Obese patients pose dilemma for ambulance companies

EMTs need special equipment to transport obese patients.

INDIANAPOLIS - Nearly one in three Hoosiers is obese, costing taxpayers billions of dollars and putting life-saving companies and their patients at odds.

13 Investigates recently got rare access inside a delicate health dilemma, one so new, the state and ambulance companies are struggling to keep up, sometimes leaving lives in the balance.

Fighting for her life, within the confines of her apartment walls, a young woman's survival weighs in the balance of two worlds. 

One you can't see.

"I'm not ready to die yet. Without my chemo, I'm not going to make it," said the woman, Trisha, lying in a large hospital bed.

The other, you can't miss. 

"I'm 5'1". Right now, I'm about 664 [pounds]," she added. 

Trisha is morbidly obese and confined, most days, to her bed. She doesn't want her face shown, saying it's the only dignity she has left. Her weight has been a problem all of her life. She now suffers from thyroid problems, along with a host of other health problems.

But she never imagined this.

"Having to sit here everyday and worrying if I'm going to die because I can't get to my appointments," said Trisha. 

She's missing cancer treatments, because ambulance companies can't or won't transport her. They say it's risky, she's too big. Even special equipment can't guarantee a ride.

EMTs at Eaton Ambulance have four battery-powered bariatric cots in their fleet. The cots are designed to carry most patients up to 700 pounds. The company is dealing with a growing number of morbidly obese patients. The company's operations manager can't talk about them specifically. 

"Has there ever been a time when you guys have had to turn somebody away?," asked 13 Investigates.

"Yeah. There actually has been. Our cots were wide enough for the patient to fit on, but not strong enough to carry this patient," admitted Dustin Reese, the operations manager for Eaton EMTs. 

He says the super-sized cots are used everyday. 

In fact, the state estimates it costs taxpayers $1.9 billion a year to treat obese patients. It's forcing ambulance companies like Eaton to make hard-line decisions.

Either strain their budgets...

"It's very expensive. Just one of these cots alone is $10,000," said Reese.

...strain their bodies...

"You've got one guy at each end. If somebody hurts their back, that puts an EMT out of service for who knows how long?" added Timothy Stapleton, an EMT with Eaton.

...or simply turn patients away. 

That's what happened to Trisha, who experienced a series of humiliating breaks to both equipment and employees trying to give her a lift. 

"The cot literally, practically folded in half, with me on it. The whole back, the hydraulic thing in the back had collapsed," she said describing those frightening moments.

Another time, she was nearly dropped.

"One of the employees at the nursing home got his arm broke trying to save me," she told 13 Investigates.

With no where else to turn, Trisha invites us in, giving us extraordinary access.

13 Investigates placed cameras around her room to get an honest account of what happens during transport. Her fiancee knows the routine, attaching straps underneath her sheets. A mechanical hoist lifts Trisha up.

It's her last ambulance ride for now. A one time deal, to get her to a doctor's appointment.

"What do you say to those people who might say, 'Well, you're in the situation you are in because of the weight and the problems that that creates for your body?" 13 Investigates asked Trisha, who says she's on a strict diet and doing exercises in her bed.

"I should not have to die now. Anybody obese that needs the help should be able to get the help," she responded.

With cameras rolling, no one can predict how it will end. Three ambulance crews back up outside. The six-member team must find the safest way to strap Trisha in and get her through the door.

"Hold on...hold on...hold on," Trisha yelled out as her leg brushed against the door.

It takes more than 40 minutes to get her out of the house and loaded. The first attempt fails. With compassion, the crew rebalances. This time, she's in.

No question, these difficult transports demand more time and resources. Many fire departments across the state are limiting lift assistance for patients - except in life and death situations.

Eaton Ambulance can't afford to tie up extra crews, it's also responsible for emergency calls.

"I can't send all my trucks out to be transports and leave our hometown uncovered for somebody having a heart attack up the road," explained Reese.

Still, the government says patients like Trisha are entitled access to medical treatment and transportation. The problem is, the government can't guarantee how they get it.

"Are (ambulance companies) allowed to refuse service to these people?" 13 Investigates asked. 

"Well, we're very limited in what we can and cannot regulate with what these companies do. We pay them for the services they provide. It's up to them to decide what services they want to provide," said Marcus Barlow, spokesman for the Indiana Family and Social Services Administration.

Now back home from her check up, Trisha is left to face the uncertainty of getting life-saving chemotherapy.

"I'm not going to quit now. I need help. Somebody's got to help me," Trisha said through tears.

St. John's Hospital says it was successful in helping Trisha get transportation for her radiation treatments. According to Trisha, future rides have not been scheduled for chemotherapy.  

The ambulance companies say the state isn't helping to offset the cost of bariatric equipment. Companies are reimbursed the same amount for a 600-pound patient as for a six-pound baby.

Update from reporter Sandra Chapman:

We appreciate all of our viewer feedback. It is a given that the patient in our story has some very serious personal challenges.

She is morbidly obese. But she is not alone, and our obesity rate in Indiana is growing. The goal was to provide a look into this dilemma since it's already costing the State $1.9 Billion dollars in treatment.

We only hope that as a community, we can get past the name calling and other degrading comments to try to figure out how to address the costs, the resource issues, and yes the humanity of the response. Also just to be clear, the footage was shot just over a month ago. We understand there have been emergency hospital visits that required transport. Thanks and stay tuned.

Sandra Chapman - 13 Investigates