Monday, May 27, 2024

The CHA Somerville Campus on June 22, 2022, where once there was an emergency room. (Photo: Marc Levy)

Almost seven years after 34-year-old Laura Levis couldn’t find the entrance to the former Somerville Hospital emergency room and later died, the state health department has adopted emergency department sign and communication requirements for hospitals throughout the state. The Cambridge Health Alliance hospital – and the emergency room – where Levis collapsed on an outside bench during a severe asthma attack no longer exist.

CHA closed the emergency department and replaced it with an urgent care center in April 2020, saying it wasn’t needed because of low volume. At the same time, the Alliance gave up its hospital license for the facility and now designates the site off Highland Avenue as its Somerville “campus.” The Alliance had ended inpatient care at the hospital when it took over the facility in 2009.

Levis, who lived in Somerville with her husband, Peter DeMarco, went to the emergency room on foot early Sept. 16, 2016, because her asthma was worsening. After trying a locked door and not seeing any other entrance, she called 911. An emergency dispatcher notified the emergency room that someone was trying to get in; a nurse peered out the door into the dark and didn’t see Levis unconscious on a bench. Somerville paramedics found Levis with difficulty, because there were two addresses for the hospital – one on Highland Avenue for medical offices and some medical departments, and the main entrance up a steep hill on Tower Street where the emergency department was.

Levis died seven days later. CHA doctors and officials never told DeMarco what happened and stayed silent as he publicly lavished praise on the hospital for its efforts to save his wife’s life. He found out the full story from a police report; his moving account of the truth in The Boston Globe Magazine brought a torrent of condemnation for the Cambridge Health Alliance. Cambridge Day had reported the incident 10 months earlier based on a federal inspection report that cited the health care system for serious violations. Cambridge Day could not obtain names, and an Alliance spokesperson refused to answer specific questions.

The new rules, which go into effect in January, resulted from DeMarco’s campaign to prevent a similar occurrence.. State legislators approved “Laura’s Law” in January 2021. It required hospital emergency departments to have entrances that are clearly marked, monitored and easily accessible.

The former CHA Somerville Hospital used the prescribed white-and-red emergency room sigh standards on Feb. 27, 2020. (Photo: Marc Levy)

The regulations lay out the details. For example, they specify that external signs identifying the emergency room must be “visible from public thoroughfares” and “shall read ‘EMERGENCY’ in all caps in red on a white background or white on a red background.” Hospitals must provide “lighted communication technology” at main entrances, emergency entrance, ambulance entrance, “any door a patient may typically use” and in “strategic locations” throughout the hospital grounds. The communications devices must work for people with low vision, hearing loss, speech impediments and cognitive difficulties.

Security desks must be staffed 24 hours a day every day, or must offer a phone number that will bring “immediate assistance,” the rules say. When Levis tried to get into the Somerville Hospital emergency room, two security guards weren’t at the desk because they were at a patient’s bedside.

CHA upgraded signs and communications systems for emergency departments at Somerville and at its Cambridge Hospital and Everett Hospital after Levis’ death. Spokesperson David Cecere said Friday that the health care system complies with the new regulations and is “continually looking to improve wayfinding and safety.”

The rules don’t apply to the urgent care center now at the Somerville site, but “we follow similar protocols during its hours of operation and have 24/7 public safety measures in place at our Somerville campus,” Cecere said.

CHA chief executive Assaad Sayah was a member of a workgroup “assembled by the Massachusetts Department of Public Health to inform the new regulations,” Cecere said in answer to a question. Sayah was chief medical officer of the health care system when Levis died; his predecessor as chief executive, Patrick Wardell, resigned in June 2020.