Grady executive blasts decision to cancel 911 call

The head of Grady hospital’s emergency medical services on Wednesday sharply criticized the decision to call off one of two medical crews responding to a teenager suffering a seizure last week at an Atlanta high school. Antoine Marc Williams, 16, went into cardiac arrest and later died.

James Bothwell, executive director of emergency medical services and trauma at Grady Memorial Hospital, said the decision to cancel one responder the afternoon of Oct. 14 violated protocols for such emergencies. He also said additional medical personnel can help save lives in similar medical emergencies.

“It is a big deal,” Bothwell said, concerned that someone in law enforcement turned back an Atlanta fire truck also dispatched to Benjamin E. Mays High School.

“Looking back at this, it was not the best decision for the child,” Bothwell said.

He said Grady’s own dispatchers immediately sent a two-person ambulance from Care Ambulance to the school when the first call came in about 3:20 p.m. The company has a contract with Grady to provide paramedic response.

A fire truck with medical personnel dispatched by Atlanta 911 at the same time was turned back about seven minutes later, officials said. Bothwell said that was a violation of protocols for such medical emergencies.

The fire truck was ultimately redirected to the school after the teen went into cardiac arrest in the Care ambulance. The fire truck arrived 35 minutes after the initial call for help was received. Williams died hours later at Grady.

Bothwell said the order to halt the fire truck paramedics wasted valuable time. The extra crew could have provided vital extra hands, especially when Williams went into cardiac arrest, he said.

Classmates said Williams, who wanted a career in international business, and another student began play-wrestling in an American Literature classroom that afternoon when a teacher briefly left the room. Williams fell, grabbed his arm and shouted “my heart. “

An Atlanta police report said Williams began “shaking out of control,” and Bothwell said a teacher called 911 for help.

The Grady ambulance and the fire truck were dispatched, but for reasons that remain unclear, the 911 operator canceled the call for the fire truck. Bothwell said the 911 operator’s order to turn back the fire truck came as a directive by an unnamed law enforcement figure.

While Bothwell believes his own emergency dispatch and ambulance crews acted appropriately, he acknowledged that finding the source of fault has been difficult.

Atlanta Police officials have declined to discuss the case, saying they will wait until they complete their investigation of why the 911 operator canceled the firetruck response.

Bothwell said that sending both an ambulance and fire department personnel is a shared protocol between Grady and Atlanta 911 dispatchers in such high-priority medical emergencies as Williams’.

The Grady official said his ambulance crews, which arrived at the school at 3:29 p.m., actually spotted a fire truck on the school grounds before they went up into the classroom, but that fire crew never made it up to the classroom.

It was at 3:29 p.m. that the 911 dispatcher canceled the call to the fire crew.

Bothwell said a fire official told Bothwell’s staff that an incident report lists a code for the person who called off the fire crew. The code given stands for “law enforcement.”

It is inappropriate and “very unusual,” Bothwell said, for any member of law enforcement to make that decision in such a medical emergency. He said that decision should be made by an emergency medical worker at the scene — only after the patient has been medically evaluated; Williams had not yet been evaluated by any medical responder, he added.

“A more appropriate response would have been to have everybody go to the patient, and evaluate them, and then make the decision” on whether to release one of the crews, he said.

As many as five medical personnel are needed to properly care for a cardiac patient — one to supervise and others to administer chest compressions, insert a breathing tube, breathe air into the patient’s mouth and to administer medications.

When Williams went into cardiac arrest, the crew alerted dispatchers. Once again, 911 dispatched a fire crew. That crew arrived three minutes later.

It was the fire crew that inserted a breathing tube down William’s throat, he said.

Bothwell said he could not say whether the fire personnel being there throughout the incident would have saved Williams’ life — but mere minutes can make a big difference in saving the life of a person in cardiac arrest..

Autopsy results are expected in a few weeks.