ASHTABULA — The Ohio Nurses Association filed a federal civil complaint Monday, asking for an emergency injunction against Ashtabula County Medical Center to prevent the closure of ACMC’s obstetrics birthing unit on Aug. 1.
The lawsuit states closing the obstetrics unit will have a severe negative impact on women’s health, is a violation of the ONA’s labor agreement and is a form of sex discrimination. Closing the OB unit removes the only OB unit in Ashtabula County, with ACMC referring expectant mothers to the Cleveland Clinic’s Hillcrest Hospital more than 50 miles away.
Stephanie Hall, an Ashtabula resident and expectant mother, and Rebekah Spencer, a registered nurse at ACMC and expectant mother, are also listed as plaintiffs on the complaint. The action, filed in United States District Court for the Northern District of Ohio, Eastern Division, requests a jury trial.
"We have referred this to our legal counsel for review," said ACMC Healthcare System President and CEO Michael Habowski.
Bob Cousins, deputy executive officer of labor relations with the Ohio Nurses Association, said the closure of the OB unit is sex discrimination and a violation of the nurses' labor contract.
"The trustees have a duty to stop this from happening and to protect pregnant women and babies in Ashtabula County, but they failed," Cousins said in a prepared statement. "The Ohio Nurses Association filed this lawsuit to fight back on behalf of Ashtabula’s mothers and babies and the registered nurses they depend on."
The complaint cites ACMC’s 2013 report on maternal health in Ashtabula County that states while the overall birth rate in the county is lower than elsewhere, expectant mothers in the county are more likely to demonstrate high-risk behaviors.
ACMC plans to continue office visits for expectant mothers, and then refer them to Cleveland Clinic’s Hillcrest Hospital, hospital officials have said.
The lawsuit states the plan would increase the risk of a pregnant woman giving birth in transit and disrupt the continuity of care. Furthermore, pregnant women in poverty or with limited transportation are relegated back to ACMC for an emergency room delivery because of the lack of an OB unit. All of these scenarios will increase the chance for poor patient outcomes, particularly for high-risk patients, in a state already plagued with infant mortality problems, according to the complaint.
The complaint also cites a violation of ONA’s labor agreement. The ONA filed a class-action grievance on July 21 alleging a breach of 31 sections of the collective bargaining agreement. The grievance states the hospital announced the permanent closure of the OB/Maternity ward without proper notice or the consent of the union.
Rather than continuing to provide local OB-GYN services to local residents, ACMC has transferred the work of its registered nurses to Cleveland Clinic’s Hillcrest Hospital. Furthermore, the ONA is investigating the role of the Cleveland Clinic in this decision, as ACMC is a Cleveland Clinic-affiliated hospital and the Cleveland Clinic has as history of closing OB units across Ohio, according to the complaint.
The ONA’s lawsuit also states the closure of the OB unit is sex discrimination in violation of the Patient Protection and Affordable Care Act. ACMC does not deny access to healthcare to men regarding male-specific conditions, regardless of the profitability of such care. The ACMC has no legitimate justification for the closure of the OB unit, according to the complaint.
In addition, the action states that the ACMC Board of Trustees have a responsibility to ensure that Ashtabula County’s expectant mothers continue to have access to obstetric and delivery medical care services at ACMC.
“This scheme clearly doesn’t benefit the community, so it is time we start asking who it does benefit," Cousins said. "ACMC plans to refer deliveries to Cleveland Clinic’s Hillcrest Hospital. The president of the clinic’s Hillcrest Hospital, Dr. Richard Parker, is also a member of the board of trustees for ACMC. Clearly, this decision benefits Hillcrest at the expense of the women and infants in Ashtabula."
The ONA is seeking an emergency hearing this week on the injunction to stop the closing scheduled for Aug. 1. The nurses cite, among other provisions in the action, that the unit cannot close until the grievances filed by the union pertaining to the closure of the OB unit are resolved by an arbitrator.
The Ohio Nurses Association represents about 15 OB nurses at ACMC.
The ONH is not the only entity upset with the decision — Ashtabula City Council sent a letter on July 9 to ACMC expressing concerns over the closing.
“While we can certainly appreciate the difficulty of your choice, we respectively disagree,” the letter from City Council said. “We feel your service as the singular source for maternity facilities in Ashtabula County is vital to our community. Closing labor and delivery units sends a bleak message to young couples in Ashtabula.”