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Early next year, Providence Health & Services will significantly reduce the availability of open heart surgery in Humboldt County by eliminating the only cardiothoracic surgeon position at St. Joseph Hospital, according to three employees who were present when the decision was announced internally last week.

In interviews with the Outpost, the employees say Providence made its decision for financial reasons, and they warn that the reduction in services will inevitably delay critical care to patients who suffer cardiac emergencies. Without a local open heart surgeon, county residents will also have to travel out of the area for non-emergency procedures such as valve replacements and coronary bypass surgeries.

A hospital spokesperson told the Outpost that Providence is not eliminating its heart program, though he declined to respond to allegations that the availability of cardiac surgery services will soon be reduced significantly.

In a staff meeting last Thursday morning with more than 100 employees present, management announced that Dr. Joseph Arcidi, the county’s only open heart surgeon, plans to resign by the beginning of February and administrators don’t intend to replace him.

Once he’s gone, they were told, Providence will have an out-of-county heart surgeon (probably from Santa Rosa) come to Eureka for six days per month to serve as the designated surgeon-on-standby during non-emergency heart procedures such as stent placements, angiograms and radial artery catheterizations. For the other 24 days per month, give or take, those procedures won’t be available locally, they said.

If anyone in Humboldt County suffers a serious cardiac emergency while the visiting surgeon happens to be in town, then local open heart surgery will likely be available. But if the emergency occurs outside of that six-day window, it won’t, the employees told the Outpost. 

“That could be detrimental to people who need cardiac surgery instantaneously,” said hospital employee Jessica Smith. [NOTE: That’s not her real name. She requested anonymity due to fear of professional repercussions.]

Asked if it’s fair to assume that local residents will die as a result of this decision, Smith didn’t hesitate. “Absolutely,” she said. “I 100% believe that.”

Austin Allison, a former Eureka City Councilmember and surgical technologist at St. Joseph Hospital, agreed to go on the record. He said that while heart attacks now are typically treated without having to open up the heart, there are other kinds of cardiac traumas that can occur without warning.

“There are accidents that happen all the time,” he said. “There’s shootings, stabbings … car accidents. Now, there will be no one [locally] available to help them” — except on those days when the out-of-town surgeon happens to be here.

Smith recalled one such incident when a patient was brought in to St. Joseph Hospital’s emergency room following heart trauma that required emergency open heart surgery. Time is of the utmost importance in such cases.

“The patient’s bleeding inside, and the pericardium is like a balloon — it can only hold so much,” Smith said. “The pressure builds up so much in the sac that [holds] the heart that the patient [eventually] dies because the heart can’t move.”

In this case, the patient was quickly moved into surgery and survived, Smith said. But if a similar incident happens after Dr. Arcidi leaves — and if it occurs outside of the six-day window when a visiting surgeon is here — then the patient will almost certainly need to be air-lifted to Santa Rosa or St. Helena, which takes at least two hours on a good day, according to Smith and Allison.

“And it’s weather-dependent,” Allison said. “You know how often our airport is grounded.”

Asked whether such a delay could prove fatal Smith said, “It’s just a matter of time.”

Emergencies can also arise during more common heart procedures. St. Joseph Hospital’s Heart Institute is a designated STEMI receiving center, meaning it is equipped to handle ST-segment elevation myocardial infarction, the kind of serious heart attack often referred to as “the big one.”

Having a heart surgeon on standby is a precondition for being a designated STEMI receiving center, in part so that the surgeon — Dr. Arcidi, in the case of St. Joseph Hospital — is available should anything go wrong during procedures regularly performed in the cardiac catheterization lab (or “cath lab”).

“The cath lab is like the plumbing department,” Allison explained. Procedures commonly performed there include coronary angioplasties (in which a balloon is used to widen blocked or narrowed coronary arteries) and percutaneous coronary interventions, or PCI (in which a stent is inserted in a coronary artery to keep it open and prevent it from closing again).

Such procedures typically involve inserting a long, thin catheter tube, or “wire,” into a blood vessel in the patient’s wrist.

“But, say if the wire leaves that vessel and makes a hole, it’s possible to have a bad outcome and [the patient] may have to have open heart surgery,” Allison said.

“If you have a puncture, you have to have someone who can fix it,” confirmed another St. Joseph Hospital employee, who we’ll call Melissa Jones [also a pseudonym].

Such incidents are very rare, but Allison said it’s still important to have the heart team on standby. Jones explained that this team includes not just the surgeon but also an anesthesiologist, cardiovascular technologists and a perfusionist to operate the heart-lung machine.

“If your dad was getting an emergency surgery, you’d want him to have this [backup team] available and not have to go to Santa Rosa,” Allison said.

Smith recalls at least two patients who came in for pacemaker procedures, which are considered “elective” in that they’re meant to prevent cardiac emergencies rather than treat them. These patients fell victim to a rare accident in which the wire inserted into the heart perforated the left ventricle, “meaning the heart is actively pumping, and every time it pumps, blood is leaking out into the pericardium,” Smith said. “That [requires] surgery because blood is pooling around the heart.”

As with the heart trauma mentioned above, acting quickly in such cases is critically important.

“There’s no time to transfer them [to an out-of-county hospital] before they die,” Smith said.

Providence Denies Changes

The Outpost first received a tip last week saying that St. Joseph’s heart program would soon be eliminated altogether. We emailed Christian Hill, senior communications manager for Providence Northern California, and he responded, “I can confirm that we are NOT closing our heart program at St. Joseph Hospital.”

He also asked us to reveal our sources.

Last Thursday, having interviewed the above-quoted employees, we followed up with Hill to relay the specifics, including Dr. Arcidi’s pending resignation; the subsequent reduction in cardiac surgery services; the plan to bring a visiting surgeon to Humboldt County for six days per month; and the elimination of “elective” heart surgeries outside of those limited business hours.

Hill’s reply, sent five hours later, was brief: “Thanks for the follow up,” he wrote. “The email from Thursday is our response.”

Smith anticipated such a denial when we interviewed her earlier in the week.

“They’ll come back and say, ‘We’re not taking it away,’ you know. But they’re gonna offer it six days a month. That’s taking away,” she said.  “We [currently] have cardiac coverage 24/7. We have cardiac coverage for open heart surgery 24/7, 365. It’s always available. We always have a cardiac surgeon ready to go.”

After Dr. Arcidi leaves, that won’t be the case, she said.

When we spoke with Jones on Monday, she said, “The fact that they’re denying it seems crazy to me because they announced it in a meeting with more than 100 people.”

The Outpost called St. Joseph’s Heart Institute in hopes of speaking with Dr. Arcidi himself, but we were told that he is out of town through the end of the month.

Financial motives

Providence Health & Services, a Catholic health care system headquartered in Renton, Wash., is organized as a not-for-profit, but critics say it operates like a greedy corporation. It has reported hundreds of millions of dollars in operating losses each year since the COVID pandemic, but it also earns hundreds of millions through venture capital and financial market investments. The industry website Fierce Heathcare recently reported that Providence racked up $7.8 billion in unrestricted cash and investments through the first nine months of 2024.

Allison said Providence cares more about profits than patients, as demonstrated by its decision to slash open heart surgery services in Humboldt County.

“The [administration] is basically saying, ‘We don’t want to keep this program because it’s too expensive to run, just like what happened to rehab,” he said, referring to the recent closure of the acute inpatient rehabilitation unit on the General Hospital campus.

“It seems like with this hospital, if a program isn’t in the black they don’t want to subsidize it, even if it helps the community,” he continued. “You’re going to have to be flown out of the area to get the care you need. It’s just a scary thing for the community.”

He also lamented the impact this may have on the larger community.

“It hurts Humboldt County because when we lose health services, it makes future industry growth here poor,” he said. “People aren’t going to want to move to the area if our health care sucks. … The greed of the corporation is really affecting the rest of the county, because there really is nothing else available.”

He paused to acknowledge that some services provided by Providence are actually expanding. For example, he said, there’s now a pulmonologist on staff for the first time in years. 

“But we have to be aware of how Providence is a monopoly for services and how that affects this county,” Allison said. “It just seems so greedy, everything they’re doing. Losing the cardiac program is just one more thing.”

Both Smith and Allison said that starting next February, more local patients and their families will have to endure the inconvenience and expense of traveling out of town and staying for days during the difficult recovery period for open heart surgery.

“Open heart surgery recovery takes at least a week,” Smith said. 

Many patients who are forced to leave Humboldt County for surgery won’t have their families nearby for support — or their families will have to travel and stay in hotels, eat out and rack up expenses.

“[Currently] you have your family, your resources here to help take care of you,” Allison said. “Open heart surgery is a very big deal, and recovery can be difficult. …. To be out of Humboldt where your family is is, like, a really big undertaking.”

But all three employees agreed that the most serious repercussion of this decision will be the increased risk faced by people here in Humboldt County who suddenly experience a cardiac emergency and are forced to wait hours to receive the necessary care.

”To only have six days a month for the cardiac program? It’s ridiculous,” Smith said. “I just hate this for the community.”