Virtua sues N.J. to thwart EMS takeover by Cooper

Virtua Health Inc. sued the State of New Jersey on Monday to block a law, signed earlier this month by Gov. Christie, that transfers control of emergency medical services in Camden to Cooper University Hospital.

Virtua, which currently provides the advanced life support, or paramedic, portion of those services, contends that the law gives Cooper an "exclusive privilege" without any rational medical basis, thereby violating the state constitution.

Ordinarily in New Jersey, a hospital system seeking to provide emergency medical service in a region is required to submit a comprehensive "certificate of need" application to the state Department of Health. Cooper was able to bypass that process through the signed law.

Christie's office and the state Health Department both referred questions to the state Attorney General's Office, which said it could not comment on litigation. Cooper also declined to comment.

Virtua CEO Richard P. Miller, who last month panned the state's move as something out of "communist China," on Monday touted paramedic and other services his health system has been providing in Camden.

"Virtua has long-standing commitments to Camden residents, not only by providing paramedic services, but also by delivering a wide range of health and community services, including emergency medical care, pediatric behavioral health, primary care and dental services," Miller said in a statement.

Without naming Cooper, the law in effect identifies it as the new provider in Camden of both paramedic services and basic life-support services. The basic services currently are supplied by Newark-based University Hospital.

Basic life support is performed by emergency medical technicians and includes such treatments as administering CPR and oxygen. Advanced life support is conducted by paramedics, who can intubate patients and administer intravenous fluids.

As elsewhere in New Jersey, EMTs arrive on the scene of emergencies in Camden by ambulance, while paramedics come in a separate SUV, if needed.

Virtua is joined in the lawsuit by Capital Health System Inc. of Trenton, which also is affected by the measure.

The law, set to take effect in less than six months, enables the transfer of paramedic services in Hamilton Township, Mercer County, from Capital to Robert Wood Johnson University Hospital.

Both Virtua and Capital Health have provided paramedic services in their regions for more than 30 years.

Philip H. Lebowitz, a Philadelphia attorney who is representing the two health systems, conceded that Christie's signature on the law "is a hurdle, because courts are instructed to give the benefit of the doubt to legislators that their enactments are constitutional."

Nevertheless, he said he was confident the law would be overturned on constitutional grounds.

Cooper, a Level 1 trauma center, has contended that patients will be better off if it oversees the whole continuum of care - treatment at the scene of emergencies, in the hospital, and even after discharge.

Dan Fee, a spokesman for Cooper board chairman George E. Norcross III, also has said that the health system's paramedics will respond more quickly to emergency calls than Virtua does.

From January through mid-June, Virtua paramedics arrived on the scene of emergencies in Camden within eight minutes of being dispatched in 69 percent of cases, according to an Inquirer analysis of data from the Camden County Public Safety Department.

The Virtua squads got to the scene within 10 minutes of dispatch in 89 percent of cases, though the health system says it routinely does so in 90 percent of cases.

Emergency-medicine experts say speed is indeed important in many types of emergencies, but they caution against setting a one-size-fits-all response time. The primary evidence for using an eight-minute standard comes from research on cardiac arrests.

Currently, 69 percent of patients requiring advanced life-support services in Camden are taken to Cooper, while 29 percent go to Our Lady of Lourdes Medical Center. The rest go to Virtua's satellite emergency facility in the city.

Virtua also provides paramedic services in the rest of Camden County and in Burlington County. The law leaves that status unchanged.

Health-care consultant Alan Zuckerman, president of Health Strategies & Solutions, said carving out the city of Camden from that larger territory may be inefficient.

"Carving it out seems like it would create redundant expenditures," said Zuckerman, whose firm has worked in the past for Virtua, Cooper, and Lourdes.

The state has 35 days to respond to the complaint, Lebowitz said.

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