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Updated: Wednesday, 27 Feb 2013, 11:27 PM EST
Published : Wednesday, 27 Feb 2013, 11:01 PM EST
HUDSONVILLE, Mich. (WOOD) - A Hudsonville woman whose 44-year-old husband died three weeks ago of a cardiac arrest at their home said she had no idea that an Ottawa County E-unit was just a mile away and wasn't called to help -- all because of a jurisdictional line.
Instead, while Hudsonville on-call firefighters worked feverishly to save Nicole Smith's husband,
she waited nearly 16 minutes for an ambulance sent from more than nine miles away on snow-covered roads.
E-units, like ambulances, carry more advanced, life-saving equipment and medication that firefighters cannot provide. They also have paramedics -- the most highly trained emergency medical responders.
"That makes me very angry, to think that something more could have been done, and it just wasn't,"
she said, though acknowledging that a different response would not have guaranteed her husband would have survived.
The case is similar to a call in January 2012 in Plainfield Township -- a woman calling 911 as her husband lay dying of a cardiac arrest. In that case, a Rockford firefighter about a mile away did not get the call. Instead, firefighters from Plainfield Township, more than six miles away, took 10 minutes to get there.
A Target 8 investigation into that call led Kent County to change its protocol -- sending the nearest first-responders and ambulances to cardiac arrests even if it means crossing territorial lines. Emergency officials say that change is saving lives.
COLLAPSED WHILE SNOWBLOWING
Nicole Smith's husband, Jerry Smith, was a laid-off woodworker who last year lived out his dream -- to drive a racecar at Berlin Raceway in Marne. He placed ninth.
He was just like a dad to his 10-year-old stepson, Anthony.
But a stress test two years ago led doctors to place two stents in his heart, and doctors wanted him
to lose weight, his wife said.
Smith was snowblowing outside his Hudsonville home just before 6 p.m. on Feb. 7 when he collapsed.
"Oh, my God," his wife told an Ottawa County dispatcher. "My husband just fell in the snow, and I
don't know what to do."
Dispatchers sent Hudsonville's on-call firefighters, along with Ottawa County deputies who are
assigned to the city.
As the 10-year-old son cried for his dad to live, a dispatcher talked the wife through CPR -- including rounds of 30 chest compressions. That is a critical first step in cardiac arrests.
"Jerry, stay with us, honey," his wife said.
In Hudsonville, as in many areas, firefighters are first-responders.
"They were here very fast," Nicole Smith recalled.
The first Hudsonville firefighter got there in 4 minutes, about the time Nicole Smith was finishing another round of chest compressions, records show. Within 2 or 3 minutes, firefighters had given the first of three electrical shocks with an AED (automated external defibrillator) -- another critical step.
Records show Jerry Smith had a "viable pulse."
AMBULANCE MORE THAN 9 MILES AWAY
Dispatchers also immediately sent an AMR ambulance -- but from Zeeland Community Hospital more than
nine miles away, and on snow-covered roads.
"I knew it was very crucial for them to be here," Nicole Smith said. "They can only do so much with
him lying on the ground, and they have a lot more technology in the ambulance they could have helped him
Ottawa County EMS Administrator Richard Szczepanek said advanced life support is critical.
"If you're able to get the meds on board, that will enhance the electrical shock," he said. "It is important to get that advanced care. CPR first, electricity, then advanced life support. You have to have all three levels. It's a continuum of care."
Even firefighters questioned when AMR would get there.
"If you get a chance, update for their ETA," a firefighter asked a dispatcher.
Nicole Smith said she didn't know a Georgetown Township E-unit was just a mile away -- until Target 8 told her on Tuesday. She wonders why it was never sent.
"I was not aware of any of that," she said. "That's very disturbing."
Ottawa County Undersheriff Greg Steigenga confirmed that a deputy at the scene asked a Hudsonville
firefighter to ask Central Dispatch to send the Georgetown E-unit. Hudsonville City Manager Patrick
Waterman said it was Deputy Fire Chief Steve Essenburg at the scene who decided against it.
"The decision was not to bring them into the scene," Waterman said.
By that time, officials say, AMR was about 5 minutes away.
"At that point, I believe they thought that this patient was going to survive," Waterman said.
The ambulance arrived at 6:11 p.m. -- about 16 minutes after the intial call.
Hudsonville's city manager said firefighters did not know the Georgetown E-unit was just a mile away.
"I don't believe, after interviewing our staff, that he was aware that it was that close," Waterman said. "No one, to his recollection, told him it was that close, so in his mind AMR was the best chance."
E-UNIT NOT IN PLAY
But, why wasn't the Georgetown E-unit sent
in the first place?
Waterman said sending the Georgetown E-unit right away is not his fire department's call.
"That question needs to be asked of Central Dispatch," he said.
Ottawa County Central Dispatch Director Timothy Smith said his dispatchers did everything right. The
computer-aided dispatch system automatically shows which units to send, he said.
"We followed the procedures," he said. "We sent the appropriate people."
But that Georgetown Township E-unit is not in play -- unless rescuers at the scene ask for it.
That's because it's paid for by Georgetown Township taxpayers -- about $1.3 million a year for a dozen Ottawa County deputies, including seven who also serve as paramedics.
Hudsonville spends about $600,000 for six Ottawa deputies, but none are paramedics.
"Typically, Georgetown's E-unit does not meander over to the city of Hudsonville," said Szczepanek, the Ottawa County EMS administrator. "Georgetown people are paying for that."
Still, Nicole Smith said she doesn't understand why the city limit line should make a difference.
"So, because we don't pay for them, we don't get the use of them here?" Smith said. "That doesn't make any sense. They're there to save lives, not to worry about who's paid for it and who hasn't."
Sheriff's officials have met with leaders from Hudsonville and Georgetown Township about the incident. Steigenga said they reminded Hudsonville leaders they could ask for the E-unit, if necessary.
Georgetown Township Manager Daniel Carlton said Hudsonville and other neighboring communities once had a mutual aid agreement with his township for E-units but cancelled that after deciding to use firefighters as first-responders.
"They told us they wouldn't call anymore," Carlton said. "We don't provide the service for the whole
world. If they're not in Georgetown, they're not available to serve our people in a time of need."
But, he said, "in a hardship situation, we would deal with billing issues later."
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