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| Lindsey Sanders, second from righ |
In an instant on a road in Uxbridge last summer that changed. A truck crashed into her bike, leaving her critically injured.
She had been on her way to visit her grandparents.
Four months later the Sanders case is one of a series that provincial investigators are probing to see if problems at Ontario’s ORNGE air ambulance service extend to patient care.
The Star has discovered that in the Sanders accident a series of mistakes and miscues led to a 44-minute delay in dispatching an air ambulance helicopter from Toronto in a desperate bid to save her life.
ORNGE documents show the medical air service is trying to reduce the number of times it launches an aircraft and then calls it back. The problem is this policy has resulted in numerous occasions when the air ambulance should have been launched but is delayed.
“If there is an issue here, then I hope it can be fixed,” said Sandy, Lindsey’s mother. “I hope it can be fixed so others can be saved.”
ORNGE receives $150 million a year from Ontario to provide air ambulance service, either to emergency scenes (helicopters) or to ferry patients from one hospital to another (airplanes).
In the Sanders case, the fourth-year wildlife biology student was home in Stouffville for the summer and was cycling to visit her grandparents on Aug. 18. Witnesses say Sanders was struck by a truck that drifted outside its marked lane.
A bystander called 911, and a York Region ambulance with paramedics was on scene in two minutes. It was 3:41 p.m.
The York team radioed for a helicopter immediately. The call went from York Region to the ORNGE headquarters in Toronto. Pilots with the ORNGE helicopter at Toronto Island readied the AW139 helicopter. It takes about 15 minutes to warm the engine and take off. Two critical-care paramedics (the highest level in Ontario) climbed into the chopper.
According to an ORNGE document, the ORNGE communication centre told them at 3:46 p.m. to “stand by.” No reason was given.
In an interview, a spokesperson for the York Region emergency medical service said ORNGE told them at the time that “the helicopter is unavailable.” The Star has determined from reviewing documents that the helicopter was available.
On the scene, York paramedics had taken over from bystanders who had been doing chest compressions on Sanders. They loaded her into the ambulance and hurried to the Uxbridge Cottage Hospital, a 20-bed community hospital with a small emergency room.
At the time, according to ORNGE documents, Sanders had a pulse and local paramedics wanted her flown to one of Toronto’s trauma centre hospitals.
Minutes clicked by. At 4:10 p.m. Sanders was rushed into the emergency room in the Uxbridge hospital. At 4:15 p.m. the pilots at ORNGE’s Toronto base were ordered to “stand down” by ORNGE communications. No reason was given. It is a 28-minute flight to Uxbridge. They would have been well on their way had they been dispatched on time.
As ER nurses and doctors worked on Sanders, a call went out again, this time from the hospital, to ORNGE: get the helicopter here.
At 4:27, the pilots were again told to ready the helicopter. They launched in three minutes and landed outside the Uxbridge hospital at 4:58 p.m. Rushing inside, the ORNGE paramedics were greeted by an angry police sergeant and upset York paramedics, sources say.
“Where the hell have you guys been?” the sergeant yelled.
At 5:10, Uxbridge doctors pronounced Sanders dead.
According to her mother, the information she received from the autopsy report revealed the young woman had a broken neck and a severed spinal cord. She finds the air ambulance delay worrying, but she believes a prompter response would not have made a difference in Lindsey’s case.
Sources at ORNGE say paramedics are frustrated because they believe they should be dispatched to all critical emergency calls. “Their job is to transport people and save lives. They should have been sent on that call.”
According to a report filed to ORNGE by paramedics at ORNGE who worked on the Sanders call: “We had multiple delays for an ‘on scene’ call where a patient ended up deceased. Land EMS asked why we weren’t there sooner.”
The paramedics, the pilot and ORNGE executives would not discuss the case.
Acting ORNGE president Tom Lepine emailed the Star this week to say he has asked the provincial health ministry to investigate the case and others raised by the Star over the past few months.
The Star’s ongoing investigation has discovered problems with the way air ambulances are dispatched.
ORNGE communication centre workers say they are under pressure to cut costs and make sure that expensive air ambulances are launched only when absolutely necessary. Executives say they are doing this on the advice five years ago of the provincial auditor general and with the blessing of the provincial health ministry.
At the ORNGE Communication Centre (OCC), where dispatchers handle calls from across the province and send helicopters and airplanes (both ORNGE-owned and those on contract to the service), staff live in fear of tirades from Dr. Chris Mazza, who until Thursday was the president.
They say he would yell about “money wasted” if helicopters were dispatched incorrectly.
Veteran OCC dispatchers, paramedics and pilots have said the policy is wrong.
“When the alarm bells ring, our job is to get out there and save a life if we can,” an ORNGE staffer said. “That’s why we have the air ambulance service. That’s why the province gives us $150 million a year.”
In a letter to the Star, Lepine said the current ORNGE policy says if a call comes in to ORNGE and a land ambulance is less than 10 minutes from the scene the helicopter will be readied but not launched until the land ambulance crew confirms the need for the chopper.
The 44-minute delay in the Sanders case is unexplained in the documents obtained by the Star.
Original Article
Source: Star
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