The nurse on staff at a care clinic in Rialto, California called 9-1-1 after a patient went into cardiac arrest. But when the paramedics arrived, they refused to enter the building, citing the city’s latest COVID-19 restrictions.
With the help of a local police officer, the staff had to bring the patient outside, so the paramedics could take him to a hospital, where he was pronounced dead. The first responders are now facing criticism for not doing more to save the patient’s life.
Standing Their Ground
Police officer Ralph Ballew arrived at the Rialto Post Acute Care Center in Southern California just before 8 PM local time on Nov. 17 while responding to a call that a patient was “undergoing cardiac arrest” and “no longer breathing,” according to the police report.
However, he noticed several members of the Rialto Fire Department standing in front of the entrance when he pulled into the parking lot. The paramedics were responding to a patient in “respiratory distress,” according to the report from the fire department.
That’s when a nurse from the center ran out and shouted at the paramedics. “He’s having cardiac arrest!” the nurse yelled, as reported by Ballew. But the paramedics said the patient had to be brought outside because they weren’t allowed to enter the building.
According to Ballew’s report, another provider asked for help and said they were providing CPR and “could not move the patient and disrupt the rescue effort.”
“You are doing the same thing we would have to do if we went in,” said one of the fire personnel. “So, hurry up and bring him out so we can help.”
Ballew added that the fire personnel turned to him and said if the staff doesn’t like the policy, they “should call their congressman,” according to the report.
So, Ballew ran into the building and left the paramedics outside. When he entered the room, he found the nurse doing chest compressions. He found “distraught hospital employees pleading for help” and “visibly upset by the lack of effort” from the paramedics, the report says.
He jumped in to help the other staff member move the patient’s bed away from the wall and towards the front entrance.
“Despite being in their line of sight, fire personnel still insisted on [the patient] being brought to them outside before they began life saving efforts and made no effort to assist me in getting [the patient] outside,” Ballew said.
He added that the nurses were visibly irritated when they brought the patient outside. The paramedics reportedly told the nurses to “slow down” while asking them about the patient’s condition.
The patient was then transported to Arrowhead Regional Medical Center, just a few minutes away. He was pronounced dead at 8:38 PM.
After the incident, the police officer and staff talked to reporters about the experience. The providers said they depend on the local fire department when administering “advanced life support care to patients who are in cardiac arrest,” which includes defibrillation, intubation, IV access, and medication administration. They added that they have called the paramedics several times during the pandemic, and they never refused to come inside.
The staff also sent a formal complaint to Rialto Mayor Pro Tempore Ed Scott, who later reviewed the body camera footage.
“It is difficult to watch the tape,” Scott said.
Acting Fire chief Brian Park said the tape was disturbing to city leaders. He said the paramedics involved have been put on leave while officials investigate. He added that the department is committed to providing “compassionate service” and that he, personally, would “ensure the independence of the outside investigation.”
While offering her condolences to the family, Rialto Mayor Deborah Robertson said, “We want to have a thorough investigation, and the actions [of the paramedics], if they were not in any way in keeping with policy, or even if it was, it will be addressed.”
“Our prayers are with the patient’s family, as well as our police officer and care center staff who had to endure such an unimaginable situation,” Robertson added.
It’s not clear which rules the paramedics were referring to when they refused to enter the building, but it was likely an outdated memo from the San Bernardino County Fire Chiefs’ Association sent in April 2020, which noted that “personnel responding to long-term care facilities” should take steps to “minimize any potential risk for exposure.”
One of the suggestions was to ask the facility to bring the patient outside. However, if the patient cannot be moved, personnel are permitted to enter and “interact with the patient.”