By Julie Scharper
The Baltimore Sun
Copyright 2007 The Baltimore Sun Company
All Rights Reserved
Baltimore, Md. — Three and a half hours after his car slid off a Baltimore County road, struck a mailbox and slammed into a tree, Gregory Guston died in a hospital bed. Aside from hospital workers tending to him, he was alone.
In the first hours after the crash, volunteer firefighters extricated the 52-year-old stay-at-home father from the wreckage and rushed him to Maryland Shock Trauma Center. Police took statements from motorists who had seen the crash, photographed and towed the mangled car and measured the skid marks on the road.
Investigators even gathered the mail that had been scattered when his car struck the mailbox, witnesses said.
But no one contacted Guston’s family.
“The system failed me,” said Theresa Peet, Guston’s wife. “I can’t explain what it would have meant to me to hold his hand one last time.”
Those who aid accident victims say they make every effort to reach family members as quickly as is practical. And they say many cases include obstacles - in Guston’s instance, an unlisted home phone number.
But a review of area police agencies’ protocols shows that procedures for notifying the families of seriously injured accident victims vary widely. Several of those agencies, including the Baltimore County Police Department, have not committed their practices to writing - and neither has Shock Trauma, the hospital that treats the region’s most gravely injured.
Theresa Peet wonders why no one picked up her husband’s cell phone after the May 2 crash and dialed the last number called or received. She can’t understand why no one - not even a police officer already on the road - drove the 10 miles from the crash scene in the Phoenix area of Baltimore County to her home just over the Harford County line, where other relatives could have been alerted.
“I’m going to pursue it until there’s a protocol in place for both the police and Shock Trauma,” Peet said. “How many of us drive around by ourselves in the middle of the day, and if we got in an accident, no one would know until we didn’t come home at the end of the day?”
Police in Baltimore, Harford and Howard counties and in Baltimore City, as well as the Maryland State Police, say that they assume that the hospital will contact relatives of accident victims.
State police and the Howard County Police Department, which has a written policy, say that officers will attempt to contact the next of kin if a victim’s injuries appear to be life-threatening. Baltimore police will try to reach relatives in certain circumstances, such as an injured child, a spokesman said.
Anne Arundel County police and Carroll County sheriff’s deputies are instructed to drive to an injured person’s home to inform relatives about a crash, under those agencies’ written policies. In Anne Arundel, police will arrange to bring family members to the hospital, according to the department’s emergency notification policy.
But law enforcement officials in Baltimore and Harford counties say that hospitals are best-equipped to notify families.
“The immediate reaction is on the medical side, because the hospital has the individual and knows where the individual is,” Baltimore County Police spokesman Bill Toohey said.
The police are primarily concerned with diverting traffic to prevent other crashes and investigating the accident, he said.
“If the police call the family, they are going to swamp the officer with a million medical questions that the police wouldn’t be able to answer,” Toohey said. “The living patient is a Shock Trauma responsibility, so Shock Trauma should be talking to the family members.”
When seconds count
Like Peet, the relatives of another crash victim said that waiting for the hospital to call can waste precious time.
In November, Miles Blauvelt, then 17, fell asleep at the wheel - driving, as Guston was when he crashed, along Merrymans Mill Road - and smashed into a grove of trees above a ravine, his mother said.
His parents did not learn about the accident until Miles arrived at Sinai Hospital more than an hour later - even though he crashed less than a mile away from their home, said his mother, Gail Blauvelt.
Miles Blauvelt, a recent Dulaney High School graduate who will attend the University of Maryland, College Park in the fall, has mostly recovered from his injuries. But his mother says that she is still troubled by the thought that her son was in pain while she and his father were sleeping less than a mile away.
“I would hate for another parent to go through the same thing,” she said. “They need to fix this somehow. They need to get some standards in there.”
At Shock Trauma, workers try to contact family members soon after a patient is admitted, but there is no formal policy that determines who will contact the next of kin or when they will make the call, according to director of nursing Karen Doyle.
“It’s a parallel process - one group takes care of the patient, and the others reach out to the family,” Doyle said. Nurses, unit secretaries and social workers use free Internet databases or a patient’s cell phone to try to find relatives, she said.
Hospital employees say that they do not have access to the comprehensive databases that law enforcement agencies use. Unlike police, who can travel to victims’ homes, hospital employees must reach relatives by telephone, a process made more difficult by the prevalence of unlisted cell phone numbers. When hospital employees are unable to reach relatives, they ask police for help.
Neither the Maryland Hospital Association, a group that drafts policy recommendations for hospitals in the state, nor its national counterpart, the American Hospital Association, have created guidelines for notifying family members of accident victims, organization officials said.
The International Association of Chiefs of Police has a detailed model policy for notifying relatives about deaths, but it does not have a model policy for contacting relatives of living accident victims, a spokeswoman said.
Representatives of the Baltimore County Fire Department and state and international groups of firefighters and emergency medical technicians say that notifications are almost always handled by police or hospital employees.
His last minutes
Theresa Peet says police agencies should adopt uniform standards for promptly notifying relatives of accident victims.
Peet, a physician with a private practice in Parkville, said her husband of 10 years was a former pharmaceutical sales representative. He became a stay-at-home father a few years ago after chronic pain caused by back and hip problems made it difficult for him to work.
She said she spoke with him for the last time about 1:40 p.m. May 2. Later, when she learned that he hadn’t picked up their 7-year-old daughter from school and she couldn’t reach him on his cell phone, she said she knew that something was wrong.
She said she called police but was told there were no serious accidents in the area. Still, she asked her in-laws to come to the family’s home near Madonna to take care of her daughter and then went to look for her husband, she recalled.
“I knew he was dead or dying somewhere,” Peet said. “I was going driving around, crying, screaming, `Where’s my husband?’ ”
According to the crash report, Guston’s Geo Tracker had swerved across a yellow line, hit a mailbox, flipped and struck a tree about 2 p.m.
Drivers who pulled over to help found Guston unconscious and covered with blood.
“He had all the signs of a dying person,” Catherine Cox, one of the motorists who stopped, said in a telephone interview. “His breathing particularly was terribly labored.”
Witnesses said that rescuers arrived moments after they called 911. They watched as EMTs used the Jaws of Life to remove Guston from the vehicle. He was placed on a backboard and a stretcher, then taken by ambulance to a helicopter for the trip to Shock Trauma.
Guston’s wallet, containing his license and insurance card, was flown to Shock Trauma with him. His cell phone, which was not damaged by the crash, was still in his car.
“At that point, the officer wouldn’t be worried about whether there is a cell phone,” Toohey, the county police spokesman, said. “He’s working on the assumption that the hospital is notifying the family.”
Peet said a family friend later found the cell phone in the car after it had been towed to an impound lot.
Guston arrived at Shock Trauma about 3 p.m. A note in his chart at 5:30 p.m. indicates that attempts to reach his family had been unsuccessful and that Shock Trauma employees were asking Baltimore County police to contact the family.
He died a few minutes later.
Handling grief
Doyle, the nursing supervisor, stressed that employees had almost certainly tried to contact Guston’s family much earlier, although this was not documented.
About 7 p.m., a police crash investigator knocked on the door of Guston and Peet’s home. Peet was still searching for her husband when relatives called her cell phone and told her to return home.
That’s when she realized that she could have been with her husband when he died, had she been told of the crash sooner.
“I could have been there for two hours,” she said in an interview, fingering his wedding ring, which she wears on a chain around her neck. “I could have made decisions about his organs. I could have said things to him I didn’t get to say.”
Grief counselors said that the desire to be with a loved one at the time of death is nearly universal.
“If we love somebody, one of the last things we can do is to be there for them,” said Alan Wolfelt, a clinical psychologist and the head of the Center for Loss and Life Transition in Fort Collins, Colo. “Even if they’re not conscious, to say `I love you’ helps you integrate that loss into your life. And sometimes, even when people are unconscious, there’s all sorts of speculation that people can hear anyway.”
Peet said that the unanswered questions about the cause of the accident and the time it took for her to be contacted compound her grief. Police determined that alcohol or drug use was not involved. But an autopsy was not performed, and the death certificate lists the manner of death as “accident,” according to the state medical examiner’s office.
Peet received a detailed report prepared by the police crash investigator. It includes, among other information, the temperature at the time of the accident and the width of the road in inches.
It brings her no consolation.
“There’s this neatly typed-up report,” she says. “But it means nothing to me because I didn’t get to say goodbye to my husband.”