Breaking cardiac care barriers: The urgent need for a STEMI bypass law in New York

Every year, thousands of Americans suffer heart attacks that strike without warning, thereby leaving precious minutes to determine whether they survive. And for patients with ST-Elevation Myocardial Infarction (STEMI) — a fatal type of cardiovascular disease characterized by a blocked coronary artery —  each minute is critical. Swift restoration of blood flow is essential to prevent irreversible tissue damage and, ultimately, save lives. Yet accessing the most appropriate treatment — known as percutaneous coronary intervention (PCI) — is often hampered by a fragmented healthcare system that frequently functions based on network protocols rather than clinical urgency. Instead of ensuring that patients are transported directly to facilities capable of performing the necessary medical intervention, numerous hospitals prioritize keeping patients “in the system” to protect their financial interests.

Unfortunately, this is not an isolated incident. Data indicate that more than a third of STEMI patients nationwide fail to receive the therapy immediately. New York also faces a similar challenge. Although the state is home to prestigious hospitals, many are not PCI-ready, and the absence of a STEMI bypass law means that ill individuals often do not reach the right facility promptly, leading to deadly consequences.

Delaying PCI can put STEMI patients at grave risk

Throughout the past decades, extensive clinical research has firmly established the crucial role of time in the treatment of STEMI. Accordingly, for every minute that coronary blood flow remains obstructed, heart muscle tissue can be seriously damaged and, worse, die, increasing the risk of severe complications and diminishing survival chances. To avoid this, medical experts have consistently emphasized that patients must receive PCI — the gold standard therapy — within 90 to 120 minutes of initial medical contact. Regrettably, despite this clear guidance, far too many patients across the nation, including those in New York, still fail to receive treatment within the necessary window. This alarming trend connotes that countless individuals are compelled to face the dire consequence: for every additional 30 minutes of late response, the likelihood of death also goes up by about 7.5%.

The dangers of this delay are not theoretical — they have already unfolded in many devastating ways. In fact, I have personally witnessed one painful outcome in a case I previously handled. This involved a man in Florida who suffered a severe heart attack and was taken to a hospital unequipped to perform PCI. That healthcare provider had a practical choice: transfer him to the nearest facility equipped to provide the life-saving procedure. However, instead of making this decision, the hospital opted to follow system protocols and sent him to a farther, in-network facility. By the time the patient finally arrived at a PCI-ready center, it was already too late, and the man had tragically died. A jury later found such an action to be reckless and awarded his family $45 million.

Though this incident occurred in Florida, the warning it carries is highly relevant to New York, which has over 130 community health and hospital systems. Such evidently underscores that when profitability and institutional loyalty override patient survival, preventable deaths become inevitable. Without a decisive policy that mandates direct transport to PCI-capable hospitals, numerous residents in the Empire State will face the unacceptable risk of being routed to facilities according to network rules rather than their immediate need for crucial care.

Why New York urgently needs a STEMI bypass law

Several states — including North Carolina and Michigan — have already recognized the necessity of bypass protocols to improve outcomes for STEMI patients. These policies specifically require emergency medical services (EMS) to transport patients directly to PCI-capable hospitals to ensure that critical minutes are not wasted on unnecessary transfers. Yet despite their advantages, New York has not enacted a similar safeguard, leaving healthcare providers vulnerable to network rules that pressure them to transport sick individuals to facilities within their system even when an equipped center is closer.

The benefits of a coordinated bypass system have been evident. Records show that patients delivered quickly to PCI-equipped hospitals are nearly three times more likely to receive intervention within the standard 90-minute benchmark, while survival rates improve from approximately 93% to more than 95%. These are not mere figures — they represent thousands of families spared from the agony of preventable loss and patients who can return to their lives with fewer long-term complications.

These remarkable results make it clear that New York cannot afford to delay action any longer. As such, lawmakers must take a step by passing a STEMI bypass law that makes sure patients are taken swiftly to the nearest PCI-ready hospital, notwithstanding their network affiliations. With such a measure in place, hundreds of residents in the Empire State could dodge tragic death or lifelong heart failure. Essentially, this is more than a matter of policy — it is a test of leadership and commitment to guarantee that every New Yorker receives the fastest and most effective care at a time when it really matters.

Sean M. Cleary is the founder of The Law Offices of Sean M. Cleary P.A., a law firm based in Miami, Florida. He and his legal team are committed to providing support and guidance to victims pursuing justice and due compensation for medical malpractice.