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Death in Francis prompts changes in East Side emergency medical services

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PROVO, Utah – An elderly man’s death last month in Francis and the time it took an ambulance to respond to the scene have prompted changes in how East Side emergency medical services are to be delivered, with officials hoping to avoid another outcome they called tragic, though they stopped short of saying it was preventable.

On March 14, an 86-year-old Francis man collapsed in his front yard, according to a report from the Summit County Sheriff’s Office. Family members said the man had become short of breath and that they were helping him walk when he fell, according to the report. They moved the man to the front porch where he appeared to recover slightly, resuming the ability to speak.

He became unresponsive a short time later, the report states, and family members and neighbors began lifesaving procedures.

The man was pronounced dead at 5:35 p.m., according to the report, 50 minutes after an ambulance was dispatched to the scene and 30 minutes after it arrived. The Park City Fire District operates emergency medical services throughout the county, though they have separate contracts in the North Summit and South Summit areas.

In a case review two days later, fire officials indicated family members were likely exhausted and traumatized after performing CPR on a dying loved one for so long.

At the time of the incident, the ambulance and two-person crew responsible for the South Summit service area were on a training mission in Wanship, according to Ashley Lewis, the Park City Fire District administrative battalion chief who oversees ambulance operations in Summit County.

It took the crew 20 minutes to drive around the Rockport Reservoir and arrive on scene in Francis, according to an incident report. The dispatch-to-arrival time in South Summit since 2015 has averaged just over 13 minutes, according to a report prepared by Summit County staffers.

South Summit Fire District Chief Scott Anderson said in an interview that a member of the deceased man’s family who lives in Peoa responded to the scene and arrived before the ambulance did.

Park City Fire District Chief Paul Hewitt said the incident raised questions about why the ambulance left its service area uncovered. Officials in a March 16 Summit County Emergency Medical Services Board meeting said they would conduct trainings within service districts going forward.

That was one of four changes or areas of renewed emphasis determined in the Emergency Medical Services Board meeting. The chiefs of the county’s three fire districts, along with Kamas Mayor Matt McCormick and other officials discussed the incident in Francis and ways to learn from it.

While Hewitt indicated there were ways to improve service, he denied that the slow response time caused the man’s death.

“There is no malfeasance here,” Hewitt said in an interview. “… Did it result in the man’s death? Again, I don’t entertain that. … As EMS, this is a high stakes business we’re in.”

Anderson said a member of the South Summit Fire District contacted the ambulance crew as it was on its way to the scene and offered to mobilize a fire engine, but was told not to respond.

That prompted another suggested change in operating procedures, with Hewitt saying assistance from supporting agencies should never be canceled, especially before responders have made it to the scene.

“Tell our crews: Never turn down help,” Hewitt said.

Anderson indicated that responders can use all the help they can get on calls like the one in Francis, where a patient is in cardiac arrest.

East Side ambulances are staffed with two-person crews, which officials have said is necessary for budgetary reasons. The ambulances have been staffed with three-person crews in the past, Anderson said, and it often now falls to his fire district to provide the de facto third staffer to supplement the ambulance crews.

Hewitt said in an interview the two-person crew isn’t ideal but that it is the most efficient setup, and a necessary one given the strictures of operating in a more rural environment.

“Could you use more staff? Yeah,” Hewitt said. “Anybody that’s watched a full (cardiac) arrest, for example, knows how much manpower it takes to run it.”

Hewitt indicated at the board meeting that another factor complicating the Francis incident was that the initial call indicated the situation was less serious than it turned out to be.

Officials also recommended in the meeting that the East Side fire districts respond to more medical calls, if not all of them. Anderson said in an interview that South Summit crews were now responding to all medical calls.

Lewis, the Park City Fire District administrative battalion chief, indicated it would become protocol for ambulance crews to notify the local fire district every time they head out of the service area. That way, firefighters would know they would be called upon if another medical emergency occurred.

He also said the Park City Fire District would be requesting funding from the Summit County Council during budget talks this fall for two or three additional full-time employees.

Longer-term goals include increasing the training level of North Summit and South Summit firefighters to provide more medical help and pursuing additional ambulance staffers, either through a revamped volunteer program or shifting to full-time service on the East Side. Officials have indicated the latter option is prohibitively costly.

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