Emergency transport feud heats up in Ponce Inlet

Staff Writer

Last update: 20 November 2003

PONCE INLET -- It was supposed to be a standard emergency call. A Ponce Inlet paramedic called Volusia County Emergency Management last Thursday to pick up an ailing town employee who is diabetic. Eighteen minutes passed, and EVAC paramedics hadn't arrived.

So Town Fire Chief Chris Phelps made a controversial decision: break county and state law and drive the patient to Halifax Medical Center.

That decision has put Phelps and his department in the hot seat and fueled the embers of a longstanding feud surrounding emergency transport protocol. The county is threatening to fine the town or, worse, yank its license to practice advanced life support on sick residents who call 911.

"That is not just tough talking," said Matt Zavadsky, director of Volusia County Emergency Medical Services.

Over the next few days, county officials will determine whether the patient was ill enough to justify breaking county and state regulations that prohibit town paramedics from transporting patients, and whether a wrong address given to EVAC played a prominent role in the response time. County officials are reviewing documents and recordings this week dealing with the emergency call.

Zavadsky said the county will complete its investigation by Wednesday.

Phelps said he's confident the town will be vindicated. Although paramedics rely on knowledge and instruments to evaluate patients, once in awhile they also go on gut instincts, Phelps said.

"When three paramedics have the hair on the backs of their necks standing up, that's saying something," he said. "We were all concerned for the patient."

While waiting for EVAC to arrive, Phelps tried calling them directly but couldn't reach them. Zavadsky questions whether Phelps was calling correctly.

In the end, the town's ambulance was ordered by county officials to stop in Daytona Beach and transfer the patient to an EVAC ambulance.

At the crux of the dispute is one paramedic's slip of the tongue.

A paramedic for the town called county EMS at 12:26 p.m. on Nov. 13 to ask EVAC to respond to a "non-emergency call" to 4680 South Atlantic Avenue. But the fire station is actually located at 4680 South Peninsula Drive.

Six minutes later, town paramedics told EVAC the call should be changed to "emergency."

"We're looking at things like how could the paramedic from the Fire Department not know the address," Zavadsky said. "And why did it take (town paramedics) so long to upgrade EVAC to an emergency response?"

Phelps said the paramedic made a mistake and that he won't be disciplined. He also said it's easy to "Monday morning quarterback" after quick decisions have already been made.

Ponce Inlet isn't the only municipality to balk at the county's transport protocol.

Daytona Beach, Deltona and Port Orange have in the past lobbied the county to get permission to carry emergency patients to area hospitals. Typically, firefighters arrive first at the scene of an emergency and prepare a patient before EVAC takes them to the hospital.

A 2001 study for the Volusia Council of Governments indicated that 90 percent of the time, EVAC paramedics take 17 or more minutes to respond to emergency calls in Ponce Inlet. A report released in February regarding a centralized communications dispatch center says the average response time for first responders throughout the county is four to six minutes.