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By Larry King

INQUIRER STAFF WRITER
Eleven Bucks County emergency dispatchers and four supervisors have been disciplined for their roles in the mishandling of the 911 call of a bedridden woman who perished Jan. 29 in a Doylestown house fire.

Brenda Orr, 53, long disabled by multiple sclerosis, waited 28 seconds - six rings - before her call was answered. A dispatcher then put her on hold, forcing Orr to wait another 26 seconds before she was able to report that her bed was in flames around her.

"That is unacceptable," said Jim Cawley, chairman of the Bucks County Commissioners, who said changes are being made to avoid such delays in the future. LINK

This is a tragic story from front to rear, beginning to end. This women's death however unpreventable illustrates what we in the fire service often point out when we say seconds count.

Even if everything was done exactly as it should have been she would in all likelihood still have perished. But at other times a few minutes is all we need. When you are in the business of saving people's lives (Assuming thats what we are hired to do) there is no room for compromise on any issue. Staffing, equipment, flexibility, standards, pay & benefits, training, infrastructure or personnel all are paramount.

Likewise when these types of mistakes are made the reason for the failure must be determined. If it is a systemic failure (As is often the case) then the system needs to be fixed. If it is a personnel failure then it must be determined if it was a training issue or a disciplinary issue. In any event appropriate corrective action must be taken to avoid repeat occurrences. Keep in mind that for most of us answering the phone or not, isn't a matter of life or death. For 911 dispatchers it may often be.

But when thinking of systemic failures we can look at our system here in Philly. Too many calls and not enough resources. On New Years Eve a Philly women died after a catastrophic failure of Philly's EMSher system.

Overwhelmed by calls (most for non emergency service) we ran out of ambulances shortly after midnight. This was predictable. Deborah Payne died after waiting more than an hour for an ambulance. When one did arrive it promptly broke down. Another one was called but it came from across town and by the time it arrived she was dead. Why? Systemic failure that continues to go unfixed. Too few resources (ambulances) multiplied by unimaginable call volume (8-10,000 a year) for some individual units. Equipment wears out, personnel make mistakes in judgment due to fatigue, stress ect. Dispatchers lose control of the big picture and people die as a result. Thats the price WE ALL pay because it could be any one of our families or friends who need that help.

It reminds me of the scene from Band of Brothers when Lt. Dyke failed in leading the attack on the German town. It was a failure that others saw coming, raised the alarm about and predicted but to no avail. In the end he had to be relieved in the middle of combat by Lt. Spears but many men had already been needlessly killed as a result of his incompetence.

After the big press conference the other day touting the EMS expansion the hidden details begin to emerge: only two ambulances of the initial five are operating. The first five will be BLS units staffed by Firemen, not Paramedics. Additionally those five will only operate during daytime hours not round the clock. They will also not operate on weekends. So we are involved in a system that is prone to catastrophic failure yet it remains unfixed. The men and women who man these ambulances every day will no doubt have to make judgment calls but will get little support when this judgment is wrong or marginal.

Hopefully things will improve but most patients in need of surgery who only get first aid rarely pull through. Time will tell.