Delays for Paramedics Draw Criticism in Oakland

Posted: December 17, 2011

NEW YORK TIMES

By SHOSHANA WALTER

DEC. 17, 2011

 

Gunshots cracked the air on a sunny morning as two men led a group of high school teachers on a tour of a violent area of West Oakland. As the teachers fled to safety, the local guides hurried to the chaotic scene on the nearby corner of 13th and Peralta Streets.

A young man named Darius Jenkins lay on the ground bleeding as friends and neighbors panicked. Sam McNeal, an attendance counselor for McClymonds High School, crouched at his side and urged him to keep breathing while Ron Muhammad, a widely known community organizer, ran to the fire station about a block away. There he discovered a truck full of firefighters, waiting in the driveway.

“What’s going on?” Mr. Muhammad asked. “Something’s happened to this guy, and y’all just sitting here.”

Mr. Muhammad said the firefighter replied: “It’s our policy. We have to wait for police.”

Across the country, first responders are often required to wait for law enforcement officers to arrive before entering a violent-crime scene. The policy is intended to keep paramedics and emergency medical technicians safe. But in Oakland, where emergency crews are often faster than the police, the delayed medical help can have tragic consequences, feeding a culture of distrust and anger.

In October, Mr. Jenkins became the city’s 90th homicide of the year. Although Emergency Medical Services officials say paramedics arrived within 10 minutes of the first call, Mr. McNeal and Mr. Muhammad said Mr. Jenkins’s death could have been prevented if medical help had arrived sooner.

“The paramedics said they could not come into the crime scene unless escorted by a police officer,” Mr. McNeal said. “I get it. But people are, like, dying.”

The Oakland Police Department’s average response time for the highest priority calls was 15 minutes in 2009, 10 minutes longer than most other agencies, the department said.

 

At that time, the department employed a record high of 800 officers. Since then, budget cuts resulted in the layoff of 80 officers in 2010, and department staffing levels have continued to drop. The department now employs about 645 officers, and due to attrition and a decimated city budget, officials expect that number to drop to unprecedented lows by the end of next year.

Because the department makes violent crimes a priority, response times to shootings have been largely unaffected by the reduced staffing. Cynthia P. Perkins, a department spokeswoman, said officers respond to high priority calls “as quickly and safely as possible.” But community organizers say the historically slow response has made residents hesitant to wait for aid.

The first-responder policy of waiting for the police became widespread in the United States in the 1990s. Before then, emergency medical technicians and paramedics frequently rushed into crime scenes alone, where some were assaulted, sometimes by the victims they were sent to help.

“In the early days, we did not wait for the police,” said Don Lundy, the president of the National Association of Emergency Medical Technicians. “We were told you go in there, that’s what you’re supposed to do.”

But as assaults against paramedics became more frequent, the policy of standing back spread. Mr. Lundy said paramedics and emergency medical technicians are now trained to be aware of armed victims and suspects, of anguished and aggressive friends and relatives and other dangers. First responders put personal safety ahead of a patient’s medical needs. Some buy and wear their own bulletproof vests.

Photo

A group of neighborhood residents held a vigil at the intersection. CreditThor Swift for The Bay Citizen

“It’s not my job to go in and get killed so I can’t help anybody,” Mr. Lundy said.

According to a study of deaths among E.M.S. workers, published in the journal Annals of Emergency Medicine in 2002, the occupational fatality rate of those workers is comparable to that of police officers. The study also found, however, that of the E.M.S. workers who died, eight times as many were killed in ambulance or helicopter crashes on route to the scene as by homicide.

In Oakland, paramedics and firefighters set up several blocks from a scene to wait for clearance from the police. Jeff Taylor, the chief operating officer of Paramedics Plus, the ambulance service provider for Alameda County, said they did not want the victims and those around them “to see you sitting there and not coming to their aid or help.”

“That’s going to upset a lot of people and easily put you in harm’s way,” Mr. Taylor said.

American Medical Response, Alameda County’s previous ambulance provider, followed the same policy. The county’s new contract with Paramedics Plus, which went into effect Nov. 1, allows the county to fine the company if the paramedics exceed the maximum response time of 8 minutes 30 seconds allotted for the highest-priority calls.

But faster emergency response does not mean that the victims will stay put. Community organizers say they have noticed an increase this year in patient drop-offs at Alameda County trauma centers. Marilyn Washington, the founder of the Khadafy Foundation, an organization that aids the families of homicide victims, estimated that at least half of shooting victims did not wait for the police or emergency medical aid.

By the time the police arrived at the scene of a shooting at a rap music video filming last month in West Oakland, the victims and the suspects had fled, many by private cars to hospitals in the area.

“There’s definitely been an increase of people driving themselves to the hospital,” said Kyndra Simmons of Caught in the Crossfire, a program that seeks to quell retaliation and provide counseling and services to victims of violence.

Other community organizers said the trend was fueled by a feeling of neglect and longstanding mistrust of authorities, particularly in Oakland’s poorest areas, where residents have endured decades of violence.

“Death is normal around here,” said Mr. McNeal, the high school attendance counselor, who grew up in Campbell Village, a public housing complex near the site of the Jenkins shooting. “These kids havepost-traumatic stress disorder, and they are not even in the military.”

Mr. McNeal and Mr. Muhammad, in the aftermath of Mr. Jenkins’s shooting in October, are still angry about what they perceive to be the paramedics’ slow response.

“I understand their policy, but everybody’s life is important,” Mr. Muhammad said. “You understand that when you take a job of service. It comes with some hazards. When you have an opportunity to save people’s lives, you got to do what you got to do.”

A group of residents dragged Mr. Jenkins’s bleeding body onto the sidewalk from a yard on the corner of 13th and Peralta. Friends and relatives wailed. The 20-year-old Mr. Jenkins gurgled a few inaudible words, then began to close his eyes. Mr. McNeal pleaded with him to stay awake. Mr. Muhammad sent bystanders to the fire station around the corner. When the ambulance did not come, Mr. Muhammad ran to the fire station and Mr. McNeal called 911, they said.

According to E.M.S. officials, the first responders were at Mr. Jenkins’s side within 10 minutes. But by then, Mr. McNeal said, he knew Mr. Jenkins was dead.

Mr. Jenkins, a former defensive lineman at a Sacramento high school, graduated in 2010. He had a 1-year-old daughter, and lived with relatives in Oakland. He was officially declared dead at the hospital.

The case remains unsolved.

http://www.nytimes.com/2011/12/18/us/delays-for-paramedics-draw-criticism-in-oakland.html?smid=pl-share