GUEST COLUMN | Sean M. Cleary
Every year, thousands of Texans face the terror of a sudden heart attack, and their survival depends on immediate intervention and treatment. For those suffering from ST-Elevation Myocardial Infarction, a life-threatening type of heart attack caused by a blocked coronary artery, swift access to percutaneous coronary intervention can make the difference between recovery and death.
Yet, across Texas, too many patients still face a deadly delay. Instead of being transported directly to PCI-capable hospitals, many are first taken to smaller facilities that cannot perform the necessary procedure.
This doesn’t happen due to medical ignorance but because hospital networks, insurance protocols, and outdated policies prioritize keeping patients “in the system” over their survival.
We’re not talking about isolated incidents. Nationwide, more than 30% of STEMI patients don’t receive the therapy they need immediately.
It’s an uncomfortable truth, and Texas faces the same issues. In the absence of a STEMI Bypass law, patients are dying because of delayed interventions.
Delaying PCI is Often Lethal
Decades of cardiac research have proven that delayed STEMI treatment leads to heart muscle failure. For every minute that blood flow remains blocked, the heart muscle is damaged and can even die.
Medical guidelines indicate that the patients must receive PCI within 90 to 120 minutes of first medical contact to prevent irreversible damage. Yet, nationwide, many STEMI patients miss that critical window, and the consequences are devastating. Every additional 30-minute delay in restoring blood flow increases the patient’s risk of death by approximately 7.5%.
Those extra minutes represent lost lives and grieving families, not just numbers. I’ve personally reviewed cases where the system- driven decisions proved fatal. In one tragic example, a man was taken to an innetwork hospital that lacked PCI capability, even though a betterequipped facility was closer.
By the time he was transferred, his heart was beyond repair. A jury later found that the hospital’s decision, driven by financial policy rather than medical judgment, was reckless. His family received $45 million as compensation, but that will never make up for the loss of a human life due to a bureaucratic mistake.
I encountered this incident in Florida, but it is also highly relevant to Texas, where 120 health and hospital systems operate in a complex network driven by administrative decisions that often override clinical urgency in favor of profitability and economic benefits. Without a clear STEMI law mandating direct transport to PCI-enabled hospitals, countless patients risk being routed to the wrong emergency room simply because of insurance ties, not medical need.
Texas Urgently Needs a STEMI Bypass Law
Texas prides itself on leadership and independence. Yet, in cardiac care, it lags behind several other states that have already enacted bypass laws to save lives. North Carolina and Michigan now require emergency medical systems to take suspected STEMI patients directly to PCI-ready hospitals.
This approach has had measurable success. Patients taken straight to PCI-capable facilities are nearly three times more likely to receive treatment within the crucial 90-minute window.
Survival rates rise from 93% to 95%, and long-term complications decrease dramatically. These figures represent thousands of patients who can return to their loved ones without severe complications and families spared from the agony of preventable loss.
For a state where heart disease is the number one cause of mortality, the STEMI Bypass law should be the leading priority for legislators. Texas cannot afford to delay action, because these people should not die because of where an ambulance takes them.
Such a law would unify Texas’s vast healthcare landscape, empower EMS responders, and reaffirm a simple yet powerful promise: when you call for help, the system will take you to where you have the best chance of surviving. It’s a moral obligation, not just a simple healthcare reform. Texas must lead the way in breaking down barriers to cardiac care, proving once again that doing the right thing can be a life-saving decision.
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.
