Inside the Summit County ERs that treat thousands of skiing injuries every season (2024)

FRISCO — Marc Doucette started working in the emergency department at the St. Anthony Summit Medical Center in 2005, when about 11,000 patients a year would pass through the emergency room.

Now, the annual traffic through the Level 3 Frisco emergency department is closer to 16,500. Anywhere from a third to half of those come from nearby ski areas: Arapahoe Basin, Breckenridge, Copper Mountain, Keystone and Loveland. The now CommonSpirit St. Anthony Summit Hospital runs emergency and urgent care clinics at the base of Breckenridge, Copper Mountain and Keystone.

The Level 1 emergency clinic at Breckenridge can see 100 patients a day when the resort is busy. Keystone and Copper Mountain clinics see 20-to-30 patients a day.

“Our volumes have trended upward,” says Doucette, a fast-talking emergency medicine doctor – and avid skier – who keeps his hospital-issued mobile phone in his hand as he hustles between rooms.

Dr. Clarice Sage is the medical director of the three CommonSpirit Health base-area mountain clinics. Breckenridge, the most visited ski area in the country, sees visits spike during holidays, with about 40% of its patients coming from the ski area and 60% are visitors and locals with urgent medical issues. Keystone is the second busiest of the three followed by the emergency center at the base of Copper Mountain. The Copper clinic sees closer to 60% of its patients injured on the ski area. And those injuries at Copper are “high acuity,” Sage says, with more intense trauma.

“There’s so many events there … just the vast quantity of people and these young people just doing crazy sh*t,” says Sage of the “athlete’s mountain,” where elite skiers and snowboarders flock to train and compete in top-tier race and freestyle venues. “The level of competition over there has gotten so big.”

On this March day, Doucette is watching 13-year-old Silas Luckett, who was knocked unconscious after colliding with trees at Breckenridge. Among the patients in the 17-bay emergency room is a 79-year-old woman from Montana who fell while loading a chairlift at Copper Mountain and was knocked unconscious.

She’s doing fine, but Doucette wants to look at her scans. He sits down in a small room and starts scrolling through images on his computer.

“Bone looks bright and blood looks bright so she’s got a little bit of bleeding here in what we call the basal ganglia deep in her brain,” he says. “It would be more than a concussion.”

He has sent the images to a neurosurgeon to see if she needs to be transferred to St. Anthony Hospital in Denver. She might need to go down there for more observation.

Then there’s a 19-year-old woman visiting from Kansas who broke her femur earlier that day after skiing into a tree at Breckenridge. She’s heading to the operating room for surgery soon. There’s a 76-year-old man who fell skiing at Loveland and broke his collarbone. An ambulance is incoming with a 33-year-old skier who broke his femur after colliding with a tree at Keystone.

Doucette has nine patients in his emergency department rooms, four with skiing injuries and the rest are patients needing medical attention for an injury from a fall, appendicitis, breathing problems and other medical issues.

“It’s surprisingly slow,” he says, describing how the previous day he had six simultaneous traumas from the ski areas. “It will get busier in the late afternoon, I imagine.”

Doucette says “it feels like” the severity of injuries is increasing alongside traffic through his ER.

He sees a lot of orthopedic injuries. The sampling in his ER on this day is a good example with a head injury and various broken bones.

Older skiers on the slopes

Lois Woodard was spending the day skiing black-diamond terrain with her husband at Copper Mountain. The 79-year-old from Dillon, Montana, isn’t exactly clear what happened as she was loading the Alpine lift — a fixed-grip double — but she fell and hit her helmeted head.

“I just could not get up,” she says.

Woodard was a volunteer ski patroller at the Bromley ski resort in southern Vermont where her husband worked as a paid patroller from 1968 through 1987. She’s never been injured skiing. Until today.

“It is embarrassing to mess up on a chairlift. The worst,” she says, her goggle-tanned cheeks glowing amid all the white in the Frisco emergency room. “I have to say the patrollers and lift operators at Copper were fabulous. They were so attentive and efficient.” (It’s important to note that virtually all the skiers interviewed for these stories — like the Woodards — offered high praise for ski patrollers who cared for them and delivered them to clinics.)

When asked if she was seeing any trends at her slopeside emergency room, Dr. Sage says there are more skiers like the Woodards.

“We have a healthier elderly population and they are skiing into their 80s,” says Sage, who has worked in slopeside emergency rooms Aspen, Vail and Breckenridge. “And sometimes we see them with breaks … bones get more brittle as we age, you know.”

Smoky Anderson knows. The last time ski patrollers at Loveland ski area took him off the mountain was after he broke his leg in 1964. On this day in March, the 76-year-old who was born and raised in Georgetown pre-released from his skis and broke his collarbone in his right shoulder as he tumbled. He might need surgery if it doesn’t heal right, Doucette told Anderson as he injected 5 cubic centimeters of pain medicine into his shoulder and fitted him with a sling.

“I guess I’m doing OK with only two injuries in 70 years of skiing,” Anderson says.

Boozing and skiing

Ryan Kalamaya with the Aspen-based Kalamaya Goscha Law firm gets 50 to 75 calls a season from skiers who were injured on the slopes. One-third of those calls are from skiers who lack legal ground to sue, he says. Another third are skiers injured in no-fault accidents, where ski patroller reports reveal a largely unavoidable accident that falls under the inherent risks of skiing. And a final third of calls into his law firm involve a skier injured by another skier who was at fault.

“The only time we will pursue litigation is when someone is at fault and they own property,” says Kalamaya, noting that claims for medical costs are most often recovered from skiers’ homeowner insurance policies.

Most skier lawsuits against resorts involve chairlifts. The Colorado Supreme Court in February heard arguments from the family of an Oklahoma teenager who was paralyzed after a fall from a Crested Butte Mountain Resort chairlift. The family of Annie Miller is asking the high court to overturn a lower court’s dismissal of their negligence claims because the family signed a liability waiver to get Miller’s lift ticket.

“Crested Butte and the ski industry as a whole is attempting to get complete contractual immunity to overcome any duty to the highest care and any duty based upon a regulatory statute,” argued Bruce Braley, the attorney representing the Miller family. “So if you can waive any negligence claim, including any claim based on the highest duty of care, any claim based on statutory duty, and if you don’t have a right to recover for gross negligence under Colorado law, even though the parental waiver statute specifically carves out an exception for gross negligence and recklessness claims, what’s left?”

Lawsuits against resorts rarely reach the Colorado Supreme Court or even make it to a jury. The Eagle County family of Taft Conlin sued Vail ski area after the 13-year-old skier was killed in a February 2012 avalanche on an expert run that the family argued was not properly closed.

The Conlin case reached a jury in Eagle County District Court in 2018, which ruled that Vail had properly closed the Prima Cornice run. The Colorado Court of Appeals affirmed the jury decision and the Colorado Supreme Court declined to take up the case in 2021.

In 2016, the Colorado Supreme Court ruled inbounds avalanches were an inherent risk of skiing and therefore resorts were protected from lawsuit under the Colorado Ski Safety Act.

Kalamaya, whose office is at the base of Aspen Highlands, watches people being loaded into ambulances, “every day,” he says.

“And so many people just staggering down from Cloud Nine,” he says.

Cloud Nine Bistro is a former ski patrol shack converted to on-mountain bistro at Aspen Highlands renowned for its apres ski scene, where skiers spray each other with $140 bottles of champagne. It’s not unusual for champagne spraying patrons to spend $10,000 or more on lunch. For years, the Cloud Nine Bistro has been touted as a top account for Veuve Clicquot champagne.

The Kalamaya Goscha law firm recently settled a lawsuit filed by a client who was injured following a 2020 collision with a Chicago skier who had just spent $4,704 at Cloud Nine.

“I’m hearing more discussions around a lot of people skiing fast and loose,” says Kalamaya, noting that insurance policies rarely cover punitive damages for injuries involving alcohol.

The doctors and nurses at the Breckenridge slopeside clinic say the flow of injuries typically ramps up after lunch “when everybody drinks,” said the clinic’s manager, Rebecca Duarte.

“It’s not openly acknowledged but yes. Usually there’s a lot of Fireball in pockets, you know,” Duarte said. “It’s not like they come in here saying ‘Yeah, I just had four beers.’ But we kind of assume that most people have something onboard after lunch.”

U.S. ski areas in 2022-23 updated the Skier Responsibility Code, which the National Ski Areas Association first debuted in 1962. The code used to have seven tenets, urging skiers to stay in control, obey signs and closures, stop where you are visible from above and noting that the downhill skier always has the right of way. The update for the 2022-23 season included a requirement to share contact information when involved in an accident and a new requirement that skiers cannot use lifts or terrain when “impaired by alcohol or drugs.”

Separating alcohol from skiing is a fraught proposition. While Vail ski area in 2022-23 hosted mountain safety workers — the Yellow Jackets — at lift-top booths to help skiers learn more about the updated Skier Responsibility Code, the mountain also opened two new mountaintop “retro” ice bars. The icy lounges revived a ski-up bar that was built on top of the Vail ski area in 1963.

“I see people stumbling down from Cloud Nine every day, and then right by my office is where the ambulance comes and picks people up all the time,” Kalamaya says.

“Using substances and pushing yourself in the mountains have a long history together. Both can foster alternative states of mind,” says Kalamaya, who prosecuted people involved in ski accident injuries as a deputy district attorney in Eagle County in the late 2000s, including a case where a father punched a drunken snowboarder who had run into his young daughter. (The snowboarder also faced criminal charges.) “Look, mistakes happen. And people come to the Colorado mountains to recreate and have fun. But as a father of a 9- and 7-year-old, there are times when I get really concerned.”