A review of medical responses after the deadliest mass shooting in modern U.S. history in Las Vegas found confusion led to a fire department broadcast that the only top-tier regional trauma center was too full to accept any more victims of the attack, a newspaper reported Monday.

The problem began when University Medical Center called an "internal disaster" alert following the Oct. 1 shooting at an open-air concert venue on the Las Vegas Strip, the Las Vegas Review-Journal reported .

The alert was intended for UMC so hospital employees would know all hands were needed, but officials said it confused emergency responders who issued a radio advisory that the emergency room was out of beds.

In January, the newspaper said it took at least 15 minutes to correct the message, and at least two injured people were diverted from the UMC Level 1 trauma center to other facilities.

Sunrise Hospital & Medical Center, which has a Level 2 trauma facility and is the hospital closest to the Strip, handled 212 patients, according to official reports. UMC took 104.

UMC and Clark County emergency management officials have not fully explained why UMC called the alert and declined to comment for the newspaper report.

The Southern Nevada Health District facility advisory board is revisiting the use of such alerts.

Henderson Fire Deputy Chief Scott Vivier said alerts usually mean beds and waiting rooms are full, extra employees have been called, elective surgeries are postponed and transfers from other hospitals are stopped.

John Hammond, health district emergency medical services and trauma systems manager, told board members in January that he planned to institute a time limit of 90 minutes on the alerts to help hospital staff members who forget to switch it off.

The term "internal disaster" alert was coined by the Southern Nevada Health District in 2004 to curb emergency room diversions that forced ambulance drivers to sometimes hop from one facility to another, said Rory Chetelat, former county health district emergency medical services manager.

In the past 14 years, the use of such alerts has become common at some Las Vegas-area hospitals, including University Medical Center, the only public hospital in the region.

In 2017, UMC issued the alerts 4.3 times a week on average, lasting nearly 630 hours for the year.

Among 12 other area facilities, only Dignity Health-St. Rose Dominican Hospital's Siena Campus in suburban Henderson used the alert more last year.

University Medical Center chief executive Mason VanHouweling told the Review-Journal that the hospital is trying to address overcrowding by adding 18 beds to its emergency room.

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Information from: Las Vegas Review-Journal, http://www.lvrj.com

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Information from: Las Vegas Review-Journal, http://www.lvrj.com