COLUMBIA - A proposal to care for some of the most delicate newborns at Trident Medical Center stalled Thursday after the governing board at the Department of Health and Environmental Control said the plan goes against the state's rules.
North Charleston-based Trident wants to build a four-bed neonatal intensive care unit, or NICU, an estimated $1.6 million project to care for the sickest premature newborns. But DHEC regulations say that Trident's plan runs afoul of its rules because the hospital is within 60 miles of Medical University Hospital.
Regulators and MUSC have argued that the rule ensures that top medical staff, expertise and experience are concentrated in fewer places throughout the state for what are known as "Level III" care centers. Those centers provide the highest level of intensive care to newborns.
A DHEC staffer told the board, though, that there appeared to be "no basis" for the 60-mile rule and officials also didn't know why the rule had been put into place by the Legislature.
DHEC's governing board said they sympathized with Trident's reasons for wanting the unit - to provide care that was more accessible to the rural communities it serves and to prevent newborns from dying. State rules say that the sickest premature newborns who are around three pounds must be transferred to MUSC, a practice Trident officials say doesn't serve patients well in some cases. Studies show that transferring those patients yields worse results, said Anil Sharma, who heads Trident's neonatal unit.
South Carolina, he said, has some of the highest infant mortality rates and ranks near the bottom for newborn childcare.
The board "doesn't make the law, it follows the law," said L. Clarence Batts, a DHEC board member. Having a child in the NICU is difficult, he said. "(It's) quite a burden and stress on a parent. To have it closer to home is far better. But right now I feel like our hands are tied."
One board member sided with Trident. "I realize it's the law but I disagree with it," said board member R. Kenyon Wells. "If Trident wants it and they can afford it and it can produce favorable results. then I'm in favor."
Trident CEO Todd Gallati said in a brief interview after the decision that he wasn't sure what the hospital's next steps are or whether they would fight the decision. He said that Trident was sailing toward an approval with DHEC until its top competitor, MUSC, stepped in to ask about the 60-mile rule.
"It's not right for patients in our area," he said.
David Annibale, chief of neonatology at MUSC who spoke at Thursday's hearing, denied that. He said that the concentration of NICU units around the state affects more than just Trident's plans. As DHEC reviews the rule, he said MUSC would not necessarily support the 60-mile rule but would try to ensure that a new rule helps to decrease the state's infant mortality rate. The concentration of NICU centers is just one piece of that puzzle, he said.
Sharma, the Trident doctor, told the board that parents who are often poorer and live in rural areas have to drive farther, and Trident takes a risk every time it transports some of its most delicate newborns.
"You're providing a disservice to your patient population because you're denying them access," Sharma said.
Reach Jeremy Borden at 708-5837 or on Twitter @Jeremy_Borden.