Edgar County 911 – Double Standard – Part 2

EDGAR CO. (ECWd) –

When complaints of similar concerns obtain drastically different reactions, most would call it hypocrisy.  As referenced in Part I, the double standard must stop and people must be held accountable to the hypocrisy they institute.

Not only must we hold those in charge accountable, but the very boards they answer to as it is their leadership, or in this case, “lack of” that has yet again brought pen to paper.

I will say that I was pleased to receive a phone call from the current Chairman of the Emergency Telephone System Board (ETSB) as it clearly outlined a failure in the system, which he stated that failure may need to be changed.

The failure I am speaking of is the protocols that have been long established by the ETSB and its Director, Nannette Crippes.  The protocols that recently lead to her sending a scathing e-mail to the Sheriff claiming a “serious” mistake was made by a dispatcher.

Now keep in mind, when I complained about no CPR instructions being given to a caller for a baby not breathing this same person did NOTHING.  Only after we exposed the dispatchers were not certified to dispatch medical calls did anything get done and even then she blamed the state for her failure.

A recent rant by e-mail from Nannette Crippes to the Sheriff shows the problems I speak of.  I will breakdown the e-mail in sections to explain the hypocrisy and failure of establishing sound protocols for emergency calls.  And for those wondering, Yes, I am more than qualified to evaluate such a thing.  I have worked in the Emergency Services for approximately 30 years and train Fire Departments nation-wide on a regular basis. I have worked with just about every type of dispatch system there is and have a pretty good grasp of capabilities, or in this county’s case, lack of, because of the current equipment and protocols.

Nannette Crippes e-mail sent to Sheriff Motley,

A serious mistake was made on a 9-1-1 call on Thursday, June 19, 2014 at 10:52 am. The call came from xxx IL Hwy 133. The caller was a male subject saying that he thought his girlfriend had a heart attack and died; he said she wasn’t breathing and was cold to the touch. Dispatcher Donna Throneburg took the call. The address was verified and she dispatched Kansas Ambulance to the call. The first thing a dispatcher should do after obtaining and entering a physical address on the dispatch form is to click on the ESN button on the dispatch form.  This tells what emergency service agencies should be paged to respond to the address. By her own admission, she did not click on the ESN button. It is unclear why she didn’t do this, and made the decision on her own to page Kansas Ambulance.  Paging the correct responders to a 9-1-1 call is paramount. Had she done what she was supposed to do, she would have seen that Paris Ambulance and Brocton First Responders were the agencies to page to a call to this location.

For the sake of the family who lost a loved one, we chose not to upload the audio but it is available to anyone that wishes to FOIA it for confirmation of what is being reported.   As it relates to the first part of Ms. Crippes’ e-mail complaint, we find some interesting problems.

The initial complaint from Ms. Crippes is about who was dispatched and not dispatched.  Her contention is that the ESN button was not used, thus the system did not pull up Paris Ambulance and Brocton First Responders as the agency to be dispatched.

My first question would be, who in the hell programmed a Computer Aided Dispatch system that dispatches based on boundaries and not the closest emergency agency needed?   She acknowledges in one breath that paging the correct responders to a 9-1-1 call is paramount, yet how is paging Paris Ambulance initially on this call the right thing to do?  Yes, it is their contractual area but doesn’t it make sense to first call the closest agency before we worry about which district it is?

One of the key principals of the 911 system was to ensure this basic principal is followed and that is why this language is in the 911 statute! Anyone who set up the system based on boundaries instead of closest agencies either has no real emergency service background or have failed to research the law.

50 ILCS 750/14) (from Ch. 134, par. 44)
Sec. 14. The General Assembly declares that a major purpose in enacting this Act is to eliminate instances in which a responding emergency service refuses to render aid to the requester because the requester is outside of the jurisdictional boundaries of the emergency service. Therefore, in implementing systems under this Act, all public agencies in a single system shall enter into a joint powers agreement or any other form of written cooperative agreement which is applicable when need arises on a day-to-day basis. Certified notification of the continuation of such agreements shall be made among the involved parties on an annual basis. In addition, such agreements shall be entered into between public agencies and public safety agencies which are part of different systems but whose jurisdictional boundaries are contiguous. The agreements shall provide that, once an emergency unit is dispatched in response to a request through the system, such unit shall render its services to the requesting party without regard to whether the unit is operating outside its normal jurisdictional boundaries.
(Source: P.A. 86-101.)

Is there fault for the dispatcher on this call?  Yes, if their protocol is as outlined, however, Ms. Crippes failed to tell the Sheriff the entire story!  Was “not” hitting the ESN button a “serious” mistake in this case?  No, with an explanation.  The actual closest ambulance to this location would have been Oakland,however, in order to dispatch them there has been proven to be up to 3 minutes of delay between contacting Coles County 911 (CCOM) and having them dispatch Oakland. I believe the initial action of contacting Kansas was spot on based on the caller advising his address was in fact Kansas, and the fact Kansas was the closest ambulance agency in this county.  I do agree Brocton first responders should have been contacted.  The dispatcher agrees as well.

What ambulance do you think the “system” should be programmed to contact first?

• Oakland 6.6 miles from the scene (1-3 minute dispatch delay between counties)
• Kansas 8.3 miles from the scene
• Paris Ambulance 12 miles from the scene

As I told Mr. Eades during our phone call, of which he agreed, the current CAD system is flawed if it is not sending the closest agency to the call.  As it relates to Edgar County, the closest Ambulance to this particular call was in fact Kansas Ambulance. I find it hard to equate dispatching the closest agency to a “serious” mistake.

(e-mail continued)

It is of great concern to us that a dispatcher who has been doing this job for almost 13 years wouldn’t know to always check the ESN before paging. Eight minutes after she paged Kansas Ambulance, Eric Shaughnessy called the Sheriff Department to question why Paris wasn’t paged to this call; he believed that this was his call. He was right. (I understand that he contacted Chief Deputy Metcalf to complain about the handling of this call also.) At this time, Paris Ambulance went enroute to the address. It was said to me that the lady was already dead when responders arrived, like it was no big deal. That’s not the point, it is a big deal. This type of mistake is not acceptable. Eight minutes is an eternity when you have an emergency. According to Chief Deputy Metcalf, there was quite a mess at the scene, three ambulances showed up. None of that would have occurred had the dispatcher done her job correctly and paged the correct ambulance to respond in the first place.

This particular dispatcher does not have a single record of any disciplinary problems in her file which indicates to most she has done a good job performing her duties over the last 13 years.  Yes, she made a mistake but what exactly is Ms. Crippes claiming the mistake was really about?

It was about a false claim that since Paris Ambulance was not initially dispatched an eight minute delay in emergency response was caused.  That is a perfect example of either failing to report all the facts or pushing an agenda against a person who has done a fine job for 13 years and has spoken out against the clear lawlessness by this group of people.

Ms. Crippes FAILED to report anything about the “other” dispatcher involved in this call.  A certified dispatcher from what I understand.  A dispatcher that took MY phone call while I was on the way to this call well short of any eight minute delay!  A phone call that asked if both Oakland AND Paris have been dispatched.  How convenient to leave that part out.  To complain that three ambulances showed up shows us just how ignorant to emergency services Ms. Crippes must be.  I asked about Oakland and Paris because I knew it was going to be in one of those designated boundaries however I was still speeding to the scene to provide emergency service for two reasons.  It is the law and it is the right thing to do.

Kansas was the first to arrive at the scene.  Oakland came in right behind us, and then a few minutes later Paris Ambulance showed up.  Had Ms. Crippes done some homework before attacking the dispatcher and ranting about how things were handled at the scene, which has nothing to do with her, she would have rapidly realized all three units played a role in providing emergency service. In fact, had we taken the position of Nanette Crippes and only had Paris Ambulance on scene they would not have been able to provide the services that they did.  You see,we in this business know the importance of working together and not focusing on some boundary set up in a computer.

Even though I was the first EMT on scene Ms. Crippes did not get a single bit of information from me.  Had she, she would have known I drove the Paris Ambulance to the Paris Hospital which ensured two paramedics were able to work together for the patient.  Two people caring for a patient is far better than one!  Doing it the way this ETSB protocol is established and the way Ms. Crippes “thinks” it should be done is yet another example of failings in this county.

Anyone that has EVER been on a call where CPR is being provided knows the more people you have the better, contrary to the current 911 Director’s wishes that only one ambulance was needed.

What is needed is people in leadership that understand this business and know how to establish protocols and mutual aid agreements that bring us together to ensure better service and not one focused on boundaries.  A system that is patient focused!

(e-mail continued)

Also, the dispatcher kept the distraught caller on the phone for 12 minutes never once asking if he had attempted CPR or did she offer CPR. This should always be done for liability reasons when a person is not breathing. It is uncertain as to why she kept him on the line this long since EMD was not being done. He mentioned that he needed to call family and she told him he needed to stay on the line with her. As a result, he had to listen to her radio traffic; a 59-year-old female is not breathing and cold to the touch, several times. There was no point in keeping this poor man on the phone for 12 minutes.

When I raised concerns over no CPR instructions for a mother claiming her baby is not breathing I was met with lies and cover-ups.  Lies and cover-ups that ended up proving the dispatchers that this Director was in control of at the time were not compliant with State License requirements.  The very liability I was concerned with was ignored but now it’s an issue?  Is this possible evidence that what many called “attacks on them” 3 1/2 years ago is actually making a difference?

The caller believed she had passed and was cold to the touch.  What does the Emergency Dispatch protocol reflect for a caller with this information? According to information gathered the following day this person had passed hours before the call.

(e-mail continued)

The liability involved in a mistake like this dispatcher made, dispatching the wrong ambulance causing a long delay in response time, is huge. This is the second time in two months that this dispatcher’s mistakes have caused long delays in response times. The dispatchers have to be held accountable because mistakes like these can mean life or death. The supervisor of the dispatchers needs to understand the 9-1-1-computer system and dispatching protocols. From our viewpoint, it appears there is no accountability or understanding. I gave Chief Deputy Metcalf a copy of this call and all radio traffic related to it.

What liability would that be Ms. Crippes?  Please do tell us.  This statement is yet another example of the ignorance of the people in charge of our 911 system.  The dispatcher’s mistake was not calling Brocton and Paris.  You can’t ignore that she called the closest Ambulance but for the sake of legal liability concerns we must ask, what liability?  The person had passed away HOURS before the call and even if this person dispatched a different agency, there is no liability to the county under these circumstances.  Yes, corrective action needs taken, primarily new protocols, but the county does not face any liability when the dispatcher contacted the closest emergency service.

A mistake that is made in dispatching that faces liability, huge liability, is when that mistake becomes a contributing factor to the patients condition.  The mistakes Ms. Crippes references had nothing to do with the patients condition nor did it contribute to a worse condition for the patient, therefore there is no liability to the county.

Her reference to a delay in “response time” is a play on words.  Was there a delay in Emergency Services to the scene?  Let’s not confuse response time to actual services being provided.  The fact they get out the door faster (response), doesn’t mean they would be first on scene to provide services.

I totally agree with holding people accountable and it has to start with the leadership that established the protocols that are the root of the problem with this call. Protocols that fail to ensure the closest emergency agency is dispatched.  An accountability that applies to everyone equally, not just the person who speaks out against past actions of the ETSB and its Director.

I recall a couple recent fire calls that Kansas received of which neither were in our district.  We responded and in one case put the fire out before the appropriate agency was called.  In both those cases the “system”, if used, must have really failed because it was neither in our district nor were we the closest agency.  I don’t see Ms. Crippes jumping all over the Sheriff over those calls, yet some want to claim this recent action is not political?

Ms. Crippes’ claims the supervisor of the dispatchers needs to understand the 9-1-1 computer system and dispatching protocols.  To her, that is the answer. For those that live this business on the street regularly, that is not the answer.

Understanding protocols that fail to ensure the closest Ambulance is being dispatched does not ensure the citizens of this county are receiving the fastest service possible.  When we get a call that we know is not in our area we DON’T CARE!  We are treating it as if it was our area because it is about lives, not territories or boundaries.  When these things happen we contact the dispatcher and let them know which agency to send based on who’s district it is while we are on the way! We work the call as if it is our own and if the agency for that district arrives they take over the call. We on the street don’t have a problem with that!  I would rather have more people helping at the scene than not enough!

 (E-mail continued)

As I stated in an email that I sent on 4-24-14, this same dispatcher cuts herself off at the beginning of almost all of her 9-1-1 radio traffic. You can hear it on this call, she is still doing this. I put a memo out to all dispatchers and reminded them to pause between keying up and speaking on the radio. I would assume that you mentioned this to her when you addressed the problem with the call on 4-24-14. She has not fixed this problem.

Thank you for your time,
Nanette Crippes
Edgar County 9-1-1 Director

When the Federal Government mandated going to narrow band radios there was a wide spread switch to digital radios.  Most of those radios do in fact require a delay of a couple seconds from keying the microphone to actually speaking.  It has been an issue for numerous agencies.   An issue that only time is going to overcome as most of us know about it, but commonly fail to pause that 1-2 seconds.  The problem Ms. Crippes wants fixed is one that we are all dealing with.  The simple fix that will, over time, lead to the cure, let the person making the call know they did not get the first part of the transmission.  We have done that with several dispatchers, as they have done with us. When you have people that have used radios without the need for a pause for 10 plus years, and then change that norm, you are going to have these challenges.

I think this particular complaint is yet another opportunity for Ms. Crippes to pile on the complaints of this dispatcher in an effort to attack, not fix the problem.

You want to fix the problem?  Hold everyone accountable,  and remove some of the ETS Board members for neglect of duty and misconduct.  Hold a Director accountable for her illegal use of ETS funds.  Put people on the board that understand Emergency Services and understand how to draft protocols that ensure they are focused on the taxpayer, not some boundary line established for tax purposes.

The problem can be fixed and I believe the phone call I received over Part I of this series was the fist step!  The first step because Mr. Eads acknowledged the flaw in the CAD system that fails to ensure the closest agency is contacted!