Strunk Hospital's much applauded increase in emergency room efficiency due to its new procedures for handling trauma patients does not withstand careful analysis. Strunk Hospital's average time before treatment for all emergency room patients is nearly 40 minutes - the highest in the city. And for trauma victims, the situation is even worse: The average time before treatment is nearly half an hour-more than twice the city average.

Which of the following, if true, would be most damaging to the conclusion about the value of the new procedures?

a. The cities with the most efficient emergency rooms utilize the same procedures for handling trauma victims as does Strunk Hospital.
b. Because trauma patients account for a large percentage of emergency room patients, procedures that hasten their treatment will likely significantly increase overall emergency room efficiency.
c. After the new procedures went into effect, Strunk's average time before treatment for emergency room patients dropped by 35 percent.
d. Due to differences in location and size of staff, not all emergency rooms can be expected to reach similar levels of efficiency.
e. The recently hired administrators who instituted the new procedures also increased Strunk's emergency room staff by 15 percent.
[spoiler]Source : kaplan Test1, OA later[/spoiler]