Probes of Fire Department Dispatch Practices Ordered

Top officials overseeing the Los Angeles Fire Department said Tuesday they will undertake separate reviews of persistent problems in the dispatching of emergency medical crews, which have been tied to at least three recent cases in which patients died.

“It is front and center to pay attention to this,” said City Councilwoman Cindy Miscikowski, chairwoman of the Public Safety Committee. She said he panel will begin an inquiry into the failure of dispatchers to ask scripted questions meant to guide them in sending appropriate help.

The president of the mayor-appointed Fire Commission, meanwhile, said he plans to explore the deficiencies during a special Thursday hearing of his oversight panel on issues confronting paramedic services.

“We have a lot of questions,” David Fleming said of the dispatch breakdowns.

Fleming expressed concern that commissioners were unaware of studies dating to 1997 that found dispatchers were failing to follow procedures in about half their calls. The panel, he said, should have been informed sooner.

“Clearly it was a breakdown in communication,” Fleming said.

The Times reported Tuesday that internal Fire Department studies--including one in July--found that firefighters who take emergency calls frequently fail to ask the scripted questions designed to obtain vital data on a patient’s status. The questions, referred to as “protocols,” are based on medical research and are posted next to each dispatcher.

On Tuesday, Fire Chief William R. Bamattre called a news conference to respond to The Times’ report and to assure the public he is taking measures to improve the department’s performance. Bamattre earlier had told the newspaper he did not recall being advised of the problems until recently.

“There were errors made,” he said Tuesday of the department’s dispatching operation. “There will always be errors made.”

But the chief added that such mistakes represent only a fraction of the more than 300,000 emergency medical calls handled by firefighters each year.

At his crowded news conference, Bamattre said the city attorney’s office advised him not to discuss any specific cases involving dispatch problems.

The July report to the chief from the department’s head of quality assurance cited “four significant complaints” in which dispatchers made “grossly inappropriate dispatches” that “potentially led to negative patient outcomes.”

Records and interviews show that three of the incidents ended in death. The Fire Department says it is still trying to track down information on the fourth incident. Fire officials say there is no evidence that the deaths could have been averted by proper dispatches.

Part of the problem is that dispatchers are under pressure to process calls quickly, said Capt. Ken Buzzell, head of the city firefighters union. After reading the same scripted questions hundreds and hundreds of times, dispatchers begin to take shortcuts, he said.

“It’s human nature. Slipping back,” he said. “When we have problems dealing with dispatch or [emergency medicine] they seem to fall on deaf ears.”

To help avoid future slips, Bamattre said the department is installing an interactive computer program to force adherence to the scripted questions.

But he said part of the solution is to put more paramedics in the field. “I think we can do a better job of getting there,” he said.

To that end, the chief said he has proposed a controversial paramedic redeployment plan in the San Fernando Valley. Under the “one plus one” pilot program, two-person paramedic teams would be broken up so that every fire station could have at least one highly trained medical rescuer.

The proposal has been attacked by many paramedics and emergency room nurses, who say it is better to have paramedics work in teams, with one backing up the other.

Bamattre said Tuesday that he hopes to add 200 paramedics to the force over the next two years, through a combination of outside hiring and retraining of firefighters.