Special report: 911 callers waited desperately for help during last year's snowstorm
Even as Seattle officials roll out an aggressive new plan to clear snow and ice from city streets this winter, they have never investigated the prolonged delays residents endured when they called 911 seeking medical help during last December's storms.
Seattle Times staff reporters
Even as Seattle officials roll out an aggressive new plan to clear snow and ice from city streets this winter, they have never investigated the prolonged delays residents endured when they called 911 seeking medical help during last year's storms.
How bad was it?
Ask Ava Hendrix, a widowed mother of four, who waited 2 hours, 12 minutes before an ambulance finally delivered her to a hospital during a life-threatening asthma attack last December.
Or Zakeea Sykes, 21, who arrived at Group Health via ambulance more than an hour after calling 911 in active labor.
Or the West Seattle man with a head injury who waited 19 minutes for emergency medical technicians and 28 minutes for an ambulance after being knocked unconscious while pulling down a tree branch in his front yard.
You won't find their names or their stories in the official accounting of last December's storm, because the city never measured how public safety was compromised. They were among hundreds of people who bore the brunt of delays in emergency service caused by Seattle's failure to clear the roads of ice and snow for nearly two weeks.
The official version of events — an after-action report ordered by Mayor Greg Nickels — indicated that fire and emergency services were barely affected even as the rest of the city was brought to its knees.
But as The Seattle Times learned, the after-action report contains information about the emergency services that is misleading, even made-up.
The report described "minor delays for limited periods," but a Seattle Times analysis of emergency-response data from the Fire Department showed that it took 10, 20, even 30 minutes on one call for help to arrive.
"We shoot to get to anyone within two to four minutes to fix anyone's problem, and when we can't do that, we get upset," said Kenny Stuart, president of the Seattle Fire Fighters Union, Local 27. "We understand very well that seconds matter."
He recalled one accident last December when a girl was run over by a vehicle while sledding. Paramedics arrived about 20 minutes before the engine company — which should have gotten there first but was delayed by icy roads, Stuart said.
"That's not acceptable," Stuart said. "If someone's got life-threatening injuries, that's not the service we want to provide and that our city deserves."
The private ambulance company that contracts with the city to transport patients to local hospitals was plagued with delays as well: The company arrived late to the scene almost 40 percent of the time during the height of the storm. In one case, it took 72 minutes to arrive, according to a report that documents how often the company met the city's time standards for ambulance response.
Some delay from snowfall in Seattle should be expected. But the city's handling of the storms from Dec. 13 to 28 compounded the problems, paralyzing the city for two weeks and crippling the downtown retail core during the holiday shopping season. The city did not use salt to clear the streets, and outfitted its plows with rubber-edged blades. Rather than clear the snow, the plows packed it down, turning streets into icy, rutted lanes lined with disabled cars and buses.
Seattle never analyzed the public-health impacts stemming from that failure, even though it could help the city prepare for the next big storm or disaster.
In an effort to get an accurate picture of what happened after residents called 911, The Times analyzed thousands of records that show the challenge faced by emergency personnel responding to people suffering from conditions as varied as head trauma, infection, sports injuries, strokes and seizures.
Sykes, who went into labor at her mom's house in South Seattle, said the main roads were so bad that the ambulance driver eventually took side streets to avoid the worst of the icy ruts.
"I started getting agitated when I was shaking and rocking and banging around," she said. "I could feel every bump and pothole. The pain was unbelievable." She delivered her daughter at the hospital in the absence of the baby's father, whose car got stuck in the snow.
Records show the emergency-response system was stretched to its limit during the storms, with daily call volumes for the most serious calls peaking at more than 200 for four days.
Delays by the private ambulances meant that the city's emergency medical personnel had to stay longer at the scene with patients or take them to the hospital themselves, something they usually do only for the most seriously injured and sick patients. To cover for the company, the city added two more aid units to transport patients to the hospital, city records show.
In some cases it took the ambulances, owned by AMR, more than two hours to respond to the incident and get the sick and injured to the hospital. Company data filed with the city show that AMR crews were late getting to the scene 488 times and never made it to the scene 18 times, requiring the Fire Department to do the transport.
"We definitely felt the impacts of the storm and the [city's] response to the storm in a negative way," said Stuart, the union president. "But we were successful. It's not like emergency services were shut down. We got there and we're going to get there. If we have to pick up the truck and carry it, we will."
Despite the impact on emergency personnel, the Fire Department was not asked to help craft the city's new snow plan put into effect this fall, and no one has asked AMR, the private ambulance company, to assess its performance and report on what it will do differently this winter, according to interviews with a company spokesman and Seattle Fire Chief Gregory Dean.
However, Dean said the department did review the city's new storm plan before it was adopted.
No city analysis
Mayor Greg Nickels — under intense criticism for the haphazard snow response and the "B" grade he initially gave to describe the city's performance — ordered 28 department heads to report to him in January on what didn't work and how performance could be improved. Barb Graff, the city's emergency-management chief, was asked to compile an after-action report.
Its conclusion: "The city was fortunate to escape any major traumatic incidents — Fire and Police Departments were capable of handling emergency responses with only minor delays for limited periods during the two weeks."
The report stated that only "one minute" was added to the average response time by emergency personnel on "only one day during the storm."
But those numbers are fiction.
No one at the city analyzed emergency-response times, and even now, neither Graff nor Chief Dean can say where the one-minute number came from or how it made it into the report.
Graff said the after-action report was compiled quickly so the city could make necessary changes while there was still the threat of winter storms. And the document, which stands as the official record, may contain errors, she said.
"We were aware there were problems on the roads," Graff said. "We leave it up to the Fire Department to determine at what point it is interfering with critical measures."
Dean said no one from the mayor's staff asked for a response-time analysis. He guessed the "one minute" came from an informal conversation between someone on his staff and a dispatcher. The marching order was not "let's go run this data and see what's going on," Dean said.
What data really show
Nationwide standards suggest that it take no more than four minutes for medical personnel to travel to the scene of the highest-priority calls — those deemed "code red," in which crews respond with sirens blaring.
The standards call for a fire department to achieve the four-minute mark on 90 percent of code-red calls, according to Curt Varone, of the Public Fire Protection division of the National Fire Protection Agency, a professional organization.
Varone said the standards are important because every additional minute of travel time can lead to harm, especially in cases of heart attacks.
Stuart, the union president, was even more adamant: "We argue about having fire poles in the station because you don't want to waste time going down the stairs. ... Two and a half minutes may feel like an hour if your baby's turning blue."
The Times' analysis showed that during the worst of the storms, the Fire Department fell below the standard:
• On five consecutive days, more than one-third of code-red medical calls exceeded the four-minute mark. The worst day was Dec. 22, when 45 percent of calls exceeded the four-minute travel standard, The Times' analysis showed.
• During the worst week of the storms, there were 62 code-red calls where emergency medical personnel took 10 minutes or longer to travel to the scene — more than three times the number for a typical week in November and January.
Varone said storm-related delays are to be expected. Analyzing them post-storm can illuminate problem areas that may require different planning and response strategies, he said.
"It's helpful to look at it," Varone said of the travel data. "For example, with winter storms, it may be that one part of the city is particularly impacted when there's snow."
Stuart agreed, saying that flatter parts of Seattle can be reached relatively easily if there's one main arterial clear. But getting to Queen Anne Hill, for example, requires extensive clearing of secondary streets, he said.
In an interview, Chief Dean said concerns about emergency response times were overblown and would unnecessarily alarm the public. He worried that people could get the impression that help would not be available, so they might not call 911, or might try to drive themselves to the hospital.
Public safety was not compromised, he said, noting there were no storm-related deaths or serious injuries. "We're not aware of any, I'll put it that way," Dean said.
"We've not had the public come forth. We checked with Harborview [Medical Center] and they were not aware of any deaths or serious injuries."
Orthopedic surgeon Jim Hsu did come forth, in an angry e-mail to the city. On Dec. 23, he wrote: "Thanks to you, I am seeing five, six people with ice and snow fractures daily."
Because of privacy laws governing medical records and the unavailability of 2008 death records, The Times was unable to determine whether anyone died as a result of the storms or was harmed by the delays.
Fire Department spokeswoman Helen Fitzpatrick acknowledged her department has no way of knowing how the delays might have impacted the sick or injured because the medical privacy laws do not allow patients to be tracked once they are dropped off at a hospital.
Scared for her life
Ava Hendrix, 33, still remembers the night she called 911, on Dec. 22.
A feeling of suffocation was growing in her chest as she struggled to breathe through what was fast becoming a life-threatening asthma attack.
A widow with four children, Hendrix tried to calm herself. The Fire Department's emergency medical technicians arrived in six minutes. Together they waited nearly an hour for the AMR ambulance to reach her West Seattle town house. She arrived at Highline Medical Center 70 minutes later, after a bumpy ride along ice-rutted streets.
"I felt, wow, I was going to die," said Hendrix, whose husband died three years ago. "The worst thought was to leave them as orphans just because an ambulance couldn't get me to the hospital," she said of her children. "I literally thought I was going to go meet my husband."
The city fined AMR $500 for the lengthy delay. All told, AMR racked up $178,750 in fines for the 488 calls that exceeded response-time limits spelled out in the company's contract with the city, and 18 calls in which AMR couldn't get an ambulance to the scene. But the city wiped away some of the penalties because of weather conditions out of the company's control, said Brant Butte, AMR's spokesman.
Dean said his department meets monthly with AMR to review its performance and discuss planning if a storm is forecast. Still, he said there was no formal review of AMR's performance during last December's storms.
"I would not expect we would sit down and discuss how many chains [they have], and how they deployed their rigs," he said.
The threat of fines provides sufficient incentive for them to be prepared, Dean said: "We gave them a break," and if they don't do better this winter, the company could be fined.
Butte, of AMR, said the company has "expanded its ability to buy more chains" and ordered an extra 40 to 50 sets. He said the company held internal meetings after the storm and decided that "generally, all the word was pretty good as far as cooperation" between the city and AMR.
As for the city, "We haven't been talking to anyone yet, but we're open to that," Butte said.
Graff, the city's emergency management chief, said recent changes to the transportation department's storm planning should make it easier for emergency personnel to navigate Seattle streets. Those changes include a new plan for clearing main streets of snow and ice, additional snow-removal equipment and a new street-maintenance director.
"The measures that need to be taken in order to have a better response in the future have been taken," Graff said.
Despite the promise of change, Nickels was ousted in the August primary. Mike McGinn, the incoming mayor, has not said whether he will retain Grace Crunican as head of the transportation department.
Susan Kelleher: 206-464-2508 or firstname.lastname@example.org
Seattle Times transportation reporter Mike Lindblom describes some of the factors that may have led to the collapse of the I-5 bridge over the Skagit River in Mount Vernon on Thursday, May 23.