such stories have officials at many Tampa Bay area hospitals taking another look at their hurricane plans, trying to make sure they're ready for the worst.

Other Pinellas and Hillsborough hospitals in evacuation zones plan to leave, and Hillsborough emergency officials wish Tampa General would, too.

"I certainly wouldn't want to be there for a Category 4 or 5," said Pete Dabrowski, county emergency coordinator. "We are concerned about that."

Tampa General officials say their hospital is a special case.

With nine floors and 1.3-million square feet, the hospital is a fortress, less prone to damage than smaller hospitals, they say.

Inside its walls, patients include people who can't breathe without machines, babies born so early they barely cling to life, and those whose burned skin or newly transplanted organs make them susceptible to deadly infections.

To move many of these patients, hospital officials insist, would kill them.

"Trying to empty a Level 1 trauma center that has about 110 critical care beds is not the same as trying to evacuate a hotel or an apartment complex," said hospital spokesman John Dunn, who also is a member of the hospital's hurricane planning committee.

The question came up Friday at a meeting of the Tiger Bay Club of Tampa, where Hillsborough County emergency manager Larry Gispert spoke.

"This is a very touchy subject," Gispert said. "I'm going to tell it like it is."

Gispert said Tampa General should be evacuated if a hurricane heads toward Tampa Bay. It will flood if the bay gets hit by significant storm surge, and likely become unreachable by car.

"They've got a number of people where they tell us, "If you move them, we kill them,' " Gispert said. "How can you tell a doctor, "We don't care what you say. Move the guy'?

"If I had the my choice, that's not the plan we use."

Bill Wagner, a lawyer who lives on nearby Harbour Island, asked Gispert about the hospital.

"I think this man is in a difficult political position when he deals with that hospital," Wagner said. "I don't think the hospital's plan, if they have one, was very carefully and thoughtfully scrutinized."

But hospital officials say they've spent millions planning for the worst.

"Each season, we've been working on what we would do," said Janet Davis, vice president of acute care and co-chair of the hospital's hurricane committee. "Every department has looked at it."

Emergency officials aren't sure whether Tampa General's massive facility could withstand the storm surge of a catastrophic hurricane, Dabrowski said.

"Nobody has seen a Category 4 or 5 flood surge come through," he said. Although Dabrowski said he's "not a structural engineer," he worries about the force of the flood.

"A cubic yard of water weighs between 1,500 and 1,700 pounds," he said. "You have the flood surge, and the wave action, pounding against buildings."

But hospital officials say the building will stand.

"There is not a fear that it would collapse," said Joey Resnick, vice president of support services and co-chair of the hospital's hurricane committee.

A structural engineer has studied the addition that the hospital is building, Dunn said, and said it would withstand a Category 4 storm. "They can't give a categorical answer" for a Category 5, he said.

Tampa General sits 12 feet above sea level, though a storm surge higher than that could flood the hospital's lower floors. If a hurricane hits, the hospital has a detailed plan for sheltering patients. That includes:

Moving patients out of rooms with windows and into operating suites and other areas in the hospital's core.

Moving patients up to the third floor and down from the top floor, in case of roof damage.

Sending patients home who are close to discharge and canceling elective surgeries.

Relocating the emergency room from the ground floor to a designated area on the fourth floor. When the hospital's new emergency room opens in 2007, it will be on the second floor.

Installing hurricane window shutters.

Using power from six generators, which are housed 20 feet above sea level and have enough fuel for three to four days.

Stockpiling medicine, medical supplies and food, including 9,000 military MREs.

Dabrowski said he knows that Tampa General staffers take the threat very seriously.

"They are making, from what I can see, an honest effort to do what they think best. There probably are a few patients who, if they move them, they will die," he said. "I would never worry about Tampa General staff abandoning patients, like (what) supposedly happened in New Orleans. I know those people and they're a dedicated bunch."

Hospital officials say it's possible they would evacuate some or all patients if a strong hurricane approached. But they say such decisions depend on too many variables to say when they would do so. Hospital and county officials discussed evacuation before last year's Hurricane Charley, a Category 4 storm that was heading straight for Tampa Bay before it took a last-minute turn.

Charley is a perfect example of why it's hard to evacuate, Dunn said. Tampa General would have to send patients to hospitals with empty beds and the ability to care for specialized patients.

"If we had tried to evacuate patients last year, we would have had to move them south and east, which would have put them in the path of the hurricane," Dunn said. Elsewhere in Hillsborough, other acute-care hospitals in evacuation zones are Memorial Hospital of Tampa and Town & Country Hospital, which plan to leave. In Pinellas, the acute-care hospitals that would evacuate are Palms of Pasadena Hospital, St. Petersburg General Hospital, Northside Hospital and Heart Institute, and Sun Coast Hospital.

Like Tampa General, Palms of Pasadena is on the water, Boca Ciega Bay. Before Charley, its patients were evacuated.

But, as Dunn pointed out, Palms is different: It's smaller, with 307 beds, has fewer critically ill patients, and is three stories high.

Pinellas emergency officials are cautious about moving hospital patients, said Gary Vickers, Pinellas emergency management director. Helen Ellis Memorial Hospital in Tarpon Springs and Morton Plant Hospital in Clearwater both are technically located in evacuation zones, but emergency officials decided they don't need to be evacuated after surveying each facility and determining that storm surge isn't expected to enter either.

"They are a critical population," Vickers said. "If we don't have to move them, we don't want to."

Even hospitals that aren't in flood zones are studying their plans. Since Katrina, Bayfront Medical Center in St. Petersburg has reviewed communications plans, said spokeswoman Kanika Tomalin. "We have gone about the process of verifying every variable in a disaster situation," she said. "The time to figure that out is now, while the sun is shining."

Times staff writer Bill Varian contributed to this report.

[Last modified September 24, 2005, 01:13:13]