Support urged for Hilo cath lab

  • HOLLYN JOHNSON/Tribune-Herald Dr. Carl Juneau, an interventional cardiologist who recently joined Hilo Medical Center's cardiology program, stands in the cath lab Wednesday at HMC in Hilo.

Proposed legislation in both the State House and Senate could help provide better cardiac care in East Hawaii.

House Bill 527, introduced by state Rep. Mark Nakashima, whose district encompasses Hamakua, North Hilo and portions of South Hilo, would provide $3 million of state general revenue funds in fiscal years 2019-20 and 2020-21 for the establishment of a full-time cardiac catheterization lab at Hilo Medical Center.


Nakashima said having a cath lab in East Hawaii would help increase a patient’s chance of survival and quality of life by having access to procedures that potentially stop heart attacks while they are occurring.

He’s heard of heart attack patients who have died after being transported off-island because the damage was already done.

“This will kind of put an end to that scenario, where if we can treat them on-island, we can increase the survival rates.”

According to Nakashima, $1.5 million was budgeted for this effort last year, and the appropriations over the next two years will bring the cath lab up to full staffing and ensure the viability of the program.

After three years, he said, HMC hopes the program will be self-sustainable.

The measure was was heard by the House Committee on Health Tuesday and recommended for approval, with amendments.

Testimony submitted before the hearing was overwhelmingly supportive of the measure, with just one person opposing the funding.

“For better or worse, over the past few years, I have developed an ongoing and personal relationship with HMC and a number of other medical institutions,” Mayor Harry Kim wrote in a letter to the committee. “HMC has given me excellent service, and Hawaii should be very pleased with the quality of care it provides. However, it could do even more if more resources were available, and better cardiac care has been identified as a priority.”

Kim has had six heart attacks, the latest occurring last summer, and had an external heart defibrillator installed in July.

Jerry Gray, a retired emergency department physician and member of the East Hawaii Regional Board of Directors that governs the hospital, also urged support for the measure.

Having spent 15 years working in the HMC emergency department, Gray said he knows first-hand the difficulty patients have getting standard-of-care services for heart attacks.

“Time is muscle, and transferring patients to Oahu for this critical service is not acceptable,” he said in submitted testimony. “With the legislature’s help last year, we have been able to begin recruiting and planning for the needed services later this year. Continuing support is needed to launch the program beyond infancy.”

Dr. Carl Juneau, an interventional cardiologist who recently joined HMC, said in submitted testimony he had first heard of the need for such services on the Big Island from a patient in Nevada who was hesitant to visit knowing there was no cardiac intervention in the case of emergency.

Juneau said while on a flight to the island, his wife spoke with a woman who was excited about their visit. Her mother had died of a heart attack because she didn’t want to be transported to Honolulu.

“Later that day, while checking in at the bed and breakfast, our hostess cried and hugged me when I told her the reason for our visit,” he said. “Our realtor’s husband has a good friend who died after a heart attack while on a transport plane. Since our arrival here, we have heard countless stories from people who have lost family members or friends to heart attacks. These are the people that this program will help.”

Juneau said he was instrumental in establishing a new interventional program in Nevada and saw the benefit to the community.

“This type of program requires an entire team. The goal is to establish a solid foundation that will grow with the community’s needs and be sustainable in the long run. The future outlook is so promising.”

Prior to Juneau’s arrival, HMC could administer clot-busting medications and perform diagnostic catheterizations to determine if a patient needed to be transported off-island.

But with his arrival, the hospital can now perform interventional catheterizations to stop a heart attack in progress and insert stents to maintain blood flow.

On Thursday, HB527 was re-referred to the House Health and Finance committees.

A similar bill has been introduced in the state Senate by Sen. Kai Kahele, a Hilo Democrat.

If passed, Senate Bill 911 would appropriate $1.5 million for fiscal year 2019-20 and $1 million for fiscal year 2020-21 for recruitment, staffing, equipment and training costs associated with cardiology care.

As of Thursday, that legislation has passed first reading and was referred to two other committees for consideration.


“Hilo Medical Center is thankful for Rep. Nakashima’s and Sen. Kahele’s continued leadership and support for building our cardiology services,” HMC spokeswoman Elena Cabatu said. “Our cardiology program is on track to meet our goal by the end of 2019 to perform interventional cardiology procedure that stops heart attacks in progress, save lives and improve the quality of life for cardiac patients.”

Email Stephanie Salmons at

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