Tracy Lanese and the off-duty Hilton Head paramedic, Adam Hoffman, said the paramedics refused to touch Brian Lanese. She and Hoffman eventually carried Brian Lanese to the ambulance themselves.

Hoffman asked repeatedly whether the paramedics planned to take Brian Lanese to Savannah's Memorial University Medical Center, a top-rated trauma center, instead of Hilton Head Hospital, which was not staffed or equipped to treat trauma cases.

One of the paramedics told Hoffman that Lanese was going to Hilton Head, adding that Hoffman had no say in the matter because Â"beggars can't be choosers,Â" according to the paramedic's written account of the incident.

The other paramedic commented that Lanese didn't need to go to a trauma hospital because he Â"was not that serious,Â" according to a letter describing the scene that Hoffman later wrote to Beaufort County administrator Gary Kubic.

The first paramedic assessed Lanese's head injury as Â"moderateÂ" and noted his level of consciousness as Â"alert,Â" although his eyes were swollen shut, he was incoherent and didn't respond to questions.

Hoffman ultimately telephoned Hilton Head Hospital's emergency room and spoke to a doctor who said he would order the ambulance to go to Savannah. Lanese was still bleeding when he arrived at the Savannah hospital 35 minutes after leaving his home, hospital reports said.

Lanese's injury turned out to be severe. He was in a coma in an intensive care unit for nearly two weeks and underwent several surgeries. He spent a month in the hospital, followed by months of rehabilitation at home.

Hoffman's letter to the county administrator prompted an investigation by the S.C. Department of Health and Environmental Control. DHEC concluded there were problems with the paramedics' conduct and Â"on-scene management,Â" and that their Â"response did aggravate the situation.Â"

The Lanese suit is at least the second filed against Beaufort County EMS in the past seven months. In March, the mother of a 17-year-old Bluffton High School student who died following a prom-night car wreck in May 2008 filed a wrongful death lawsuit, alleging county paramedics took her son to Hilton Head Hospital instead of a trauma center.

To qualify as a trauma center, a hospital must meet standards established by the American College of Surgeons. Level 1 facilities, such as Savannah's Memorial University Medical Center and the Medical University of South Carolina in Charleston, must have a full range of surgeons, specialists and equipment available 24 hours a day.

Beaufort Memorial Hospital is a Level 3 trauma facility, able to provide emergency resuscitation, surgery and intensive care, but fewer surgeons and specialists are on-call there. Hilton Head Hospital used to be a Level 3 center but dropped that status in July 2007.

The teens accused of attacking Brian Lanese are expected to stand trial in the coming months, according to the 14th Circuit Solicitor's Office.

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