Marc Pickard is clearly frustrated as he explains why a man who suffered a stroke recently did not receive faster medical attention. Pickard is the training director for Convalescent Transport, a private ambulance company in Lenoir County. He notes that even though his company sits across the street from the stroke victim’s house, county law prevented Convalescent Transport from responding. Instead, the man had to wait for a county ambulance. Later, he died.
Although perhaps only an autopsy can settle the matter, one can’t help but wonder whether the man would have survived if Convalescent Transport had been allowed to respond. Convalescent Transport provides nonemergency medical transportation, and, until recently, it could respond to emergencies if callers dialed the company directly. However, recent actions by the county have effectively outlawed private emergency transport, and left county residents with no alternative to county care.
Pickard is frustrated by what might have been an unnecessary death, but he’s been frustrated too often to be surprised. From his office Pickard can eavesdrop on the county’s emergency dispatch system. He says it often takes more than 10 minutes for an ambulance to arrive at Meadows North retirement home, which is also across the street from Convalescent Transport headquarters.
“It can take the county as long as 12 minutes to get to the scene,” Pickard said. “We could be there in 12 seconds.” But, again, responding would mean breaking the law.
The county’s aversion to private EMS leads to other bizarre—and possibly dangerous—outcomes. Pickard cites an incident report from August in which a Convalescent Transport ambulance encountered a three-automobile accident while he was returning from another call. The crewmembers decided that tending to the three injured people was more important than following the letter of the law, so they loaded the patients into their ambulance. But before they could transport the patients to the hospital a county officer arrived and said that only a county ambulance could transport the patients. The county ambulance arrived 20 minutes later.
Luckily, the accident victims did not suffer serious injury.
Thankfully, the West Pharmaceutical plant explosion preceded the county’s crackdown on private EMS. Bill Howard estimates that Convalescent Transport provided the most emergency support that day, and he doesn’t understand why the county would not turn to the private company for the burgeoning emergency of slow response times in rural areas. Howard has 20 years experience in firefighting, and he sits on the board of the fire department that serves Hugo, a rural community in Lenoir County. He blames the county commissioners for the slow response time his community must endure.
“They’re going to run you off a pretty little chart that says they have a response time of 9, 10 and a half minutes, but most of those are in the city,”Howard said. “If you get out here in the rural areas there’s no way they’re averaging 10 and a half minutes.”
What’s particularly troubling is that the county’s official 10 1/2- minute response time is not exactly stellar. The Mayo Clinic recently placed the critical marker at six minutes — responding to a cardiac arrest patient within six minutes greatly increases survival rates, but after six minutes the chance of survival plummets. Howard claims that emergency patients in Hugo have had to wait as long as 26 minutes for an ambulance. Howard thinks the county should contract with Convalescent Transport to help improve rural response times. And, even before the recent tragedy, Howard worried that catastrophe would come sooner than EMS reform: “My hope is that before someone has to die someone in politics will wake up and realize that this is happening.”
Now that someone has died, let’s hope someone in politics paid attention.
Ted Balaker is the Jacobs Fellow at the Reason Public Policy Institute, and editor of Privatization Watch.