By Brian Chasnoff
San Antonio Express-News
Copyright 2008 San Antonio Express-News
Visit the EMS1 Video News section if you are having trouble viewing the video |
SAN ANTONIO, Texas — A San Antonio paramedic who responded to the scene of a head-on collision last month failed to check for the pulse of a victim trapped inside a car with a severe head injury, city officials revealed Tuesday.
Instead, Mike Gardner, a paramedic with five years’ experience in the Fire Department, deemed merely by looking that Erica Nicole Smith, 23, was dead a violation of the Fire Department’s standard operating procedures.
Checking for vital signs “is part of the protocol, and it’s part of the protocol for a reason: To save lives,” City Attorney Michael Bernard said.
Smith’s life was not saved.
Gardner told someone to place a tarp over her body, and Smith remained inside the smashed Honda Accord for more than an hour in near-freezing temperatures before a medical examiner called to the scene noticed that she was breathing.
Paramedics again were called, and Smith was taken to a hospital, about two hours after the 4 a.m. crash. She died there the next day.
“I’m sorry for what the Smith family has endured,” Fire Chief Charles Hood said Tuesday, “and I’m sorry for the mistake that was made on our part for the incident.”
Hood added, “Medical protocol was definitely violated in this instance. It was an error in judgment.”
Hood’s apology and his admission of error, delivered in an interview late Tuesday with the San Antonio Express-News at City Hall along with Bernard and City Manager Sheryl Sculley, represent stark reversals in the city’s response to the incident. The day after the incident, Hood refused to apologize, instead casting blame on Jenny Ybarra, 28, who was charged with intoxication manslaughter after she veered into oncoming lanes of traffic on Loop 410 and smashed into the Accord on Dec. 16.
Hood that day added he did not expect the paramedics to be disciplined. He told the Express-News the next day that paramedics had sought Smith’s pulse but could not find one.
“We were assuming (they had checked for her pulse),” Hood explained on Tuesday.
Sculley added, “Because it is standard operating procedure to do that.”
Paramedics here are required to seek vital signs regardless of a patient’s injury, according to protocol. Gardner, 35, has been permanently barred from working as a paramedic in San Antonio. He was transferred to the Fire Department’s firefighting division.
Three other paramedics involved in the incident, including two who arrived at the scene more than two hours after the wreck in a second wave, have been de-authorized for an indeterminate length of time and transferred to the firefighting division. They are: Michael Collins, 39, who arrived on the scene with Gardner and treated Ybarra; and William Bullock, 33, and Jeremy Huntsman, 30, both of whom responded to the scene after officials realized Smith was alive.
All four paramedics were in the 21st hour of a 24-hour shift that began at 7 a.m. the previous day, Hood said.
Chris Steele, who heads the San Antonio Professional Firefighters’ Association, said he met with the four paramedics Monday after their meeting with Hood. He said they had a “basic feeling” about “what was coming,” but all were so exhausted that they’re “pretty much not emotional anymore.”
Upon de-authorization, paramedics are demoted to fire apparatus operator and lose their license to practice emergency care in this city. The demotion would guarantee a pay loss of at least $1,000 a month, Steele said, not including the dozens of overtime hours paramedics normally work if they choose.
A supervisor of the Fire Department, Sculley said the incident has sparked plans to improve training.
“We’re going to use this incident to incorporate into additional training, immediately,” she said.
Officials also are casting a wary eye toward the city’s communications center. In another blunder, a Fire/EMS dispatcher miscoded the call from the scene of the collision as a non-high speed auto accident, officials said.
“Had it been coded as a high-speed auto accident, then certain equipment would have been dispatched,” Hood said.
Those resources, including a ladder truck with the Jaws of Life, were dispatched to the scene after the medical examiner realized that Smith was breathing.
Hood said the Fire Department likely would seek to incorporate new technology, including computer-aided dispatch capabilities, into the center.
Smith’s relatives, including her father, said Tuesday that city officials’ admissions of error have not quelled their own outrage.
“I’m very angry,” Robert Smith said. “It’s a struggle, minute by minute.”
Erica Smith, a senior at Texas State University, was a passenger in the front seat of the Accord, driven by her friend Sabrina Shaner, 22. A police source who didn’t want to be identified because the case remains under investigation said Tuesday that Shaner was legally intoxicated at the time of the crash. She had not been charged as of Tuesday, the source said.
Shaner and Amber Wilson, 22, a backseat passenger in the Accord, suffered minor injuries in the wreck and were treated at a local hospital. All three occupants were wearing seatbelts, a police report said.
Lomi Kriel contributed to this report.