Could an ambulance switch have kept an elderly woman with a head injury from getting to the hospital in the quickest way possible?
That is what D.C. Fire and EMS officials are investigating after learning that two ambulance crews may have actually discussed the transport amongst themselves while a 93-year-old woman who was injured in a fall waited for help.
“We dispatch our closest unit to the emergency,” says Assistant Chief For Operations Timothy Gerhart.
But instead of driving directly to the woman’s home, sources tell FOX 5 Ambulance 6 drove past her house to Ambulance 29′s station and insisted they transport her instead.
“Ambulance 6 was dispatched, and currently we’re looking into why Ambulance 29 was consequently dispatched to the emergency,” Gerhart says.
For ambulances to switch assignments like that, EMS officials say the Office of Unified Communications would need to be notified, as well as records updated, among other things. All of that adds to the response time.
Sources say switching out those two ambulances caused a 15 minute delay in getting this 93-year-old woman with a head injury to the hospital. Fortunately, she survived and is now recovering at home after a five-day hospital stay.
New York Times Editor David Rosenbaum wasn’t so lucky. He was injured in a robbery, but the EMS crew misdiagnosed him, and transported him to the hospital as a low priority patient. He died two days later.
D.C. Fire and EMS has been under fire ever since to revamp its system so that seriously injured people get to the hospital in less than seven minutes.
“We expect our emergency vehicles to get on the scene as quickly as possible when they’re dispatched to a response, and that’s why we’re investigating it very actively and we will take appropriate action,” Gerhart says.
Gerhart says GPS tracking data from the ambulances is key, but he says it’s too soon to say if any discrepancies were uncovered.
It is also too early to say if the delayed response has hampered the 93-year-old woman’s recovery.
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TV news report says DC ambulance crew drove past house to nearby fire station to get crew there to take call. Report of 15 minute delay.39 comments
Another view on DC shift change controversy. Brother of slain New York Times reporter David Rosenbaum points to studies saying current 24/72 & Chief Ellerbe’s 12-hour shifts both aren’t safe.54 comments
Marcus Rosenbaum has written a column for The Washington Post about Chief Kenneth Ellerbe's proposal to do away with the current shift for firefighters of 24/72 and replace it with 12-hour shifts of three days, three nights and three off (3-3-3). Rosenbaum's brother David was a former New York Times reporter who was beaten on a Northwest Washington street six years ago. David Rosenbaum's treatment by the Metropolitan Police Department, the DC Fire & EMS Department and Howard University Hospital was found to be greatly flawed and highlighted problems with the way EMS was delivered in the Nation's Capital.
Following David Rosenbaum's death, his family dropped a lawsuit against the City in exchange for a task force to lead the way to major improvements for EMS. The task force called for "shorter shifts for all employees . . . to ensure the goal of having alert and awake employees who can provide competent patient care.”
Chief Ellerbe has cited the report in justifying both his shift change plan and the recent controversy over the department's logo.
Marcus Rosenbaum, pointing to studies done on performance for those who are sleep deprived, believes that 24-shifts are not safe when it comes to patient care. But Rosenbaum says the studies also show that Chief Ellerbe's plan is not the way to go either. Rosenbaum thinks both sides need to come together and approach this with open minds so they can develop a schedule that does not include extended work hours that can cause sleep deprivation.
Here are some excerpts from this latest opinion piece on the shift change issue:
Sleep deprivation leads to underperformance and serious mistakes. In fact, in 2008 the National Institute of Medicine recommended that doctors-in-training should not work more than 16 hours in a row, should not be awakened to treat patients and should not even drive home if they have worked longer than 16 hours. And a 2009 article on shift work in the journal Current Neurology and Neuroscience Reports concludes that firefighters’ performance “is likely to be significantly degraded” on shifts like those used in the District.
Setting aside whether it’s proper for anyone to be paid to sleep during work hours, people who have life-and-death jobs need adequate sleep, whether they are doctors or airline pilots or firefighters or EMTs. That’s impossible in a busy firehouse. “If you’re waking up every two hours,” says Charles Czeisler, director of the Division of Sleep Medicine at Harvard Medical School, “you might as well be up all night.”
Shorter shifts are the only way to ensure that our emergency workers get enough sleep. But this doesn’t mean that Chief Ellerbe’s 3-3-3 plan is the right way to do it. Indeed, Czeisler thinks it’s perfectly horrible. First, he says, no one should work six 12-hour days in a row. Ever. Twelve-hour shifts make people “chronically sleep-deprived”; six in a row is a disaster. (Ellerbe says that built-in, rotating extra days off would rarely require anyone to work six days in a row, but to avoid it they would have to forgo quite a bit of overtime pay.)
Second, Czeisler says, no one should have to work three day shifts followed by three night shifts. Instead, people should work days for an extended period, followed by nights for an extended period. “You don’t want to be jerked around from one shift to another,” he says. If you are, your biological clock can never get set, and your body is always out of sync; you’re working below your ability no matter what shift you’re on.
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IAFF Local 36 president Ed Smith's rebuttal to a December 26 Washington Post editorial supporting a move away from a 24/72 work schedule has now been posted on the Post's website. Smith disputes the claims of DC Fire & EMS Chief Kenneth Ellerbe that a 3-3-3 schedule of 12-hour shifts will provide improved patient care because firefighters will be better rested and that $36 million dollar in overtime will be saved.
Smith says that shift change overtime expenditures will more than double with two shift changes a day instead of one. He cites an increased call load for the afternoon or evening changeover that will mean more units on calls when the shift change is suppposed to occur.
But Smith focuses most of his attention on the fatigue rotating 12-hour shifts will cause firefighters. He points to a 2005 study of firefighter work schedules from Canada that concludes the current 24/72 arrangement is the best schedule for "sustaining cognitive performance in the face of nocturnal alarms":
Noting that sleep deficits are cumulative, the study determined that working back-to-back night shifts is more exhausting than powering through a single, longer shift with more time to recover. The research concluded that recovery time, rather than shift length, is the most important factor to consider in creating a firefighter work schedule.
imagine yourself working such a schedule: It can take weeks, or even months, to adapt to a full 12-hour change in sleep hours; it is simply impossible to healthily switch from day work to night work and back over the course of a week, every week, as Ellerbe proposes. Such a regimen will inevitably lead to sleep-deprived firefighters who are less able to perform their jobs.
Ellerbe’s budget calculations are also problematic. He has asserted that a 3-3-3 schedule will save the city $36 million a year by reducing overtime and allowing the city to use attrition to thin the ranks of firefighters.
Local 36 of the International Association of Fire Fighters has done its own analysis of Ellerbe’s proposal, and our math shows that the 3-3-3 schedule would actually cost the city between $16 million and $45 million the first year, depending on how it is implemented.
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Washington Post supports DC Fire & EMS Department shift change. Editorial board calls it ‘A shift for the better’.63 comments
This evening The Washington Post published an editorial on its web site titled, "A shift for the better: New hours for D.C. firefighters". In it, the Post generally supports DC Fire & EMS Department Chief Kenneth Ellerbe's plan to do away with the 24-hours on, 72-hours off, four platoon shift currently in place.
Besides echoing Chief Ellerbe's money will be saved, the Post editorial board says for the department to be fully unified, as recommended by the task force that looked into the 2006 death of New York Times reporter David Rosenbaum, firefighters should work the same 12-hour shifts as the civilian EMS force.
The editorial also makes the point, with EMS being bulk of the work load for firefighters, the department needs to move away from 24-hour shifts to reduce errors, similar to the trend of hospitals shortening shifts for interns.
Here are some excerpts from the editorial:
An altered work schedule has the potential to save money while ensuring better emergency services.
Mr. Ellerbe said the change would help curb excessive overtime while enabling (through attrition) a reduction in the number of full-time employees, eventually saving $36 million per year.
Whether the so-called 3-3-3 plan is the best combination is to be determined, but the chief is persuasive on the need to reexamine the 24-hour shift. Shorter shifts would allow for more training opportunities.
Since firefighters, paid annually, would work more hours per week under the new scenario, more compensation is in order, particularly since they have not had a raise since 2006.
More money won’t appease everyone who has built a life around a work schedule that — with its requirement of just eight or nine workdays a month — allows extended time with families, second jobs and the ability to live as far away as North Carolina. Ed Smith, president of the firefighters union, says he believes the change will prompt an exodus from the department, including by EMS-qualified firefighters who were recruited to upgrade the department in the wake of the Rosenbaum case.
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Investigation after death of elderly woman in Washington, DC. WTOP Radio reports medic on leave after failing to accompany patient to hospital.62 comments
A D.C. paramedic has been placed on leave and an investigation is under way after an 87-year-old woman died at a local hospital.
The incident occurred Nov. 17 when D.C. Fire and Emergency Medical Services responded to a call for a woman experiencing abdominal pains.
A fire engine and ambulance from Engine Company 11 — located at 14th Street and Park Road NW — responded to the call. According to sources familiar with the investigation, the paramedic who arrived on the fire engine determined the woman's condition was not serious and declined to accompany her to the hospital, despite the request of ambulance personnel that the paramedic stay with the patient.
Fire and EMS Chief Kenneth Ellerbe tells WTOP the medic who declined to stay with the victim has been placed on administrative leave with pay.
"I do take this matter very seriously," Ellerbe said. "The employee has been placed on administrative leave pending further action and there is a very serious ongoing investigation."
Howard University Hospital spokesman Ronald Harris says the woman did not die in the hospital waiting room as previously reported, but was seen by a doctor and a cardiologist just before her death. Harris says the hospital is looking into the matter.
The medic in question is a five-year veteran of D.C. Fire and EMS and is classified as an "intermediate paramedic," which is the a grade between emergency medical technician and paramedic.
Ellerbe says he personally briefed Mayor Vincent Gray about the incident.
"The mayor wants a quick resolution to this investigation," Ellerbe said.
The case is similar to the death of David Rosenbaum, who died in 2006 at Howard University Hospital after first responders failed to properly assess his condition and hospital staff failed to provide immediate treatment. An inspector general's report called the Rosenbaum incident "an unacceptable chain of failure."
Rosenbaum's family agreed to drop a $20 million lawsuit in exchange for improvements in the District's Fire and EMS protocol. Ellerbe says part of the investigation will be to determine if those protocols were followed in this latest incident.
Wall collapse caught on video: It looks like Martin Grube and his FireRescueTV.com got the best video from yesterday morning’s two-alarm fire at the Grand Furniture warehouse in the 6300 block of Virginia Beach Boulevard in Norfolk, Virginia. At :55 into this video (about 35-minutes after the fire was reported) the wall on Side C collapsed. Firegeezer has additional video and more details about the fire. Here is the Google Maps Street View of the building.
Lots of new videos from around the country (look over here >>>>>>>>>>>>>>>>>>>>>>>>>>) - Emily Cyr has been busy loading up our player in the right hand column. The latest entries include another version of the Norfolk, Virginia furniture store fire, a Lexington, South Carolina house fire caused by someone’s (un)controlled burn (read more), the riverboat Robert E. Lee that burned in St. Louis (more here) and a concrete plant that burned in Sacramento, California. If you want to beat the editor of this blog to the news check the player on a regular basis. Emily often gets video loaded there (like the DC rowhouse fire on Peabody Street, NW) well before I have a chance to write about it.
You will definitely want to see this one: I figured it was just a matter of time before we saw the video from a camera from the locomotive of the Amtrak train that hit Detroit’s Ladder 13 earlier this month. That time is here. Check it out.
Some DC fire action: Broadcast engineer and historian Tom Buckley had his camera at the ready when the DC Fire & EMS Department showed up in his neighborhood yesterday morning. Here are the results.
Rosenbaum son-in-law gives view on latest DC EMS problems: Toby Halliday sat on the task force formed to reform EMS in the Nation’s Capital after the serious problems noted about the care provided to Halliday’s father-in-law, David Rosenbaum. With new, high-profile incidents receiving a lot of attention, Halliday provided The Washington Post his thoughts on the progress made since the task force made its final report. Click here.
Accused firefighter/arsonist doesn’t fit the usual pattern: The stories we find about firefighters setting fires tend to be about younger, newer members of a department. That is not the case with 43-year-old Stark Liedtke who has now been fired after 22-years as an on-call firefighter with New Hampshire’s Alton Fire Department. Investigators say Liedtke admits to setting 11 fires over four years. Here’s the story.
Firefighter reinstated after firing: This is a rather complex sexual harassment case from Westbrook, Maine that we first mentioned in October. The allegations were rather graphic. Now, a state labor board has told the fire department to reinstate Firefighter Matthew Lamontagne. Here is the latest.
Parity means pay up: The City of Wilkes-Barre, Pennsylvania has once again been told to live up to its promise that firefighters are to get pay parity with the cops. It could mean 13k for each firefighter. Read about the court ruling.
Aw chute: This is a really stupid story (but if it weren’t for things like this many of you would find the work much more boring). A 20-year-old man, acting on a dare from some children, wanted to show that he could make it down a home’s laundry chute. You can guess the rest and who had to come save the guy. The rescue apparently traumatized a young girl. Read more from Wisconsin Rapids, Wisconsin.
Vacant car dealership burns, firefighter hurt: The firefighter hurt his knee helping homeless squatters get out of this vacant building in Vallejo, California yesterday morning. The fire went to three-alarms. Read the details.
NEW – DC Rescue Squad 1 involved in serious collision: On the way to a reported of a building fire in Northwest Washington, DC Fire & EMS Department Rescue Squad 1 collided with a vehicle that then hit another vehicle. It happened just after 7:30 this morning at 14th and Constitution, NW. Spokesman Pete Piringer says three civlians were hurt, listed as traumas by mechanism. No firefighters were injured. We will have more later.
Was paramedic criminally negligent?: That’s the question the Special Victim’s Unit of the Metropolitan Police Department Homicide Branch has been charged with determining following the death of two-year-old Stephanie Stephens. The mayor, fire chief, police chief and attorney general of the District of Columbia contend there is enough information about the actions of the paramedic in charge when the decision was made on the initial 911 call not to transport the little girl that detectives specializing in the deaths of children need to take a closer look. Here’s the story.
DC’s former fire chief now says fire & EMS should be separated: Former DC Fire & EMS Department Chief Adrian Thompson now believes EMS in the District of Columbia should be a third service. Thompson tells Matt Cella of The Washington Times, “It’s not working. It’s a cultural issue. They’re not going to change the culture of this department.” Here are more excerpts-
The former chief, who is black, said white firefighters with generational ties to the department largely have been less accepting of the job’s evolving responsibilities, particularly an increased emphasis in recent decades on providing pre-hospital care.
“They want to be firefighters and firefighters only,” he said, adding that black firefighters have entered the department in significant numbers in only the past 20 or 30 years and largely have been more open to other responsibilities if it meant securing a job.
Deputy Chief Kenneth Crosswhite, a spokesman for Chief Dennis L. Rubin, who is white, called Mr. Thompson’s conclusions “totally ludicrous.” He estimated that the department has about 45 percent non-minority employees and 55 percent minority employees.
“For someone to make an assertion like that is totally, totally out of touch with today’s reality,” he said. “Leadership starts at the top. If he had that notion during his tenure, he should have solved the problem.”
Chief Thompson was in charge of the department in January, 2006 when former New York Times reporter David Rosenbaum was murdered. Thompson initially told reporters that his review of the case found no problems in the care provided to the dying man. An inspector general’s report discovered many issues in how first responders and Howard University Hospital dealt with Rosenbaum.
Life sentence for man who killed Delaware’s Michelle Smith: Joseph Taye was give his sentence yesterday for running down Firefighter Smith as she tended to the victim of a motorcycle crash near the Wilmington airport. Taye, a paraplegic, apologized in court for the harm he has done. Click here for the story.
Black firefighters talk about race relations in Chicago: As the Supreme Court deals with a case that hinges on hiring practices, some firefighters give their views on the state of race relations in the Chicago Fire Department. Click here and here.
Late assault report between firefighters in North Carolina: In Elon a fire captain is accused of assaulting a firefighter who was welding at the firehouse after some initial horseplay over keys. Here are the details.
Children’s Hospital doctor blasts DC Fire & EMS Department over death of child. Calls lack of transport ‘inexcusable’. Refers to case as a ‘pediatric Rosenbaum’.29 comments
DC’s Task Force on Emergency Medical Services Final Report (September, 2007)
DC inspector general’s follow-up report to Rosenbaum investigation (September, 2009)
As the investigation into the death of Stephanie Stephens continues, a top official at Children’s National Medical Center has made his views about the case known. In a letter to the editor in Monday’s Washington Post, Dr. Joseph Wright said, “The decision not to immediately transport a 2-year-old with respiratory symptoms is inexcusable.”
Dr. Wright is referring to the crew from DC Fire & EMS Department’s Medic 33 who did not take the little girl to the hospital after her mother’s first call to 911 on the morning of February 10. It wasn’t until another 911 call, about nine-hours later, that a different crew from Medic 33 took the girl to Children’s. She died the next day. The family told 9NEWS NOW Stephanie had pneumonia.
Dr. Wright, a senior vice president and pediatric emergency physician, pointed out in his letter that he believes the city has made little progress since the controversy surrounding the inadequate care provided to dying former New York Times reporter David Rosenbaum. Wright wrote to the Post, “It was only a matter of time before a pediatric Rosenbaum case surfaced.”
According to Dr. Wright’s biography, he is a founding director of the hospital’s Institute for Prehospital Pediatrics and Emergency Research and “provides state-level leadership as the EMS Medical Director for Pediatrics within the Maryland Institute for Emergency Medical Services Systems”. Wright is also a senior investigator and medical director with “the federally-funded Emergency Medical Services for Children National Resource Center.”
DC Fire & EMS Department spokesman Pete Piringer disputes Dr. Wright’s claims. In an email to STATter911.com Piringer said, ”During the past few years significant progress has been made in many areas concerning the state of EMS in the District of Columbia.”
Piringer points to the implementation of the large majority of the goals from the task force ordered by Mayor Adrian Fenty to provide a blueprint for the future of EMS following Rosenbaum’s death in 2006. According to Piringer, “As of today, the Department has completed 39 of those 50 action items, most well ahead of schedule, and is making substantial progress on completing the remaining 11 items.”
Chief Dennis Rubin headed the the task force. Rubin is about to celebrate his third anniversary in command of the DC Fire & EMS Department. Critics, like Kenneth Lyons, president of the union representing civilian EMS workers, point out that Chief Rubin is now in search of his third medical director and is on his fourth crew to lead EMS training. Lyons calls the lack of continuity ”schizophrenic”.
While Lyons believes Dr. Wright is premature in judging the EMS crew in the Stephens case, he concurs with Wright’s claims there are problems in providing pre-hospital care to children. In his letter Wright said, “I have stated often for the public record before the D.C. Council Committee on Public Safety and the Judiciary just how little attention D.C. Fire and EMS has paid to preparing its workforce in the care of children.”
Lyons tells STATter911.com that Dr. Wright has long been an advocate for improved training and protocols in dealing with children who are ill or injured and has offered to assist the city in making these improvements.
The public relations staff at Children’s National Medical Center was unable to schedule an interview with Dr. Wright on Tuesday.
Voting ends tomorrow. Firegeezer is catching up, but this lame blog is in the middle of the pack: Clearly that picture of me on the masthead doesn’t help in this beauty contest. Not that this is anything real important, but just a fun exercise by Rhett Fleitz at FireCritic.com (notice how Dave downplays this now that he is getting his clock cleaned … what a jerk!).
House fire in Spring, Texas: The Bravest Online posted this fire from Saturday. You will hear the air horns around 2:15 in the video. Here’s more from the description posted with the clip - “Forced defensive when the living room flashed. Regained control of the fire and put a hole in the roof. Spring, Ponderosa, and Klein fire departments on scene. No injuries and no cause known.”
Even though Rhett’s contest has ruffled a few feathers in the blogging community (this isn’t t-ball, everyone can’t be picked or win) there are some good fire and EMS blogs out there like FireDaily.com and a new one by Doug Walton covering Howard County, Maryland (don’t let this junk I write sour you on the rest of them). If nothing else the voting process will familiarize you with some other voices in cyberspace. So, click here and let them know your favorite blog from the ten finalists. You can vote as many as four times a day.
EMT ordered rehired takes on The Washington Post: An interesting statement released by the attorney for Selena Walker, the DC Fire & EMS Department EMT who was fired over the David Rosenbaum incident. We told you Friday the DC Court of Appeals affirmed previous rulings that Walker should get back pay and be returned to her job. The statement lashes out not only at the DC government, but makes a case against the editorial board of The Washington Post. Read the statement. Read the court ruling.
Staying on course: We have run a number of stories about first responders who become last responders due to the inability to find an address. Fire service veteran and STATter911.com reader Alan Studt says it doesn’t have to be that way. Read his article on the U.S. National Grid.
He’s a fake: There is very clear surveillance video of an impostor fire inspector who has been hitting businesses in Maryland, DC and Virginia. Click here to view the video and watch the story.
Cop PIO goes out of his way to praise firefighters: It isn’t often I get an email from a police PIO telling me what great work firefighters have done. In fact, this may be a first for me. That’s exactly what United State Park Police Sgt. David Schlosser did last week. We took his hint about a recent ice operation in the District of Columbia and went even further, taking a look at how the DC Fire & EMS Department is handling the deep freeze. Click here for our coverage.
Must see video – is it a cop or a firefighter?: Just like David Schlosser I am trying to give credit where credit is due. The video caption says it is a firefighter in Brazil who rappels down the side of a building catching a jumper in his arms and bringing him to safety. A STATter911.com reader had some doubt. We have added another video that seems to answer the question. Check it out.
HD helmet-cam shows more than good fire video – it illustrates staffing problems: The video of a December fire in an East St. Louis, Illinois night spot is pretty awesome. But if you look around you will see lots of fire and few firefighters. Check it out.
Fireground audio from Fairfax County second-alarm and other multiple alarms: Our friends at FireSceneAudio.com are at it again. They have already posted audio from last night’s house fire on Cherry Drive in Fairfax County. Click here to listen.
They also have fires from Saturday in Chicago, Boston and Jersey City. Click here.
Update on Modesto, CA firefighters: Jason Clevenger is back in the hospital scheduled for skin grafts after is was determined his burns are a little worse than originally thought. Jim Adams remains sedated with burns over half his body. Both fell through the roof of a burning home New Year’s Night. The Modesto Bee has the latest.
Save in Quebec City: Read the story from Canada on the rescue of a 3-year-old boy from a fire on Friday night.
Lots of video of commercial fire in Millburn, NJ: Click here to watch Sunday’s multi-alarm fire in a row of stores.
This is exhibit number 1 on why you shouldn’t read this blog: In case you missed it, Dave had just a little too much fun on Friday with the story of a pipe dream that turned into a pipe nightmare for a man from the UK. Firefighters went beyond the call of duty to solve the problem and not turn the man into John Bobbitt. Click here, if you must.
Bullet hits firefighter: Exploding ammunition at a house fire hit a target but did not hurt a Denver firefighter. Read more from Firefighter Close Calls.