Paramedic, patient raise concerns on Portland’s 911 system after long ambulance wait

PORTLAND Ore. (KPTV) - A local paramedic is speaking out to FOX 12 Investigates after her father-in-law waited in agony for over an hour for an ambulance. This paramedic, Talitha Saunders, says this instance is symbolic of the problems facing Portland’s emergency management services right now, which include under-staffed EMTs and paramedics and some 911 calls not being prioritized as well as they could be.

Saunders and some of her family contacted FOX 12 Investigates after seeing previous coverage on staffing issues facing the local EMS systems.

Back on Sept. 28, Talitha Saunders father-in-law, Lynn Saunders was at a physical therapy appointment in Northwest Portland while recovering from hip replacement surgery. While getting ready to ride a stationary bike, the unexpected happened and he fell and broke his femur.

“I had my foot in a chair because I don’t have enough flexibility to put on my shoes on the floor,” said Saunders. “And the chair tipped over while I was bent over and I was trying to maintain my balance and I hit hard on a tile floor and the pain was off the charts.”

Saunders had broken his femur, on the same side of his body where he had just undergone hip replacement surgery. Staff at the physical therapy center quickly called 911. According to 911 call records, Saunders’ physical therapists called at 11:08 a.m. that day, and a few minutes later, the call was relayed to American Medical Response ambulances to get to Saunders and take him to the hospital, but that is when Saunders said the long wait began.

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“So the pain again was horrible and people were trying to help me and the time just rolled on and rolled on and rolled on,” he said. “I’m right downtown at 15th and Raleigh in the middle of Portland. I thought an ambulance would be there in 10 minutes and 10 minutes came and then 20 minutes came and then 30 minutes came.”

Records show that physical therapy staff also called 911 back again after waiting some time, only to find out there weren’t any ambulances available.

According to Portland’s Bureau of Emergency Communications or BOEC, under a previous 911 dispatch system, ground-level falls like the one Saunders experienced were treated as any other medical trauma. Under the current system implemented about two years ago, BOEC says falls are now treated as their own category, and the nature of the fall determines the kind of response needed.

In Saunders’ case, he says after waiting for more than a half hour, he called his son, who happens to be a paramedic with Portland Fire and Rescue to try and get some help.

“I got a call through to him at 11:30, half an hour into this, and told him the problem. And so he started working for me internally to try to get me some pain relief, and they showed up at 12:10. So I was laying there for an hour and 10 minutes and it was unbearable, horrible.”

Records show about 15 minutes after Portland Fire paramedics arrived, an American Medical Response (AMR) ambulance finally got to the scene at 12:26 p.m. to take Saunders to the hospital where he underwent emergency surgery. Saunders says had he not contacted his son, he may have been waiting longer.

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Like Lynn Saunders son, his daughter-in-law, Talitha Saunders, is also is a local paramedic, but for AMR, the company that Multnomah County and other metro area counties utilize for ambulance services. After seeing what her father-in-law experienced, she says he is not alone. Saunders stresses when serious falls happen where bones are broken, it’s critical to dispatch both fire and ambulance paramedics to the scene.

“One of the biggest problems that I think we have with our ground level falls is if they’re coded as a code one, we don’t have a fire response,” she said. “And in particular, if you’re dealing with the elderly population that has a high probability for a hip fracture, not having a fire response, it’s kind of a delayed care potentially, because we are such a busy system, we don’t have enough ambulances.”

A spokesperson for Portland Fire and Rescue sent the following statement on how fire paramedics are utilized on serious medical calls like falls, it reads:

“Fire is dispatched on specific call types based on the acuity and priority level of each call. This information is collected by the dispatcher at the time of the call, from the caller. Detailed information from the caller at the time of the 911 call greatly increases the ability of this system to send the appropriate responder. PF&R meets regularly with all involved to collaborate and ensure quality emergency response is delivered to the community.”

Talitha Saunders says she began noticing problems about 2 years ago, when Portland’s Bureau of Emergency Communications implemented a new system for handling medical and fire calls that the bureau says helps dispatchers better identify the nature of each emergency to ensure the right response. In a statement regarding Saunders’ concerns, a BOEC spokesperson sent back the following which reads:

“In our previous system, falls were treated the same way as other traumatic injuries. In medical priority dispatch system, falls are treated as their own category to help identify medical causes that may take priority over the fall itself, such as a stroke, seizure, heart attack, etc.

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…a ground-level fall could result in an ambulance without lights and sirens or an ambulance with fire with lights and sirens. It depends on the injury and if the patient has any other priority symptoms.”

In a recent Multnomah County meeting on 911 dispatch and first response staffing, BOEC director, Bob Cozzie says his bureau is heading in the right direction on medical calls.

“With 1,902 medical calls that we processed, this is a timeframe March through August of 2023, of those 1902, 1800 were processed ideally, 3.5% or 56 of them had an under-response, 20 or less than 1% had an over-response or a waste of resources,” said Cozzie. “Our goal is to maintain lower than 5% in the under-response or over-response categories, and we’re hitting that.”

A BOEC spokesperson also tells FOX 12 Investigates the bureau is having ongoing talks with AMR, Multnomah County’s ambulance service, about how to streamline and improve call triaging. The spokesperson also says there are currently 47 dispatch trainees learning how to prioritize different calls. But for Talitha Saunders, she says the community she serves should not have to suffer while waiting for a response.

“In my opinion, that’s not good enough because the patients are the ones that are suffering from it.”

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