Paramedic Cutback Puts a Life in Jeopardy : Emergency: Fire officials say because of ‘rolling brownouts,’ the rescue of a choking woman was delayed four minutes. She is now in the intensive care unit.

It was after midnight, and Ruth Tiede, 64, was still up, taping an old television movie for her daughters and working on a book she was writing in her Beachwood apartment.

Suddenly, she found herself choking, unable to breathe. She called 911, asked for help, and was calm enough to unlock the door for the paramedics and hide her purse in a closet in case she needed to go to a hospital.

By the time Los Angeles Fire Department paramedics arrived seven minutes after her call, she was choking on fluid from her lungs and suffering from severe pulmonary edema.

“Thirty seconds later,” paramedic Jim Goldsworthy said afterword, “she would not be alive.”

The incident last Wednesday was the closest near-miss detected in the first week of City Council-mandated budget cuts that have resulted in “rolling brownouts” of fire and paramedic service throughout Los Angeles, fire officials say.

As part of the cutback service, the ambulance that would have responded to Tiede’s call, Rescue 82--stationed three minutes from her apartment--was out of service that night. The next closest unit, Rescue 827, about five minutes away, was on another emergency call.

Dispatched to Tiede’s home, therefore, was Rescue 52, stationed at Melrose and Western avenues--bringing help four minutes later than Rescue 82 could have.

“This (Tiede’s case) looks to me like the classic, exactly what we’ve been worried about,” said Fire Chief Dean Cathey, a department spokesman. Reflecting warnings by city fire officials that the cutbacks may result in worse fires and may cost lives, he added: “The clock is ticking.”

Tiede, a retired Las Vegas real estate broker who was later diagnosed as having congestive heart failure and emphysema, Monday remained in intensive care on a ventilator at Kaiser Permanente Medical Center in Hollywood.

“I can just imagine those extra four minutes, what they must have done to her,” said Ruth Collins, Tiede’s daughter. “Just being worried. With heart failure, you have to take it easy. But she’s a nervous person anyway, and she was all by herself.”

Had his ambulance arrived earlier, Goldsworthy said, he could have given Tiede medication to expand her breathing capacity. Instead, he said, her condition was so severe that he was forced to put a tube down her trachea and use an emergency respiratory device that forces oxygen into the lungs, saving her life but putting a strain on her system.

“That extra four minutes it took us to get up there--they would have given us a chance to get medication in her,” Goldsworthy said. “On this particular call, had a rescue been there sooner, her condition might not have ended up as severe as it was.”

The intubation procedure is only to be used in life-threatening situations and can cause death if improperly administered, said Dr. Gregory Palmer, Fire Department medical director.

“I can’t say whether or not her (Tiede’s) condition would be different had there been an earlier response,” Palmer said. “She still would have been sent to ICU, but she might not be on a respirator.”

The American Heart Assn., which sets standards for emergency responses, says the first team should arrive within 3 1/2 minutes prepared to administer cardiopulmonary resuscitation, with fully trained paramedics arriving within eight minutes.

“We didn’t meet the heart association criteria in this case,” Palmer said.

Before the brownout procedure, he said, the department responded to emergency medical calls within five minutes 80% of the time. He does not expect to have significant data on brownout response times for three months.

What the Fire Department calls a “collision of calls”--multiple emergencies reported at the same time--can even cause a domino effect in normal times, requiring response teams to move out of their districts to answer calls. The brownout exacerbates the problem.

The $22-million budget cuts have prompted the department to remove six of the city’s 54 ambulances--and 13 of its 97 engine and truck companies--from daily service for nine-day periods on a rotating basis throughout the city. The rolling brownouts began July 8.