# mad dies after calling 911 10 times



## firecoins

http://www.postgazette.com/pg/10048/1036403-53.stm
\

Ambulances were dispatched *three times *on Saturday, Feb. 6, to the couple's home in the 5100 block of narrow Chaplain Way, but couldn't get there because of the snow. *Paramedics twice asked whether Mr. Mitchell could walk to an intersection, even after he told them that he could not because he was in too much pain.*
Emergency vehicles were within blocks of his home three times --* once so close Ms. Edge could see the ambulance lights from her porch *-- but did not make contact with him. They finally reached the home on Sunday morning, Feb. 7, but Mr. Mitchell was already dead.
So they responded several times to the house and got close enough to see the house but no EMT/Medic thought it was a godd idea to get out and actually assess the patient and see if his actual condition.


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## rescue99

firecoins said:


> http://www.postgazette.com/pg/10048/1036403-53.stm
> \
> 
> Ambulances were dispatched *three times *on Saturday, Feb. 6, to the couple's home in the 5100 block of narrow Chaplain Way, but couldn't get there because of the snow. *Paramedics twice asked whether Mr. Mitchell could walk to an intersection, even after he told them that he could not because he was in too much pain.*
> Emergency vehicles were within blocks of his home three times --* once so close Ms. Edge could see the ambulance lights from her porch *-- but did not make contact with him. They finally reached the home on Sunday morning, Feb. 7, but Mr. Mitchell was already dead.
> So they responded several times to the house and got close enough to see the house but no EMT/Medic thought it was a godd idea to get out and actually assess the patient and see if his actual condition.




There is no excuse for this sort of incident to ever happen. Why the heck was fire not called given the significance of wheather conditions? Oh yeah, it wasn't in their job description to help. I guess there were no friends or family avilable either...ugh! 

Dispatch should be fired..each and every one of those who failed to do his or her job. The Doc..what was he thinking several 911 calls later?? Shame on him for not making it a priority. Not to mention, somebody with a pair of sissors should be searching out some responders looking for their licenses'. Ghads, how sad.


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## 281mustang

That's pathetic. It would be one thing if the house was a few miles beyond the road, but the fact that they would rather pack up and call it a day as opposed to getting off their asses to walk a couple hundred yards is mind-numbing.


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## medic417

Cool "mad" died.  Maybe the world will be more peaceful now.

Lets not judge the crews as we do not have all details.


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## nomofica

medic417 said:


> Cool "mad" died.  Maybe the world will be more peaceful now.
> 
> Lets not judge the crews as we do not have all details.



How's this for enough details:



> "If he wants a ride to the hospital, he is just going to have to come down to the truck," a medic told the dispatcher



This is completely inexcusable. It is clear that THIS medic (THIS medic, not the others) was clearly too lazy to do his/her job. Since when was "okay, you call us to come help you BUT you have to walk over to us" in ANY SOP? Hell, they could have requested help from the fire department if they didn't feel they could help the patient to get to the ambulance on their own.

This is obvious negligence on the part of the entire responding service. 10 911 calls over three days and 3 instances of being in visual of the property... Is there really any excuse you can think of that would justify what took place? Especially considering one crew DID make it to the house, when unfortunately it was too late to do much for the guy...


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## nomofica

Also, this strikes a nerve as well:


> Ms. Edge called again to tell dispatchers that her boyfriend took sleeping and pain pills and she "could not get him up."
> 
> A doctor who called Ms. Edge back was "convinced he took his prescribed medications and went to sleep," Dr. Roth said, and the call was canceled.



A doctor assuming a patient's condition without even assessing the patient and being "convinced [the patient] took his prescribed medications and went to sleep" after the 911 call indicated a possible overdose of pain killers and sleeping pills...? This doctor should lose his/her licence.



I know first hand that the system isn't perfect, but this was an all-around inexcusable failure to the Nth degree. I hope legal action is taken against the EMS department, the medics who didn't do their jobs (especially the one saying the patient should go to them and not the other way around), and this doctor.

​


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## DrParasite

*lets read the entire article first, shall we?*



> Hazelwood man dies after 10 calls to 911 over two days
> Wednesday, February 17, 2010
> By Sadie Gurman, Pittsburgh Post-Gazette
> 
> In his first call to 911, Curtis Mitchell sounded calm, explaining to dispatchers that his "entire stomach [was] in pain."
> 
> By the time his longtime girlfriend made a 10th call nearly 30 hours later, she was frantic. He wasn't breathing. He was cold to the touch.


Read more: http://www.postgazette.com/pg/10048/1036403-53.stm#ixzz0fpeIsehx


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## DrParasite

*and....*

**Post removed**


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## trevor1189

Definitely sounds like an abandonment issue. It would be one thing if he died while they were trying to gain access, but just leaving....


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## medic417

nomofica said:


> How's this for enough details:
> 
> 
> 
> This is completely inexcusable. It is clear that THIS medic (THIS medic, not the others) was clearly too lazy to do his/her job. Since when was "okay, you call us to come help you BUT you have to walk over to us" in ANY SOP? Hell, they could have requested help from the fire department if they didn't feel they could help the patient to get to the ambulance on their own.
> 
> This is obvious negligence on the part of the entire responding service. 10 911 calls over three days and 3 instances of being in visual of the property... Is there really any excuse you can think of that would justify what took place? Especially considering one crew DID make it to the house, when unfortunately it was too late to do much for the guy...



How?  Are they properly equipped by the service to be hiking in snow and ice?  Are you sure that was actually said?  Have you ever heard of "is the scene safe"?  

Don't judge as you may not have all the facts.


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## LucidResq

It's hard not to judge... 

Out here in CO our SAR team has been called on multiple occasions to assist EMS/fire in blizzard conditions when the ambulances had trouble getting around.

We have carried patients, on foot, to the hospital with a Stokes litter or Thompson litter. 

None of us know the situation, but I find it hard to believe that anyone was really trying their hardest. I would get Fire out there shoveling, if necessary to access the patient, and call around to find a litter if necessary to get them out. I find it hard to believe that no agencies in the area had shovels or litters.


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## PotatoMedic

rescue99 said:


> Why the heck was fire not called given the significance of wheather conditions? Oh yeah, it wasn't in their job description....


People here should be happy the FD was never called.  It was a medical emergency so only people trained only in EMS should be sent.  Except for cardiac arrest because firefighters are smart enough to press things.



medic417 said:


> How?  Are they properly equipped by the service to be hiking in snow and ice?  Are you sure that was actually said?  Have you ever heard of "is the scene safe"?
> 
> Don't judge as you may not have all the facts.


No we don't have all the facts.  And they probably are not equipped to hike in the snow.  But if you find that there is something blocking your way the the Pt do you just say 'ahh sh*t' and go home. No.  You call PD to secure the scene if needed.  Call FD if the house is on fire (unless you are FD).  Heck I bet they could have had dispatch call the DOT to have them send a plow.  But you don't just flat out abandon a Pt.   I am not saying that they were not justified in only go as far as they did.  But they should have solved the problem instead of saying ahh sh*t.  Oh well.


I really like this quote from the article.  "The call was canceled after paramedics learned that Mr. Mitchell was in too much pain to walk out to them."


Note:  Let the picking apart of my post begin since I said something against the EMS only movement.


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## Veneficus

FireWA1 said:


> Note:  Let the picking apart of my post begin since I said something against the EMS only movement.



While I disagree that the FD should be involved in medical care, I don't think that has anything to do with this particular story or relevant for discussion in this thread.

Any responder, medical or otherwise, should understand that when there is entrapment involved (like in this case caused by snow) The victim must first be accessed before medical care can be rendered.

Main Entry: res·cue 
Pronunciation: \ˈres-(ˌ)kyü\
Function: transitive verb 
Inflected Form(s): res·cued; res·cu·ing
Etymology: Middle English rescouen, rescuen, from Anglo-French rescure, from re- + escure to shake off, from Latin excutere, from ex- + quatere to shake
Date: 14th century
*: to free from confinement, danger, or evil *: save, deliver: as a : to take (as a prisoner) forcibly from custody b : to recover (as a prize) by force c : to deliver (as a place under siege) by armed force

It should be considered that no priority dispatch system is perfect, people will always fall through the cracks. 

As for who is responsible in this particular case, I'd be willing to bet it is settled.  

It seems the take away message from this particular story is: If you need emergency medical treatment, you have to use the magic words:

"I am having difficulty breathing and chest pain."

You can sort out the situation after the responders get to your side.


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## PotatoMedic

Veneficus said:


> While I disagree that the FD should be involved in medical care, I don't think that has anything to do with this particular story or relevant for discussion in this thread.



On the contrary.  If this happened and it was a FD that was responding you guys would be allover the fact it was a FD.  (but I will admit that is speculation on my part... but it has good standing with the track record of this forum).




> Any responder, medical or otherwise, should understand that when there is entrapment involved (like in this case caused by snow) The victim must first be accessed before medical care can be rendered.


I agree!  And what was the problem... the roads had too much snow.  So call the DOT for a plow.  Heck break out the shovels and start digging if you feel you must.  The FD is no more qualified to shovel snow that anyone else so why do they (in your opinion from what I am inferring) get the special job of shoveling snow?



> Main Entry: res·cue
> Pronunciation: \ˈres-(ˌ)kyü\
> Function: transitive verb
> Inflected Form(s): res·cued; res·cu·ing
> Etymology: Middle English rescouen, rescuen, from Anglo-French rescure, from re- + escure to shake off, from Latin excutere, from ex- + quatere to shake
> Date: 14th century
> *: to free from confinement, danger, or evil *: save, deliver: as a : to take (as a prisoner) forcibly from custody b : to recover (as a prize) by force c : to deliver (as a place under siege) by armed force


Not sure what this is about...  maybe something towards FD's.  To rescue the Pt call a plow and while your waiting read a book.  Start walking if you want to get to them sooner.  But abandoning them is not an option.



> It should be considered that no priority dispatch system is perfect, people will always fall through the cracks.
> 
> As for who is responsible in this particular case, I'd be willing to bet it is settled.
> 
> It seems the take away message from this particular story is: If you need emergency medical treatment, you have to use the magic words:
> 
> "I am having difficulty breathing and chest pain."
> 
> You can sort out the situation after the responders get to your side.




I agree.  Nothing is perfect.


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## WolfmanHarris

All I can think of when I read this is about a call I did during the fall.
Lady thrown from a horse while trail riding. We arrived on the farm and were directed to follow an SUV towards the back paddocks. Upon reaching a fence line we determined that any further and the truck would be in danger of getting stuck. So we grabbed a long-board and our bags and hopped into the bystander's SUV riding that to the next fence line. Where the driver said this was as far as his car would go. We then humped it another 600m to make pt. contact.

Ended up extricating her with the LSB in a stokes, tied into the back of FD's pick-up truck and a slow easy drive out.

What's the moral of this story? Never considered before this that someone would have said "Not in my job description!" And left a patient alone. Yes, I wasn't there, but it stands to reason that we're still talking snow and ice here, not confined space, high angle, or any sort of truly unsafe scene.


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## Veneficus

FireWA1 said:


> On the contrary.  If this happened and it was a FD that was responding you guys would be allover the fact it was a FD.  (but I will admit that is speculation on my part... but it has good standing with the track record of this forum).



Honestly, I can't think of 1 FD I have ever encountered, volunteer or otherwise, that would leave a trapped victim because of percieved inability to reach them short of a major disaster, which I doubt snow in Pittsburg is, having spent many winters there with family and freinds, I don't see anyway to defend such behavior. It was extremely poor judgement.

My argument with fire based EMS is a bit more logical and nuanced than just shaking my fist in the air. As a former firefighter, if a large percentage of FDs in the US would admit to their shortcomings and address them, I would support them with all my ability. Sadly many don't even think they have a problem.

I am also equally quick to call out non fire based agencies with shortcomings, but they usually try to hide them rather than publishing propaganda on how perfect they are.




FireWA1 said:


> I agree!  And what was the problem... the roads had too much snow.  So call the DOT for a plow.  Heck break out the shovels and start digging if you feel you must.  The FD is no more qualified to shovel snow that anyone else so why do they (in your opinion from what I am inferring) get the special job of shoveling snow?.



It was not I who posted call the FD to shovel snow. However, every fire truck I have been on did have a shovel. I have only been on a handful of ambulances, both fire or otherwise, that had one. It sounds like a failure of the local EMS agency to not have a shovel on its units, considering it snows in Pittsburg every year.

And if we didn't have a shovel on the ambulance it meant our pants and socks were going to get wet as we trekked through the snow. 

It is worthy to note though that in Bratislava, Slovakia, The fire department there considers it a duty to help EMS reach patients and in particularly inclimate weather, ( routinely more snow and cold than Pittsburg) the FD helps by taking on as part of maintaining emergency readiness, clearing major roadways of snow so there is better access in the event of an emergency. 

Likewise, when I was part of a suburban US fire department, we had a plow on one of the FD pickups that would precede both the squad and heavier apparatus in heavy snow, because DOT wasn't always nearby. It seems quite possible (and probably a good idea) to equip a plow on many ambulances if you may have need of one.

It is not that the FD should have cleared the snow, or they are better at it then anyone else, they just happen to usually have equipment and manpower. It makes more sense to have the EMS crew attend the patient while anothers dig them out or make a sled. In this case it seems the patient would have been better off calling the ski patrol than 911.



FireWA1 said:


> Not sure what this is about...  maybe something towards FD's.  To rescue the Pt call a plow and while your waiting read a book.  Start walking if you want to get to them sooner.  But abandoning them is not an option..



I was trying to make the point that this was a rescue call that went unrecognized.(when last I heard Pittsburg EMS had its own rescue units, but it has been about a year since i spoke with somebody there) It had nothing to do with FDs. I agree fully, if you work in EMS in a winter climate and you are not able to walk through snow, then you didn't come to work prepared and you didn't do your job.


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## firecoins

medic417 said:


> How?  Are they properly equipped by the service to be hiking in snow and ice?  Are you sure that was actually said?  Have you ever heard of "is the scene safe"?
> 
> Don't judge as you may not have all the facts.



Clealry was not a safety issue if you can aska a patient to walk through the snow. Are you in a location that gets snow on a regular basis?  If you expect the patient to walk through it, the healthy medics can at least wlak through it and do an assessment to see if its serious.


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## medic417

firecoins said:


> Clealry was not a safety issue if you can aska a patient to walk through the snow. Are you in a location that gets snow on a regular basis?  If you expect the patient to walk through it, the healthy medics can at least wlak through it and do an assessment to see if its serious.



The patient attempted to walk to them but could not cross the bridge, perhaps the medics did get out and try to reach them to find that they could not cross said bridge either.  Also note that a doctor cancelled the calls as well.  So this could also be considered a case of triage where you have to move on to help someone in greater need.  Sorry that's life.


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## firecoins

medic417 said:


> The patient attempted to walk to them but could not cross the bridge, perhaps the medics did get out and try to reach them to find that they could not cross said bridge either.  Also note that a doctor cancelled the calls as well.  So this could also be considered a case of triage where you have to move on to help someone in greater need.  Sorry that's life.



The ambulace got within visual distance of the house. The wife saw the ambulance but no attempt herself.

Also note the doctor was not onscene. He did it over the phone. You got have the in person assessment. 

from the article


> "We should have gotten there," Public Safety Director Michael Huss said. "It's that simple."




http://www.postgazette.com/pg/10048/1036403-53.stm#ixzz0fqo0m5ei


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## Veneficus

medic417 said:


> The patient attempted to walk to them but could not cross the bridge, perhaps the medics did get out and try to reach them to find that they could not cross said bridge either.  Also note that a doctor cancelled the calls as well.  So this could also be considered a case of triage where you have to move on to help someone in greater need.  Sorry that's life.



I think it was unfortunatly a case of many small things that led up to a big one. 

If nobody could cross the bridge, (big steel structure and most of the bridges in PA I have seen are unsafe to walk across on a warm sunny day)  then the patient needed rescued. Appropriate resources should have been called. Clearly a desire for medical attention was there. It wasn't like the EMS crew was being asked to walk out onto the ice of the river. 

There was a failure of priority dispatch. But priority dispatch will never be perfect.

Whoever the doc was probably made what we now see in hindsight as a poor decision, but probably made it with imperfect 2nd or 3rd hand information. We all know the picture you paint to med control determines what they will say.

The EMS system was clearly had major shortcomings. (like dispatchers not being able to recognize an increasingly worse patient description with subsequent calls from the same address. since I doubt it was the same dispatcher answering the phone each time, it was probably a lack from the computer software.

Who was notified that there were multiple calls from the same address so that somebody farther up the chian could help address it?

The city apologized, took responsibility, and started to initiate changes so soon. I don't think they would have done that if they thought everything went well.

Undoubtable an EMS responder from any agency has the responsibility of ensuring their own safety. However the EMS agency has the responsibility to make sure responders are trained and equipped to handle the needs of its populous or that resources that are so capable are brought to bear. It could be as simple as callingthe FD or somebody on the other side of the bridge from a neighboring jurisdiction.   

http://pghbridges.com/glassport/0594-4458/maladyelizabeth.htm

PA51 is also a major artery

http://www.gribblenation.com/swparoads/51/51Intro.html


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## 46Young

FireWA1 said:


> On the contrary.  If this happened and it was a FD that was responding you guys would be allover the fact it was a FD.  (but I will admit that is speculation on my part... but it has good standing with the track record of this forum).
> 
> 
> 
> I agree!  And what was the problem... the roads had too much snow.  So call the DOT for a plow.  Heck break out the shovels and start digging if you feel you must.  The FD is no more qualified to shovel snow that anyone else so why do they (in your opinion from what I am inferring) get the special job of shoveling snow?
> 
> 
> Not sure what this is about...  maybe something towards FD's.  To rescue the Pt call a plow and while your waiting read a book.  Start walking if you want to get to them sooner.  But abandoning them is not an option.
> 
> 
> 
> 
> I agree.  Nothing is perfect.



I'm usually one of the first to tell everyone to get off of the FD stick when the FBEMS lynch mob gets going. You're probably correctin that it would have been ugly if it was the FD's doing. But, in this particular case, the earlier posts were pretty damning of the EMS system alone and it's crews in this incident. 

There were a few weak attempts to somehow link the FD to this whole mess, but the fact of the matter is that they would need to be called to help. I'm sure they would have done their best if they were toned out for the assist with this one. If they're not called, how are they supposed to know there's a problem developing?


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## 46Young

Where I work, in Northern VA, we maybe get a decent snowstorm every ten years or so. This region is certainly not facing such conditions every year as Pittsburgh does. The thing is, we had no issue in reaching pts during both of our snowstorms, which both dumped around two feet each.

All our units, ambulances and apparatus alike, have on spot chains, Z-cables, and heavy snow chains. We carry shovels on our pieces. We had 12 or so 4WD utility vehicles, each equipped with plows and also two FF's, to be johnny on the spot with any access issues. I've driven in many a NY snowstorm in mini mod's, with no chains or anything, and managed. Having chains made it a joke to get around. You need to know your first due, to have the foresight to know that you won't make it up a particular hill or bridge, and react accordingly. We had suppression units routinely doing ALS assessments (and tx if necessary) and bringing pts out to the ambulances, either by carrying or by ambulation if appropriate beyond doubt. Not bad for a dept that hardly ever gets even one storm, let alone two that were each around two feet. What's Pittsburgh's excuse? Maybe lack of available units, since restricted access resulted in repeated cancellations, rather than sending another unit from a different direction? FBEMS ALS first response really helps when conditions are poor, and also when units are scarce, which is the intention of having ALS first response in the first place. I've seen this firsthand through two storms, and things worked great. The concept works well if applied properly, with competent individuals. The alternative, of course, is working with the bare minimum, and getting jammed up on occasion, where sometimes preventable injury and death occur.

I'm willing to bet that there wasn't four feet of snow on the ground when the first 911 call was made in this incident. Since snowstorms in Pittsburgh are a given, the plows should have been out, and I can't see there being more than 6 inches or a foot down at the time, at least up to a block away from the residence, which is within walking distance. If you can't manage through even a foot of snow with a monitor and a couple of bags between two people, then you're physically incapable of working period. I've had to carry pts on a scoop or reeves a block or more to the rig with just my partner, as plowing from previous storms blocked any other egress (in NY). If I can carry someone a block or more in a foot of snow, you can't walk with just a couple of bags?

This particular situation makes a great case for ALS first response (I'm talking about fire based, of course). You get three or four physically capable individuals, ALS capable as well (how capable varies from dept to dept, but still), and additional resources if needed.

Speaking of additional resources, to get someone out of a house during a snowstorm it's real simple. You can use either a reeves or a stokes. Use 4-6 people to carry. Wrap the pt in blankets, and don't forget to cover the head. If a car ejects a pt down a steep enbankment (such as I-26 in North Charleston) a stokes and some ropes do wonders in getting a pt out. Imagine what a stokes will do on the horizontal? Get a utility truck with a plow if you need to. I find it hard to believe that the city of Pittsburgh has no such thing.


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## EMSLaw

I've been in this situation all too often lately.  Recently, in one of our monster snowstorms of this month, the rig got stuck on the way to a fire call where we were told we had a patient.  So, I told the driver to try and get the rig unstuck, I slung the jump bag over my shoulder, and I walked the three-quarters of a mile to the scene.  Only to find out there was no patient, but that's really neither here nor there.  

I refuse to accept that there was no way to get to the patient because there was a storm.  Improvise, adapt, overcome.  Tell your dispatcher to send a plow.  Hit out the fire department for lifting assistance and carry the patient out on a Reeves, scoop, or folding stretcher if you have to.  Whatever it takes.  Response times will suck in a blizzard, but if someone calls an ambulance, I firmly believe said ambulance should (as soon as possible) show up.  

And by the way, I also refuse to accept that the scene is unsafe because there's snow on the ground.  I'm a fatty, and I managed to walk through the snow to calls.  It's probably good for me.  If I can do it, I think anyone can.  If you get snow on your pants, suck it up.


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## 46Young

EMSLaw said:


> I've been in this situation all too often lately.  Recently, in one of our monster snowstorms of this month, the rig got stuck on the way to a fire call where we were told we had a patient.  So, I told the driver to try and get the rig unstuck, I slung the jump bag over my shoulder, and I walked the three-quarters of a mile to the scene.  Only to find out there was no patient, but that's really neither here nor there.
> 
> I refuse to accept that there was no way to get to the patient because there was a storm.  Improvise, adapt, overcome.  Tell your dispatcher to send a plow.  Hit out the fire department for lifting assistance and carry the patient out on a Reeves, scoop, or folding stretcher if you have to.  Whatever it takes.  Response times will suck in a blizzard, but if someone calls an ambulance, I firmly believe said ambulance should (as soon as possible) show up.
> 
> And by the way, I also refuse to accept that the scene is unsafe because there's snow on the ground.  I'm a fatty, and I managed to walk through the snow to calls.  It's probably good for me.  If I can do it, I think anyone can.  If you get snow on your pants, suck it up.



Wearing two pairs of socks to help with the cold steel toes helps, as does changes of socks for wet feet.

Anyway, you're correct, as shifting the onus, shifting the blame, or CYA is necessary for longevity in EMS. Calling dispatch via a taped line or radio when any issues arise, as well as a well written PCR are two vital practices.


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## DrParasite

I would like to point out a few things:

1) the call was for abdominal pain, which in most systems (pitt included) is a low priority calls.  

2) the earlier ambulance that went got stuck in the snow, and was unable to respond as well.  so it was probably pretty bad.

3) NJ got hit with a major storm in the past week.  the GSP, RT 1 and I287 were all plowed, yet they were all still snow covered.  Some of the county roads were plowed.  most side streets still weren't.  So the response of "they should have plowed the streets" is kinda BS, because if the snow is still falling, there is often no way to catch up.  

4) Pittsburg EMS has 2 heavy rescues, staffed with 2 paramedics.  not sure why they weren't sent to assist, but they are an option if they were available.

5) this patient called 10 times.  I don't care if they called 30 times.  abdominal pain is still a low priority, unless something changes.  if you have a chest pain, rollover, unconscious, and cardiac arrest who only call once, should the abd pain take precedence because they call many times?  I am guessing the system is like mine, where we only have a finite amount of resources.  you have to prioritize your calls, deal with the life threatening calls first, and then deal with the non-life threatening ones.  it might sound harsh, but many urban cities only have so many units, and many don't use mutual aid for non-life threatening (BLS) calls.   that, if if the city was hopping, how much you want to bet all your mutual aid companies were tied up as well?

That all being said, I find it completely unacceptable that a unit cancels a call because access is obstructed by snow.  Asking the person to walk up the block wouldn't be something I would suggest, but canceling the call was a poor decision by the crew.  They should have made every effort and found a way to get through the snow, even if it meant getting pulled by a winch out of the snow bank.


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## 46Young

DrParasite said:


> I would like to point out a few things:
> 
> 1) the call was for abdominal pain, which in most systems (pitt included) is a low priority calls.
> 
> 2) the earlier ambulance that went got stuck in the snow, and was unable to respond as well.  so it was probably pretty bad.
> 
> 3) NJ got hit with a major storm in the past week.  the GSP, RT 1 and I287 were all plowed, yet they were all still snow covered.  Some of the county roads were plowed.  most side streets still weren't.  So the response of "they should have plowed the streets" is kinda BS, because if the snow is still falling, there is often no way to catch up.
> 
> 4) Pittsburg EMS has 2 heavy rescues, staffed with 2 paramedics.  not sure why they weren't sent to assist, but they are an option if they were available.
> 
> 5) this patient called 10 times.  I don't care if they called 30 times.  abdominal pain is still a low priority, unless something changes.  if you have a chest pain, rollover, unconscious, and cardiac arrest who only call once, should the abd pain take precedence because they call many times?  I am guessing the system is like mine, where we only have a finite amount of resources.  you have to prioritize your calls, deal with the life threatening calls first, and then deal with the non-life threatening ones.  it might sound harsh, but many urban cities only have so many units, and many don't use mutual aid for non-life threatening (BLS) calls.   that, if if the city was hopping, how much you want to bet all your mutual aid companies were tied up as well?
> 
> That all being said, I find it completely unacceptable that a unit cancels a call because access is obstructed by snow.  Asking the person to walk up the block wouldn't be something I would suggest, but canceling the call was a poor decision by the crew.  They should have made every effort and found a way to get through the snow, even if it meant getting pulled by a winch out of the snow bank.



Yes, self cancelling a call is a major faux pas, and is a quick and easy way to get fired.

As medics, we're taught to consider all differentials for any complaint. The differentials with abd pain are numerous. It's unknown if Pittsburgh's dispatchers are only hired with prior field EMS experience, or if they are lay people who determine call type by flipping through the EMD cookbook. Experienced EMS field providers ought to be able to ask more focused questions to get a better picture of the pts situation, and then place a more accurate call type. Otherwise, you get the 35 y/o female with a H/A getting priority over the dizzy 74 y/o with an extensive medical Hx.


----------



## firecoins

46Young said:


> Yes, self cancelling a call is a major faux pas, and is a quick and easy way to get fired.
> 
> As medics, we're taught to consider all differentials for any complaint. The differentials with abd pain are numerous. It's unknown if Pittsburgh's dispatchers are only hired with prior field EMS experience, or if they are lay people who determine call type by flipping through the EMD cookbook. Experienced EMS field providers ought to be able to ask more focused questions to get a better picture of the pts situation, and then place a more accurate call type. Otherwise, you get the 35 y/o female with a H/A getting priority over the dizzy 74 y/o with an extensive medical Hx.



in this case, an MD apparently called and cancelled the call at one point.  

Of course, making it too the house and seeing the patient would have made a big difference. If the crew can get close enought o have the patient walk to them, than they can go walk to the patient.  

How did they get to the patient once he became a high priority on the 10th call?


----------



## Foxbat

DrParasite said:


> I would like to point out a few things:


^ What he said.
On that day, Western PA, including Pittsburgh, was hit with a blizzard. Yes, Pittsburgh sees snow every once in a while, but it was, if I recall correctly, the worst one since 1993. We went from no snow at all to about 2 feet of snow in less than a day. State of emergency was declared, and many, if not most city streets were not drivable.
On that particular Saturday, Pittsburgh EMS was overloaded with calls. On Saturday evening city had a few dozens of priority calls pending. Abdominal pain in Allegheny county dispatch system is coded as an E-2 (ALS, but low-priority), and, if I am not mistaken, Pittsburgh Fire Bureau is not dispatched to these.
From what I have been told by dispatchers working the county 911, they have very strict policies to adhere to, and there's very little left to dispatchers' discretion.


----------



## fortsmithman

The medics should have gotten out of their rig and walked up to the residence and went in and did an assessment.  One of the calls I was on a year ago involved my and my team going in to bget the pt by hiking approx 1.5k (roughly a mile) We had to wlk down a river bank across a frozen river then up the other bank both of which were steep then the rest of the way through a wooded area to a trappers cabin.  After we arrived we were able to secure a snow machine to transport our pt to the rig.  The team leader rode back with the pt myself and the other member of the team had to walk back.  My town is primarily rural the nearest town is about 2.5 hrs highway speed from us.


----------



## rescue99

fortsmithman said:


> The medics should have gotten out of their rig and walked up to the residence and went in and did an assessment.  One of the calls I was on a year ago involved my and my team going in to bget the pt by hiking approx 1.5k (roughly a mile) We had to wlk down a river bank across a frozen river then up the other bank both of which were steep then the rest of the way through a wooded area to a trappers cabin.  After we arrived we were able to secure a snow machine to transport our pt to the rig.  The team leader rode back with the pt myself and the other member of the team had to walk back.  My town is primarily rural the nearest town is about 2.5 hrs highway speed from us.



YEP!

Even the GF has to take some responsibility for this man's needless death. However, the GF had no training to give her strong clues nor, was there a duty to act on her part. 

The answer was so easy a caveman could do it. No one, not even the GF could manage to....call the dog-gone fire department!! A fire department will pluck ducklings out of storm sewers and dogs out of frozen ponds. They would not hesitate to get one sickly man across a snow covered bridge. In order to do that, they have to be called, eh?


----------



## EMSLaw

rescue99 said:


> The answer was so easy a caveman could do it. No one, not even the GF could manage to....call the dog-gone fire department!! A fire department will pluck ducklings out of storm sewers and dogs out of frozen ponds. They would not hesitate to get one sickly man across a snow covered bridge. In order to do that, they have to be called, eh?



They live for that stuff, and sending an old guy across a rope bridge in a stokes basket makes a good "No sh**, there I was..." story.


----------



## nomofica

firecoins said:


> in this case, an MD apparently called and cancelled the call at one point.
> 
> Of course, making it too the house and seeing the patient would have made a big difference. If the crew can get close enought o have the patient walk to them, than they can go walk to the patient.
> 
> How did they get to the patient once he became a high priority on the 10th call?



If you read the article, the MD canceled the call because he *assumed* the patient took his prescription drugs and went to sleep.

You never assume that somebody just took their meds and went for a nap, especially when an ambulance has been called out numerous times in the past day or two. And you never cancel a call because you assumed as much without an actual patient assessment.


----------



## Veneficus

nomofica said:


> If you read the article, the MD canceled the call because he *assumed* the patient took his prescription drugs and went to sleep.
> 
> You never assume that somebody just took their meds and went for a nap, especially when an ambulance has been called out numerous times in the past day or two. And you never cancel a call because you assumed as much without an actual patient assessment.



my favorite part was the guy with abd pain couldn't walk across the bridge to the ambulance. Take a look at my earlier link for how big that bridge is.


----------



## nomofica

Veneficus said:


> my favorite part was the guy with abd pain couldn't walk across the bridge to the ambulance. Take a look at my earlier link for how big that bridge is.



They expected a patient with severe abdominal pain to hike across THAT bridge?:wacko:


----------



## Foxbat

rescue99 said:


> The answer was so easy a caveman could do it. No one, not even the GF could manage to....call the dog-gone fire department!! A fire department will pluck ducklings out of storm sewers and dogs out of frozen ponds. They would not hesitate to get one sickly man across a snow covered bridge. In order to do that, they have to be called, eh?


All 911 calls are handled by same dispatchers anyway... Her call would still be handled the same, and unless medics would request FD to respond, which they probably should have done, there would be no different outcome.


----------



## phildo

Ok, I have a question. Forgive me if I have not heard all the news on this.  What was the cause of death, or has that not been determined?  Abdominal pain can be anything.  Could be a AAA, an atypical MI, pancreatitis, necrotic bowel.  How is this a low priority dispatch?  I can't imagine not taking extraordinary measures to make contact.   If they were so busy, they'd know as soon as they went in service, they'd get launched out on another call. So why the (perceived) apathy on the part of the crews?  Its not like the Superbowl was on at the station.


----------



## firecoins

nomofica said:


> If you read the article, the MD canceled the call because he *assumed* the patient took his prescription drugs and went to sleep.
> 
> You never assume that somebody just took their meds and went for a nap, especially when an ambulance has been called out numerous times in the past day or two. And you never cancel a call because you assumed as much without an actual patient assessment.



you mentioned the dispatchers not asking the right questions and I replied by mentioning the MD spoke to the patient.  I am unaware of any system where a doctor can cancel a call prior to EMS arriving unless he speaks to the pt.  If the MD canceleed the job without even speaking to the patient, his license may need to be taken.


----------



## DrParasite

phildo said:


> Abdominal pain can be anything.  Could be a AAA, an atypical MI, pancreatitis, necrotic bowel.  How is this a low priority dispatch?


and toe pain for the last 3 days on a diabetic can sign an atypical MI.  does that mean every toe pain should be a high priority dispatch?

like it or not, dispatching is based on odd, history, and playing the percentages.  most abdominal pains are non-life threatening.  most unresponsive calls have the potential to be life threatening.  so if you have one ambulance, who are you going to send to first?

also like it or not, every EMS system has a finite amount of resources.  so they have to prioritize their calls, and do the best they can.  I am willing to bet that the majority of people on here have not worked as dispatchers in a busy 911 system.  If you did, you would know that trying to manage resources on a busy system when all your units are busy and you still have 5-10-20 jobs holding can be more emotionally draining than a shift on the streets.  They do the best they can, with the rules and regulations and protocols that they are given. remember, a field unit may deal with 18 incidents on a busy shift 12 hour.  a dispatcher/call taker has to deal with maybe 60-100 incidents during a 12 hour shift.

If you guys think you can do better, apply to Pittsburgh EMS 911 Dispatch division.  I'm sure once you get there, they would be more than welcome to see you do their job better than they could ever do.  or more likely, see you fall on your face and say "damn, this job is a lot harder than I thought it was..."


----------



## rescue99

Foxbat said:


> All 911 calls are handled by same dispatchers anyway... Her call would still be handled the same, and unless medics would request FD to respond, which they probably should have done, there would be no different outcome.



I know the non emergent number to the local area FD's. They're listed. But, yer right. Dispatch should have made the call.


----------



## Foxbat

This is the QA review of that event by city EMS's medical director, released by city's public safety director. Recommended read for all interested.
http://www.scribd.com/doc/26960692/Medical-Call-Review-for-5161-Chaplain-Way
Accessed via http://roguemedic.blogspot.com/


----------



## medic417

Foxbat said:


> This is the QA review of that event by city EMS's medical director, released by city's public safety director. Recommended read for all interested.
> http://www.scribd.com/doc/26960692/Medical-Call-Review-for-5161-Chaplain-Way
> Accessed via http://roguemedic.blogspot.com/



This was a failure by everyone based on that.  But based on that the Paramedics did not cancel rather the caller did.  The Paramedics also had no knowledge based on this of the other calls and were told caller cancelled so they were not given reason to pursue a rescue attempt.


----------



## CAOX3

Snow in Pittsburgh in the winter, wow that never happens.  They should have been better prepared.

Get your check book out.


----------



## medic8613

medic417 said:


> How?  Are they properly equipped by the service to be hiking in snow and ice?  Are you sure that was actually said?  Have you ever heard of "is the scene safe"?
> 
> Don't judge as you may not have all the facts.



Any paramedic worth a damn can suck it up and walk three blocks in the snow. It's not summiting K2, it's walking down a city street. If a medic shows up to work not ready to be outdoors for a while, they are bad at their job. I have never seen an EMS job description that did not mention being outdoors in all weather conditions for an extended period of time. When I go to work every day, I have the right clothes and gear to be outdoors. And yes, Pittsburgh EMS has really nice warm jackets. I know this because I used to have one.


----------



## ebassamore

ok first off if his wife could see the lights both the medic and the emt could have walked there and second i dont know what its like there but in minnesota where i work dispatch can have the road plowed by the closet city vehicle of a sheriff truck but 9 out of 10 times our first responders have it plowed out with there personal vehicles.
they do not desereve there tittle if they cant walk 1 block to save someones life, its not like they would be endangering there own life.


----------



## jrm818

It isn't like that in Pittsburgh...in 4 years there I think I saw an actual plow once in the city.  I'm sure there are some, but not many.  

I was also wondering about the medics not walking to the patient.  From the review it sounds like they weren't sitting in their nice warm ambulance staring at the snow and drinking coffee: they were actively trying to dig the (now stuck) ambulance out!


----------



## EMSLaw

Foxbat said:


> This is the QA review of that event by city EMS's medical director, released by city's public safety director. Recommended read for all interested.
> http://www.scribd.com/doc/26960692/Medical-Call-Review-for-5161-Chaplain-Way
> Accessed via http://roguemedic.blogspot.com/



A very interesting read.  Seems like the situation was a bit different than I envisioned it initially.  Still a tragic situation, though, and the QA identifies at least some of the areas where things fell apart.


----------



## medic8613

jrm818 said:


> I was also wondering about the medics not walking to the patient.  From the review it sounds like they weren't sitting in their nice warm ambulance staring at the snow and drinking coffee: they were actively trying to dig the (now stuck) ambulance out!



If the rig was stuck, they should have called for FD to help with the rig and to clear a path, and then proceeded on foot to the patient to begin care while FD responded and got to work. PEMS is an all ALS service with EMS physicians in fly-cars (4 wheel drive fly-cars). Even without a means of transportation, tarting treatment on scene could have made a big difference (sadly, we will never know).

This is a reason I am a big advocate of some sort of training in wilderness medicine. It provides people with the skills and mindset to work in situations where definitive care is not an immediate option, and extended patient contact is necessary. In wilderness medicine, "wilderness" is generally defined as being 1 hour from definitive care. The wilderness can be in a city too, not just the woods.


----------



## eynonqrs

There was no excuse for this. A few years ago in my area we had the Valentines day storm. We had crews from outside agenices and the county put out an alert to anyone had 4wd units or pov's to help out. They would transport pt's to a waiting ambulance that was in a safe area where they were in no danger of getting stuck. My service has a 4wd chase truck, and they recently purchased a 4wd truck with a utility body with a plow. It is going to be used as rehab unit/chase unit, but also for bad weather help crews to get unstuck or to plow ahead of them if they need access to a call. Also to be honest, that day of the valentines day storm I was running calls with my volunteer unit, we had no chains on our units. We had no problem getting arround despite increasing poor road conditions.


----------



## Foxbat

http://www.wpxi.com/news/22886177/detail.html
*
State Clears EMS Workers In Hazelwood Snow Death*

_A report released Friday from the Pennsylvania Department of Health found Pittsburgh EMS workers did not violate state law in the death of her common law husband, Curtis Mitchell, 50.
...
The city is conducting its own investigation and has yet to decide if the EMS workers will be disciplined, but Mayor Luke Ravenstahl said he disagrees with the state ruling._


----------



## medic417

Foxbat said:


> http://www.wpxi.com/news/22886177/detail.html
> *
> State Clears EMS Workers In Hazelwood Snow Death*
> 
> _A report released Friday from the Pennsylvania Department of Health found Pittsburgh EMS workers did not violate state law in the death of her common law husband, Curtis Mitchell, 50.
> ...
> The city is conducting its own investigation and has yet to decide if the EMS workers will be disciplined, but Mayor Luke Ravenstahl said he disagrees with the state ruling._



Finally some common sense prevails.  If it is unsafe they should not be forced to go.  If they volunteer to go it is their choice.   No one should fault someone for applying the first rule of EMS....................SAFETY!!!!!!!!


----------



## JPINFV

So walking in the snow is now too dangerous?


Edit: 

Let me clarify, when statements like this


> Medics claimed they couldn't get near the house in the deep snow. At one point they asked Mitchell to walk to an ambulance four blocks away, but he was in too much pain.



are made, then obviously the conditions aren't to the extreme of being considered "dangerous." If you can expect a sick person to do it, then the EMS providers on the ambulance should be able to do it too.


Edit number 2:







PLUS






equals 






Or use a






to move patient from house to ambulance.

or at the very least, set up shop and administer care on scene.


----------



## medic417

JPINFV said:


> So walking in the snow is now too dangerous?



Don't be stupid if you read anything about it you know there was much more than a little snow in the way.  You should never decide your safety is important because if you do you are going to a hypocrite.


----------



## JPINFV

So the condition isn't severe enough to ask the patient to walk but too bad for the professional rescuers? Sorry, but that concept is mutually exclusive. It's like saying that fire fighters shouldn't go into burning houses because it's dangerous and the people inside should just walk out.


----------



## VFFforpeople

medic417 said:


> Don't be stupid if you read anything about it you know there was much more than a little snow in the way.  You should never decide your safety is important because if you do you are going to a hypocrite.



I am just kinda taking in the situation, lets see to start:

At least one of the EMS workers must have lived there for Xamount of years and knows it snows.

If you can drive in it, I am fairly sure you can walk in it, unless they are driving monster truck boxes

How many unsafe things do we do in a day(s) drive Code 3 that isnt safe for anyone, walk into houses for medicals,fire,low angle,TCs, all that is unsafe to because I dont know what os on the other side of that door, or if my rope will break, or a semi will drive into my "safe" zone on the highway or road way.

Your walking out in the open, daylight, radio, a partner, not seeing a whole lot of danger involved in walking to them.


----------



## eynonqrs

This is bull:censored::censored::censored::censored: ! EMS stated the ambulance wasn't at fault ? I tell you what, it if was my family or anyone one that I knew got denied EMS beacause they were too lazy to do anything. You bet that I would get a lawyer in this. I have been on plenty of calls in bad snow storms, and we found a way to get to the pt ! It's called bad planning, not calling for assistance. Call it what you want. There is no reason for this !


----------



## EMSLaw

JPINFV said:


> PLUS
> 
> 
> 
> 
> 
> 
> equals
> 
> 
> 
> 
> 
> 
> Or use a
> 
> 
> 
> 
> 
> 
> to move patient from house to ambulance.
> 
> or at the very least, set up shop and administer care on scene.



Best. Post. EVAR.

And right and my reading level, too.  Though I think I said it first.  FDs love to play with ropes and stokes baskets.  If it was a five-year old with difficulty breathing in a rich part of town, I guarantee it would have been done.  (Cynical?  Maybe a little).


----------



## LucidResq

City disciplining 4 EMS workers over snowstorm death




> Pittsburgh officials this afternoon announced disciplinary action against four Emergency Medical Services workers for not doing enough to help Hazelwood resident Curtis Mitchell during a February snowstorm.





> "He ain't [expletive] comin' down, and I ain't waitin' all day for him," acting crew chief Josie Dimon was heard to say on a 911 recording played at a news conference today. "I mean, what the [expletive]. This ain't no cab service," she said during a transmission at 2 a.m. Feb. 6. A 911 dispatcher eventually aborted the call.
> 
> Facing three-day suspensions are crew chief Kim Long, a union member, and district chiefs Norman Auvil and Ron Curry. Ms. Dimon, also a union member, faces a five-day suspension pending termination.
> 
> Before this afternoon's press conference, paramedics told city council this morning that they've been made scapegoats for the city's failed response to the February snowstorm.
> 
> "The truth is, there was a total system failure," union grievance chairman Tom Polito said.
> 
> "There are no grounds or merit to discipline," he said. "Zero."
> 
> Read more: http://www.post-gazette.com/pg/10082/1045012-100.stm#ixzz0j35FuVwd


----------



## DrParasite

here is another part of the article that is pretty important:





> Although paramedic union President Anthony Weinmann said his medics were following orders, city Public Safety Director Michael Huss said he expected more. Mr. Huss said he was particularly concerned about the lack of compassion EMS workers showed both in the field and in the 911 center.
> 
> Read more: http://www.post-gazette.com/pg/10082/1045012-100.stm#ixzz0jAkdUfo2


So the paramedics were just following orders in doing what they did.  not saying they were necessarily right, but most large EMS systems are treated like paramilitary organizations.  if they disobeyed orders they could be discipline for insubordination or not following the directions of a supervisor.  

He can expect all he wants, but change starts at the top, and works it's way down.  Fix the management, correct their attitudes, and let them know that their actions won't be permitted. then deal with the field personnel.


----------



## JPINFV

According to the union goon (and, to be fair, I wouldn't trust union goons any farther than I can throw them and I'm out of shape), they were just following orders. According to the director, they didn't do enough. No mention of marching orders were mentioned in the medical directors report.


----------



## DrParasite

JPINFV said:


> According to the union goon (and, to be fair, I wouldn't trust union goons any farther than I can throw them and I'm out of shape), they were just following orders. According to the director, they didn't do enough. No mention of marching orders were mentioned in the medical directors report.


To be fair, the union goon's job is to stand up for the people, and fight for their jobs, regardless of if they were right or wrong.  

also to be fair, the director is often a political appointee, who frequently never did the job in that city as a street medic, and as such, their opinion is often whatever is in the best interest of their (the director or mayor's) career, or in response the the public outcry, regardless of if it's based in fact or if its in the best interests of the people they are in charge of.


----------



## MrBrown

DrParasite said:


> also to be fair, the director is often a political appointee, who frequently never did the job in that city as a street medic, and as such, their opinion is often whatever is in the best interest of their (the director or mayor's) career, or in response the the public outcry, regardless of if it's based in fact or if its in the best interests of the people they are in charge of.



You're onto it mate, he is just spouting words that sound good.

Not to excuse the ambo's but come on .... you cal 911 ten times over what was it, about two days, and yet you make no effort to get the patient to the hospital yourself or meet the ambulance if it can get so close you can see it? Where is a little initaive here???


----------



## Veneficus

DrParasite said:


> here is another part of the article that is pretty important:So the paramedics were just following orders in doing what they did.  not saying they were necessarily right, but most large EMS systems are treated like paramilitary organizations.  if they disobeyed orders they could be discipline for insubordination or not following the directions of a supervisor.
> 
> He can expect all he wants, but change starts at the top, and works it's way down.  Fix the management, correct their attitudes, and let them know that their actions won't be permitted. then deal with the field personnel.



I have noticed that "just following orders" is nothing more than a pathetic excuse. 

If a paramedic wants to be considered anything more than an ambulance driver, (a taxi cab to use some of Pittsburgs terms) they have to make decisions at some level on their own. Poor/no decisions or initiative were shown and those people are not needed in EMS. 

Forget bout paramilitary, even in the millitary there is a feedback system and a proper way to bring objections. 

On the extreme end there is a duty to disobey an unlawful order. But in this case "Sir I really think we should make patient contact if they say they cannot walk to the ambulance before terminating the response." 

If a patient claims they couldn't walk, but made an effort, either the patient lied and didn't make the effort, or the condition renders them incapable of ambulating. 

Would you leave an elderly person with a fractured femur because they couldn't walk to your ambulance in the snow?

I agree there were system failures. But there is also some individual responsibility too. Ask some former soldiers who commited crimes and used the "I was just following orders" defense how well it works. 

Part of being a professional, or even a grown up, involves taking responsibility for your decisions.

The union in this case has such a weak argument it makes paramedics look like morons who need to be told when to tie their shoes.


----------



## CAOX3

This guy dialed 911 ten times over a 30 hour period and then died.  Everyone gets fired, this coming from a union person myself, no one deserves protection in a case like this.  We dont promote or defend incompetency

This wasnt a guy who dialed 911 once and died waiting for an ambulance that was delayed 15 minutes in a snowstorm.

Devise a plan and then execute it or pack your bags.  Simple.


----------



## DrParasite

CAOX3 said:


> This guy dialed 911 ten times over a 30 hour period and then died.  Everyone gets fired, this coming from a union person myself, no one deserves protection in a case like this.  We dont promote or defend incompetency
> 
> This wasnt a guy who dialed 911 once and died waiting for an ambulance that was delayed 15 minutes in a snowstorm.
> 
> Devise a plan and then execute it or pack your bags.  Simple.


out of curiosity, do you work in NYC, or in another concrete jungle?

Based on your statement, I can tell you have never, ever worked as a dispatcher.  because I can have a guy with severe abdominal pain call me 5 times when we are backed up with shooting and stabbings and chest pains, while other higher priority calls only call once.

In fact, the last shift I worked, I received a call for a person having a seizure (in my system prioritized as a low priority call, by more educated people than I).  in fact, while I was taking the call, my partner was taking the exact same call, from another person in the same house.  3 minutes after we took the call (well, both), they called back again.  person was postictal, but they ambulance showed up.  2 minutes later, another call.  thankfully it was a slow night, so an ambulance was sent right away, but if we were busy, the job would have held.  So those 4 calls in the span on 10 minutes don't equate to the call being more life threatening than a chest pain or resp distress call, where the caller only calls once and then waits for the ambulance.  There is absolutely no correlation.

Now before you jump all over me, keep this in mind: it was during a massive snow storm, there were probably dozens if not hundreds of calls holding, and the city didn't have enough units.  You need to give the dispatchers some leeway, as well as the field units.   and I'm sorry, but a low priority calls that just this one time turns out to be fatal is the exception, not the rule, to priority dispatching.  

yes they should have found a way to make it to the scene, or even better, the sick person's family should have gotten the patient into the car and driven to the hospital (I know shocker there), esp when it became obvious that help wasn't coming after the first hour of waiting.  but the caller canceled the ambulance too.   As a result, they share some part of the burden (as does DPW for now plowing, the medical director, the city for not staffing enough units, the idiot director who is throwing his crews under the bus, and the crew and supervisor, who didn't use their rescues or the FD to make patient contact (although it may be because the EMS rescue and FD were tied up on other calls during this horrific storm), and of course, mother nature for sending this mother of all snow storms).

btw, I once called 911 in NYC, midtown Manhattan to  be exact, for a coworker of mine who was having chest pains.  we were on the 40th floor of a highrise.   after 20 minutes of waiting, I called 911 again, to see what the status was of the ambulance.  the dispatcher told me they came and left.  apparently the original crew picked up some bum from outside and took him to the hospital, and never came to the 40th floor.  another unit finally showed up (30 minutes after the initial 911 call), and took him to the hospital for eval. 

 should the paramedic/emt crew who was sent first be fired?  they were obviously incompetent, for not even bothering to come to the floor we were on.  no call back was made to confirm they had the right patient.  hell, if we had been patient, and not called 911 again, an ambulance might have never shown up.  using your line of thinking, the dispatcher, call taker, EMS crew, supervisor and medical director should all be fired for gross incompetence.  I just want to make sure we are on the same page here.


----------



## CAOX3

No I do not work for FDNY.  They dont pay enough 

You cant compare the two, your buddy waited 30 minutes for an ambulance this guy waited 30 hours, then died.

I dont know the role the dispatcher played in this mess, if they didnt follow their protocols then yes fire them.  Who ever didnt have a comprehensive plan in place to deal with a blizzard when its very likely you could recieve one then yes your fired.  If the crew did not not make an adequate attempt to reach and treat the patient then yes fire them.

We have four wheel drive vehicles, they can reach just about anyone.  I have a four wheel drive truck and have yet to be snowed in.  Its possible but it takes some planning and determinaion.  Your best bet is not to put yourself in these situations, have a plan in place to deal with these situations when they arise.  Delays will happen, somone waiting 30 hours for ambulance in this day and age with the technology we have available is ridiculous.


----------



## Foxbat

As far as I remember, the QA report said that 4WD with supervisor was responding but then dispatcher said the caller requested to cancel.
P.S. It's a small world, it turned out I know one of the people who were suspended...


----------



## eveningsky339

I work for an ambulance service in the foothills of Western Maine.  We've had to climb snowbanks up to fifteen feet high (no exaggeration) with c-spines, BLS bags, and fairly cumbersome rescue equipment, and we didn't once think about asking the patient to come to us, or returning to the ambulance because we can't reach the patient, my poor little legs don't work so well, I spend all my down-time munching junk food in front of the television, etc.

This fiasco is a *joke.*  Fire every last one of the responding crews and dispatchers and press charges.


----------



## DrParasite

CAOX3 said:


> No I do not work for FDNY.  They dont pay enough


I didn't say, FDNY, I said NYC.  there are more EMS agencies in NYC that just the FD, and almost all pay better B)


CAOX3 said:


> You cant compare the two, your buddy waited 30 minutes for an ambulance this guy waited 30 hours, then died.


you are absolutely right.  in my case, the crew willfully neglected to go to the location they were dispatched to, on a clear day, neglected to do a call back to ensure they had the right patient (since the patient wasn't where they were dispatched to), and picked up some random guy, instead of the person who called 911.  In the Pittsburgh case, the system was uber backed up, it was during a blizzard where the roads were horrendous, and often unpassable, and the caller canceled the ambulance several times (as the report says).  You are right, you can't compare the two, one is willful incompetence, and the other one is during a massive snow storm where the caller canceled the ambulance.


CAOX3 said:


> We have four wheel drive vehicles, they can reach just about anyone.  I have a four wheel drive truck and have yet to be snowed in.  Its possible but it takes some planning and determinaion.  Your best bet is not to put yourself in these situations, have a plan in place to deal with these situations when they arise.  Delays will happen, somone waiting 30 hours for ambulance in this day and age with the technology we have available is ridiculous.


I am not disagreeing with you on any areas.  but not every system has 4 wheel drive vehicles available.  And if the system (pitt EMS) doesn't have the plans in place, then its the director and management staff who should be fired, not the crew because the system lacks the proper resources to handle the calls.  

Also, many people are focusing on the 30 hours, and how the caller was waiting 30 hours.  this is not correct.  several calls were made, and several times the call was canceled.  once the call was canceled (by the caller), the clock restarts.  the other times were inexcusable, but when the caller cancels you, well, that's what happens.

fix the system, but don't look to hang the field crews because of limitations and the lack of planning of the agency.


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## CAOX3

http://www.post-gazette.com/pg/10093/1047597-53.stm

The paramedic has been fired.


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## DrParasite

*I know this is going to shock everyone but...*

She deserved to be fired.  Not only that, but the City can't tolerate that type of behavior, esp if it gets on a recorded line.


Family sues over Pa. man's unheeded 911 calls
One paramedic was fired and three others were suspended over his death

PITTSBURGH — The children of a man who died after waiting 30 hours for help during a snowstorm despite repeated calls to 911 are suing.  The lawsuit claims the city, the county dispatch center and the various paramedics and emergency medical services brass are responsible for the February death of 50-year-old Curtis Mitchell.

Mitchell died after ambulance crews didn't reach him despite calling 911 repeatedly over 30 hours as a storm dumped nearly two feet of snow on the city.  One paramedic was fired, and three others were suspended over Mitchell's death. The lawsuit claims he endured agonizing stomach pain while waiting for help.

Allegheny County Medical Examiner Karl Williams later determined Mitchell died of natural causes — heart disease complicated by a fatty liver — though toxicology tests confirmed that a poor blood supply caused Mitchell's intestines to swell and likely led to the discomfort he suffered.  Mitchell's family contends he might have lived had he gotten help sooner in the 51-page lawsuit obtained by The Associated Press. It was being filed Thursday by Mitchell's children, Theresa Thornton and Jeremiah C. Mitchell in Allegheny County.

read the rest: http://www.ems1.com/communications-...-Family-sues-over-Pa-mans-unheeded-911-calls/


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## SirensSong102

If I was the medic on that call, I would have got out and crawled through that snow if I had to. That's ridiculous. 

Where were the DOH snow plows??


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## Shishkabob

If the judge rules in favor of the family, that's going to cause a horrible precedent.


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## jjesusfreak01

DrParasite said:


> btw, I once called 911 in NYC, midtown Manhattan to  be exact, for a coworker of mine who was having chest pains.  we were on the 40th floor of a highrise.   after 20 minutes of waiting, I called 911 again, to see what the status was of the ambulance.  the dispatcher told me they came and left.  apparently the original crew picked up some bum from outside and took him to the hospital, and never came to the 40th floor.  another unit finally showed up (30 minutes after the initial 911 call), and took him to the hospital for eval.
> 
> should the paramedic/emt crew who was sent first be fired?  they were obviously incompetent, for not even bothering to come to the floor we were on.  no call back was made to confirm they had the right patient.  hell, if we had been patient, and not called 911 again, an ambulance might have never shown up.  using your line of thinking, the dispatcher, call taker, EMS crew, supervisor and medical director should all be fired for gross incompetence.  I just want to make sure we are on the same page here.



Thats the most clear case of abandonment i've seen in a while. They have a few options. If they think the street bum is more urgently in need of a trip to the hospital (than a chest pain patient), transport him and call out for another ambulance immediately. If they think he isn't as urgent call out for a second ambulance to transport him and proceed to original call. 

They should most certainly be fired if they didn't call for another ambulance immediately.


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## TransportJockey

jjesusfreak01 said:


> Thats the most clear case of abandonment i've seen in a while. They have a few options. If they think the street bum is more urgently in need of a trip to the hospital (than a chest pain patient), transport him and call out for another ambulance immediately. If they think he isn't as urgent call out for a second ambulance to transport him and proceed to original call.
> 
> They should most certainly be fired if they didn't call for another ambulance immediately.


How is it abandonment if they never made contact with the patient that was originally called for? IIRC to be considered abandonment you actually have to make contact with the patient.


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## Aidey

Linuss said:


> If the judge rules in favor of the family, that's going to cause a horrible precedent.



I agree. It sets the precedent that no matter what extenuating factors exist we can still be held responsible for a patient's outcome. There were mistakes made on the part of the city. The dispatch messed up by not recognizing that there had been multiple 911 calls from that number in a short period of time. The medic that was fired was very unprofessional. Those issues can and have been addressed. 

However, the family can not blame the EMS agency for the snow. It would make more sense to sue the people responsible for clearing the roads than it does to sue the ambulance. The mans 911 calls weren't ignored, they attempted to respond and because of extreme circumstances could not reach the man. When a catastrophic weather event occurs there will be a break down in the system, and there may be nothing anyone can do about it. I am all for assigning responsibility where responsibility is due, but you can't hold people responsible for the weather.


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## LonghornMedic

Aidey said:


> I agree. It sets the precedent that no matter what extenuating factors exist we can still be held responsible for a patient's outcome. There were mistakes made on the part of the city. The dispatch messed up by not recognizing that there had been multiple 911 calls from that number in a short period of time. The medic that was fired was very unprofessional. Those issues can and have been addressed.
> 
> However, the family can not blame the EMS agency for the snow. It would make more sense to sue the people responsible for clearing the roads than it does to sue the ambulance. The mans 911 calls weren't ignored, they attempted to respond and because of extreme circumstances could not reach the man. When a catastrophic weather event occurs there will be a break down in the system, and there may be nothing anyone can do about it. I am all for assigning responsibility where responsibility is due, but you can't hold people responsible for the weather.



They were able to make it to within one block of the house. You mean to tell me that they couldn't have called an engine company over to assist them in moving the patient? Come on! We're talking two feet of snow here. Yes that's deep, but not impossible.


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## Shishkabob

So where do you draw the line?

What about the swift water team that wasn't able to rescue someone?  I mean, it was only 6" of water, right?


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## Aidey

Given the state of the area after/during the snow storm, assistance may not have been readily available. I'm also not sure what they could have moved the patient on unless someone ran to the store and got a sled. A gurney is NOT making it through 2 feet of snow, no matter how many people are pulling it. There were also concerns about downed power lines under the snow that no one could see.


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## JPINFV

Linuss said:


> If the judge rules in favor of the family, that's going to cause a horrible precedent.



I draw the line when the paramedic thinks that it's safe enough for the patient to leave the house and come to the ambulance. If a sick patient is supposed to make that trip, I damn well expect the paramedic to make the trip. However, this only really affects the third crew and not the first two crews.


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## Shishkabob

I damn well expect a patient to walk through a fire to reach me instead of me going through it to reach them.  (Or gunfire, or a rapidly moving river, etc etc)



Since when did provider safety mean less than patient safety just because it's snow?


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## LonghornMedic

Linuss said:


> So where do you draw the line?
> 
> What about the swift water team that wasn't able to rescue someone?  I mean, it was only 6" of water, right?



I get your point. But the article say "up to two feet of snow." Traversing through two feet of snow down one city block isn't going to kill you like swift water. There's no excuse to at least call the fire department and see if they could help. They have equipment that is larger and higher than an ambulance. Maybe their engine could have made it down the street. Maybe four FF and two medics could have formulated a plan to get him down the street. Maybe the medics could have requested the streets department to see if there was a snow plow nearby. The point is, NONE of these approaches were attempted. They pulled up, said "tough :censored::censored::censored::censored:" and cleared the scene. Bad service and bad medicine.


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## Shishkabob

LonghornMedic said:


> I get your point. But the article say "up to two feet of snow." Traversing through two feet of snow down one city block isn't going to kill you like swift water.



Wait, were you IN north Texas this February when we had that snow storm?


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## JPINFV

Linuss said:


> I damn well expect a patient to walk through a fire to reach me instead of me going through it to reach them.  (Or gunfire, or a rapidly moving river, etc etc)
> 
> 
> 
> Since when did provider safety mean less than patient safety just because it's snow?



So if the patient could barely walk and was on the opposite bank of the river, you'd suggest that he walks to you?

If the patient was in a secure room (either fire or active shooter), you'd expect him to leave safety to come to you?

This wasn't a case of someone in a compromised location. It was a situation of a patient in a perfectly good shelter who needed medical attention. I will definitely accept that some of the crews couldn't reach him. However, to suggest that someone who could barely walk walk through, if we take the report of downed powerlines (which, to be fair, did anyone see any downed powerlines hanging from poles?), a few feet of snow that is in essence a mine field is crazy. In a situation like that, if it's too dangerous for the responders, it's definitely too dangerous for the patient. As far as "Since when did provider safety mean less than patient safety just because it's snow?" well, that really is situationally dependent. If you want to take it to the logical end, then there shouldn't be things like swift water response units. After all, if the patient got there, the patient can get out. However, this also ignores the fact that the responders should have more ability to handle dangers since they are, well, uninjured and unaffected by acute disease.


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## JPINFV

LonghornMedic said:


> Maybe the medics could have requested the streets department to see if there was a snow plow nearby. The point is, NONE of these approaches were attempted. They pulled up, said "tough :censored::censored::censored::censored:" and cleared the scene. Bad service and bad medicine.


If I recall correctly, the first ambulance dispatched did request resources and was denied them.


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## LonghornMedic

Linuss said:


> Wait, were you IN north Texas this February when we had that snow storm?



Having lived in Montana, I can safely say two feet won't kill you. People living in PA are also accustomed to snow. North Texas, not so much.


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## Shishkabob

LonghornMedic said:


> Having lived in Montana, I can safely say two feet won't kill you. People living in PA are also accustomed to snow. North Texas, not so much.



Having lived in Michigan for half my life, I can safely say 6" of snow can kill you.


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## Aidey

LonghornMedic said:


> I get your point. But the article say "up to two feet of snow." Traversing through two feet of snow down one city block isn't going to kill you like swift water. There's no excuse to at least call the fire department and see if they could help. They have equipment that is larger and higher than an ambulance. Maybe their engine could have made it down the street. Maybe four FF and two medics could have formulated a plan to get him down the street. Maybe the medics could have requested the streets department to see if there was a snow plow nearby. The point is, NONE of these approaches were attempted. They pulled up, said "tough :censored::censored::censored::censored:" and cleared the scene. Bad service and bad medicine.



Do you know that none of that stuff was done? It is possible that it was, and we just haven't heard about it in the media.


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## DrParasite

having lived in Syracuse NY for a few years, I can tell you that if a city isn't prepared for a snow, it can cripple it.  and even if a city IS prepared for snow, getting 2 feet of snow in 24 hours can cripple any town.  And no, just saying "tell the road department to bring a plow" well, that might work for routine snow, but when everything is under 2 ft, it's not always that easy.  I mean, ideally the best thing would be to assign a plow to EVERY ambulance to ensure a clear path but we all know that is cost prohibitive, unless you budget for it in advance.

That all being said, I think the family will win.  They should.  However, they should not win 10 million.  the City/Pittsburg EMS failed to live up to their expectations and obligations, which resulted in a death.  because of this the family should get money.  

however, there are many mitigating circumstances.  The blizzard snow storm, the cancelling of the ambulance by the family, and unusually high call volume are all factors that need to be taken into consideration, and should result in lower settlements.  And because the family kept cancelling the ambulance (regardless of the reason), they need to accept part of the blame.  Nature is a simple fact, that no one could anticipate, nor could you anticipate the call volume.

but I think the city will settle with the family before a judge make a decision.


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## firecoins

Aidey said:


> Do you know that none of that stuff was done? It is possible that it was, and we just haven't heard about it in the media.



It is certainly possible they did request additional assistance to get to the house.  Than the question is how come they didn't get it.  

It has been suggested in the media that the ambulance crew asked the patient to walk to the ambulance in the snow. This begs the question how come the crew didn't at least walk to the patient and assess the patient.


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## Shishkabob

DrParasite said:


> That all being said, I think the family will win.  They should.  However, they should not win 10 million.  the City/Pittsburg EMS failed to live up to their expectations and obligations, which resulted in a death.  because of this the family should get money.



Again, that sets a HORRIBLE precedent that will screw every single fire, ems, and police agency in America.


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## jjesusfreak01

jtpaintball70 said:


> How is it abandonment if they never made contact with the patient that was originally called for? IIRC to be considered abandonment you actually have to make contact with the patient.



If you are dispatched, choose to transport another patient, and don't call for another unit to go to the original call, then the people with the patient probably aren't going to call for help again until they are sure you aren't coming. You would be unnecessarily delaying the care of the original patient, possibly resulting in their harm or death. 

This isn't a question of triaging...I agree that triaging is necessary and may result in you having to redirect resources, but when resources are not the issue there are few excuses when care is delayed.


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## usalsfyre

I have a sneaking suspicion they might have never known they WEREN'T at the original call. If you respond to an address, and you are met by someone c/o a similar complaint, would you not assume that is the caller?


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## EMDispatch

DrParasite said:


> however, there are many mitigating circumstances.  The blizzard snow storm, the cancelling of the ambulance by the family, and unusually high call volume are all factors that need to be taken into consideration, and should result in lower settlements.  And because the family kept cancelling the ambulance (regardless of the reason), they need to accept part of the blame.



Canceling the ambulance can play a huge factor. If a crew sent a request for a plow, when they were canceled, it's likely that a plow would have been canceled too. 

Overall I view it as more of a failure of ICS and emergency management activities. Communication between agencies seems to have failed in what was an obvious weather emergency situation.


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## Foxbat

PITTSBURGH -- An arbitrator has ordered reinstatement for a Pittsburgh paramedic fired after a snowbound Hazelwood man died during a 30-hour wait for an ambulance last winter.
...
Josie Dimon was a medic crew chief during a blizzard in February 2010. She was fired after recordings revealed her saying that a man suffering from abdominal pain should walk to an ambulance that couldn't reach his home in the snow.

The rest of the story


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## firetender

thanks for the update!


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