NIGHTCLUBS HIRE AMBULANCES FOR OVERDOSES, SKIPPING 911

Some Manhattan nightclubs have hired private ambulance companies to wait
outside and to swiftly take revelers who overdose on drugs to hospital
emergency rooms, bypassing the 911 system and the attention of the police.

The practice was noticed last fall by emergency room nurses at St.
Vincent's in Manhattan when a large number of young people suffering from
acute drug overdoses began showing up on weekend nights, usually
transported by private ambulances. Often, the nurses said, the patients had
not been given the proper care en route, and many were in such serious
condition that they needed to be put on respirators.

Deputy Mayor Rudy Washington said last night that he was outraged by the
practice, and that it was further proof that the clubs should be shut down.

"By using private ambulances, it makes it more difficult for us to keep
track of how many people are going to the hospital and it keeps it
difficult for the police to find out what is going on because they are
never called with these companies," he said. "It is ludicrous. People are
overdosing and the fact they put an ambulance outside a nightclub should be
enough to establish that nightclub should be closed."

St. Vincent's officials said they notified the Manhattan district
attorney's office about the numerous overdose patients arriving from
nightclubs. The district attorney's office began an investigation into the
drug activity at the clubs and whether the private ambulances were being
used to circumvent the police, according to hospital officials.

Many of the club patrons, almost all around 19 years old, come from Twilo,
a dance club in Chelsea that the city has long tried to close down,
contending that it serves as a drug marketplace. Last summer, a young
medical student passed out on the dance floor of Twilo and was pronounced
dead at St. Vincent's of a drug overdose.

Night nurses at St. Vincent's reported that most of the revelers arrived
from the nightclubs unconscious, often half dressed and wet from being
splashed with ice water in an attempt to sober them up, said Suzanne Pugh,
nurse manager at the hospital.

Many had low body temperatures and were breathing very slowly, known side
effects of a drug overdose, usually caused by Ecstasy or GHB, or gamma
hydroxybutyrate, which is commonly known as a date rape drug.

Ms. Pugh said she became concerned not only over the number of patients
arriving in drug-induced stupors -- four or five a weekend night, a 100
percent increase from the prior year -- but about the care that the private
ambulance crews, mostly from MetroCare Ambulance, the state's largest
private ambulance firm, were providing.

"The Police Department did not know what was going on," she said, adding
that it did not appear that the patients had been attended to by
paramedics, who are trained and equipped to give advanced life support.
"The kids were not getting the level of care that 911 would have given. One
kid was breathing four times a minute. If these kids were not young and in
really good condition they would not have been able to sustain as they did."

Twilo and the Roxy, a club on West 18th Street, hired MetroCare in recent
months, and several clubs have been clients for even longer, according to
Robert Hirsch, director of MetroCare's sports and entertainment division.
He denied that care was substandard, saying that while some of his clients
contract for basic life support, which uses technicians and basic emergency
equipment, Twilo and the Roxy both pay for advanced life support with
paramedics, at a cost of about $225 an hour.

Mr. Hirsch said that if patients arrived needing life support, "I would
need to see if we brought them in."

Nightclub executives say that their use of MetroCare is no different than
that of sports teams or large concert arenas, which often hire private
companies to keep an ambulance waiting during major events. They also
acknowledge that the principal reason they need the ambulances is to deal
with people on drugs.

"The main reason that we hired MetroCare is because of GHB," said Jason
McCarthy, general manager of the Roxy. "Several clubs in the neighborhood
have had people die in them because of GHB. And when people go down, 911 is
useless. I do this to protect my clients who go into cardiac arrest."

A spokesman for the Fire Department, which oversees the city's Emergency
Medical Service, denied that service is slow. "Our response times are the
lowest they have been," said Deputy Fire Commissioner Frank Gribbon, citing
an average of less than six minutes.

Twilo is the subject of a lawsuit by two young patrons who allege that club
employees tried to hide them from an E.M.S. crew last summer when they
suffered drug overdoses.

"My clients were moved to isolated areas in the club and medical treatment
was denied," said Gregory Longworth, a lawyer for the two club patrons,
whom he did not identify. He said his clients were still undergoing medical
care.

Twilo, a club built in a former warehouse at 530 West 27th Street, has
attracted the ire of the city for more than two years. The Police
Department's Civil Enforcement Division filed a lawsuit in November 1998
seeking to close the club. The suit contended that the sale of drugs like
Ecstasy created a public nuisance. So far the city's efforts have been
unsuccessful.

No one at the district attorney's office would comment on its investigation
into the club's use of private ambulance firms, but a St. Vincent's
spokeswoman said nurses there had been interviewed and were cooperating.
Mr. Longworth said he had worked with assistant district attorneys in their
investigation.

Twilo officials contend that the city has bullied them rather than help
combat the rampant drug use.

"We are blamed for everything and we are never given the benefit of the
doubt," said Peter R. Sullivan, the club's lawyer. "The reason we are still
open is because we have been able to prove to the courts that we are the
safest club in New York."

He added: "People who go out dancing are in more medical need today than
they were 10 years ago because of the way that they entertain themselves.
We have been asking the city for two years to work with us to make sure
there are no illegal drug transactions in the club and they have refused.
So we have had to create a state-of-the-art medical system of our own."