AMR ambulance service facing more questions over response time

DEKALB COUNTY, Ga. — As DeKalb County prepares to choose its new ambulance provider, its current contractor, American Medical Response, is facing new questions about whether it’s responding quickly enough to emergencies.

Last Tuesday, Terry and Shanna Tolbert called 911 from their Dunwoody home because their 4-year-old daughter, Ireland, was having a seizure.

“Ireland is epileptic and has prolonged seizures…which is a life-threatening condition that requires immediate emergency care,” Tolbert told Channel 2’s Mike Petchenik. “Historically, her seizures do not stop until she’s laying (sic) on a trauma table at the hospital.”

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In a 911 call, Tolbert can be heard telling dispatchers to hurry.

“She’s blue,” she said about three minutes into the call. Eight and a half minutes into the call, Tolbert asked whether she needed to put Ireland in her car and take her to a hospital.

“There’s this decision we have to make when this happens: Do we keep waiting or do we put her in the car ourselves, which is also very dangerous?” she said.

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Nearly 12 minutes into the call, dispatchers told Tolbert an ambulance had marked itself on the scene, but Tolbert said she never saw one.

According to her call, a firetruck arrived first, followed by the ambulance.

“Somebody told a big fat lie,” she said, adding that every minute's delay put her daughter in grave danger.

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“Her doctors at the hospital are on pins and needles waiting to see when she wakes up with brain damage,” she said.

Tolbert said in about a third of the dozen calls to 911 she’s made since 2015, an ambulance arrived in 15 or more minutes, and on two occasions, the family drove themselves to the hospital when an ambulance never arrived.

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In a statement, American Medical Response’s regional director, Terence Ramotar, said of the recent call:

“All emergency calls in Dunwoody are received and routed by a separate service (ChatCom) from the rest of DeKalb County, which is handled by DeKalb County 911. ChatCom screens these calls and then routes to DeKalb County 911, which then dispatches the closest appropriate fire department resource and ambulance to each call. Since we are not the call center, AMR cannot speak to how this particular call was received and routed, but we can confirm that once we received the call, an ambulance was dispatched and arrived on the scene in 9 minutes, 11 seconds.”

Through a spokesperson for the city of Dunwoody, ChatCom 911 told Petchenik that when the call came in, it was “triaged” and electronically assigned to DeKalb County 911 within three minutes and 17 seconds of the initial call for help.

Police Chief Billy Grogan characterized that handoff as “not unusual.”

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Dunwoody City Councilman Terry Nall, who has been an outspoken critic of AMR and DeKalb County, said what happened to the Tolberts is not uncommon.

“The Tolberts, in my opinion, represent the face of these statistics, the face of all these delayed responses,” he said.

“The problem is getting worse, not better.”

[READ: Records show repeated poor response times from ambulance company]

Nall has been advocating for the state EMS Council to intervene and to separate Dunwoody out as its own emergency medical services zone.

In its contract extension with AMR, the county obligates the company to respond to “Advanced Life Support,” or tier one emergency situations, within eight minutes and 59 seconds.

But according to a document provided to Petchenik by the city of Dunwoody via the DeKalb fire chief, in the first three months of 2019, the average response time across the entire county was 15 minutes and 55 seconds.

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While Dunwoody saw an average response time near the 12-minute mark, others fared worse, the document showed.

In Stonecrest, for example, the average response time was more than 17 minutes.

In the Atlanta portion of DeKalb County, the response was about the same.

“Unless DeKalb demands better responses from the contractor, AMR in this case, they will not perform any better,” he said.

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A spokesman for American Medical Response said the company was going to withhold comment about overall responses because it's vying to be the county’s new provider and didn’t want to violate any rules about making public statements.

DeKalb County officials sent Petchenik a statement:

“Prompt response times to emergency calls are critical. DeKalb County has implemented an integrated, dual response system that utilizes a first unit on the scene model of care.

"DeKalb County Fire Rescue (DCFR) is an integral component of the medical call response system in the County. DCFR utilizes medically trained fire rescue personnel who, in coordination with our contracted transport providers, are dispatched to all emergency medical calls, as well as select non-emergency medical calls.

"DCFR’s system of medical response is designed to ensure that trained personnel and equipment are on scene of a call for assistance as soon as possible, so that medical care may be initiated promptly.

"Our data demonstrates that our dual response system improves countywide response times, which minimizes the time it takes to initiate care on the scene.”

CEO Michael Thurmond told Petchenik the county now considers the response time to be the moment a firetruck arrives at a location, because firefighters are trained as emergency medical technicians and can render aid before an ambulance arrives.

Thurmond said three companies are now under consideration to take over the ambulance provider contract, and he said the county commission would be voting on that “soon.”