Imagine feeling a sharp pain spread across your chest, dialing 911, and waiting more than 20 minutes for medical attention.
According to police dispatch reports, a 47-year-old Hoboken resident had that experience on April 26 at approximately 6:34 a.m., when police received a call from the Jersey City Medical Center informing them of a man having a mild to moderate heart attack in the area of 13th and Hudson streets.
According to the police log, Police Officer Jonathan Butler was first to arrive at the scene at approximately 6:50 a.m., where he was joined by paramedics from Jersey City five minutes later – meaning that an ambulance took approximately 21 minutes to reach the victim from when the police dispatcher initially received the call.
One of the reasons the victim was unable to receive medical attention sooner was that Hoboken’s Volunteer Ambulance Corps (HVAC), the only in-town emergency medical service provider operating on a 24-hour basis, did not have anyone available due to a scheduling mix-up that left the facility unmanned for two hours, from 6 a.m. to 8 a.m.
They turned out to be a crucial two hours, although the victim survived.
Two conflicting procedures
According to HVAC President Thomas Molta, the lapse in coverage occurred as a result of a volunteer having to leave his post prematurely, while his replacement, who was supposed to arrive two hours early to cover the shift, failed to do so.
Although Molta acknowledged the blunder, he said that police dispatchers, if unable to reach the HVAC, are supposed to contact the Hoboken Fire Department (HFD) which has personnel trained as first responders who can arrive at the scene before an out-of-town emergency service and stabilize the victim.
The HVAC response to a call in Hoboken typical takes three to four minutes from being dispatched. Molta’s protocol was challenged by Police Lt. Nicholas Manente, a supervisor in the training bureau that oversees the Police Department’s dispatch. Manente said that according to the department’s proper procedure, the dispatch is only supposed to notify the HFD if no medical emergency provider can respond to the call. Because the call was received from Jersey City Medical Center (who initially got the call from 911), and the dispatcher was told that an ambulance was on its way, the call from that point on became the medical center’s responsibility, according to Manente.
Generally, when 911 gets a call for a life-threatening situation, they automatically call Jersey City Medical Center, who calls the police dispatcher to call the Hoboken Volunteer Ambulance Corps. JCMC sends its paramedics who are better equipped to deal with a life threatening situation, but HVAC should arrive first to immediately stabilize the individual.
There also could have been a slow-down if HVAC was tending to another patient, but the matter seems more egregious because it was the result of an error.
The Fire Department could not be reached to comment on the incident.
Hoboken’s medical center
Having been aware of the situation from a conversation he had with the victim, the city’s Interim Executive Director for the Hoboken Hospital Authority, George Crimmins, said he was in favor of the municipality obtaining its own paid ambulance service in order to shorten the period of time patients might wait if they should have to depend solely on out-of-town medical services in the future.
“The city should have its own ambulance. The volunteers do a very good job, [but] no one should have to wait for an ambulance that long,” said Crimmins, who added that Hoboken University Medical Center on Willow Avenue is currently in the “discussion stages of exploring the possibility” of contracting out with an emergency medical service.
The HVAC, which currently consists of 92 volunteers, has been providing Basic Life Support (BLS) services in Hoboken since 1971, according to Molta, who described the call above as “an isolated incident [that was] unacceptable and unfortunate.”
Although he acknowledged that in the past there have been similar situations where the HVAC had no one on duty to field calls, he said they were “few and far between.”
Molta added that if the HVAC is aware of an emergency in town but unable to respond, they reach out to Hoboken High School’s Emergency Response Team, which consists of several certified Emergency Medical Technicians (EMT) and students who are in training to become certified one day. The student-led emergency service, which has at least one adult at all times, operates Mondays through Fridays from 8:30 a.m. to 3:30 p.m. If the emergency cannot be fielded by the students, HVAC will reach out to an ambulance from a neighboring municipality via a mutual aid agreement in which various emergency service providers in Hudson County assist each other if the need arises.
The Jersey City Medical is the primary Advanced Life Support (ALS) provider in this part of Hudson County, according to the medical center’s Director of Emergency Medical Services Christopher Rinn, who added that in 2006, the average response time for an ambulance from Jersey City responding for a BLS call in Hoboken is 7 minutes 54 seconds.
In 2006, Jersey City Medical Center ambulances provided Basic Life Support services 267 times in Hoboken, while HVAC provided BLS services to Hoboken residents just under 5,000 times.
The difference between BLS and ALS is that the latter is a treatment that involves the resuscitation of someone who has gone into cardiac arrest, while the former is more basic and includes a number of lifesaving techniques that do not involve the use of advanced medical care.
Michael Mullins can be reached at mmullins@hudsonreporter.com.