A Canadian construction worker was touring Mexico with a Canadian woman he met while there to build a set for the Highlander TV series.

One afternoon, the woman's ex-boyfriend kicked in their hotel-room door, rushed in cursing, clubbed her twice on the head, and shot the worker. Vacationers on a nearby beach heard their screams and called an ambulance, and the injured soon were in the hospital.

The scene may resemble an afternoon TV drama, but to Setareh P. Shemali, assistant director of operations for Timonium-based Medex Assistance Corp., it was part of a day's work.

"When the phone rings, it can be as simple as a broken toe in Japan or a bad case of the flu in Singapore, or it can be as dire as hepatitis-B in Indonesia or a miscarriage in Turkey," said Claude G. Cadoux, an emergency-medicine doctor who is the firm's medical director.

Other people's overseas health risks have made Medex, which specializes in solving the medical problems of Americans, Canadians and Britons working outside their home countries or traveling on business or pleasure, a fast-growing company, its executives say.

"The force driving this company's growth is the globalization of the world economy. The more people businesses send to work overseas, the more they need the help of an assistance company that knows the entire world medical network, knows how to evaluate a medical problem and knows how to get an air ambulance to some remote place fast enough and with the right equipment and personnel on board," said Thomas L. Hudson, who became the company's president and chief operating officer this month.

The company has averaged 25-percent annual growth in the nine years since Avemco Corp., a publicly traded Frederick-based firm that now owns nine insurance-related enterprises, bought it from its Texas founders and moved it to Maryland, Mr. Hudson said. It now handles about 40,000 cases annually, he said.

That growth has made Medex one of the world's top three or four companies in one of the world's fastest-growing fields, Mr. Hudson, said, but he declined to provide any financial details.

"As a wholly owned subsidiary, our financial results are folded into Avemco's annual reports, and for competitive reasons, we believe it is important not to break them out for public reporting," he said.

Avemco, which trades on the New York Stock Exchange, last year reported profits of $10.8 million on revenue of $104.6 million.

A year ago, Mr. Hudson, 46, left the old-line Baltimore law firm of Venable, Baetjer and Howard, where he was a partner, to move " to Medex, which had been one of his clients.

He took charge this year from John F. Shettle Sr., who oversaw the company's growth from the time Avemco brought it to Maryland.

Mr. Hudson, a University of Virginia graduate and University of Baltimore law graduate who still dresses, looks and sounds like the business lawyer he was at Venable, says Medex's services are not a hard sell.

"As soon as we sit down with a corporate human resources director, they see that what we offer meets a need that has been on their minds," he said.

At the firm's Timonium operations center, assistance coordinators speak a babble of European, Asian and Middle Eastern languages into telephones at 20 computer-equipped workstations.

The Timonium facility also is company headquarters, employing a total of 38, including the coordinators.

Eight additional coordinators and two administrative staffers work in the firm's center in Brighton, England. The company is preparing to add a center in Beijing.

For Ms. Shemali, who speaks English, French and Parsi, the Canadian worker's June 7 call from Mexico was easy to handle. His treatment was already completed, and all he needed was payment from his insurance company so that he could be released from the hospital.

But two stations away, the same day was less routine for Junko Takagi, a senior assistance coordinator who speaks English and Japanese.

The call she was handling was from Bamako, Mali, where a worker for a U.S. aid contractor had been rushed to the hospital with internal bleeding, apparently caused by malaria-prevention pills.

"I could see very quickly that I needed to call on the regional medical adviser, and when I did, he rushed an air ambulance from Paris, with a doctor, nurse and blood packets in the patient's blood type, which had not been available in Mali," Ms. Takagi said.

The patient was given three packets of blood from Paris on board the plane and was in stable condition last week in a French hospital.

The company has 60 regional medical advisers, whom it pays case-by-case to decide what care patients need and how to move them when required.

"Our stock-in-trade is knowledge of where the best medical care is, and much of that knowledge resides in our global network of regional medical advisers," Mr. Hudson said.

The company sells its services three main ways, Mr. Hudson said.

One is through contracts with more than 60 health insurance companies, such as Aetna and Blue Cross firms in more than a dozen U.S. states and Canadian provinces.

Another is through direct sales to 1,300 companies that have employees based or traveling abroad, from firms as big as McCormick & Co., the giant spice maker, to small consulting and engineering offices.

"We think we are No. 2 to International SOS Inc. in the corporate segment of our market," he said.

The third is government contracts.

"We are the leader in government contracts. We are in the third year of a five-year contract with the United States Agency for International Development that requires every USAID contractor to buy Medex protection for its expatriate and traveling workers, and that contract has been very good for us, averaging about $75,000 a month," he said.

"We haven't even tapped the British, French and Dutch corporate markets yet, and I think that and the tremendous opening and development of China are our next big growth drivers," Mr. Hudson said.

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