DC 911 Incidents Show Stress, Errors in Emergencies
"What's the location of your emergency?" asked a District of Columbia Office of Unified Communications 911 call taker on June 5 just before 4 p.m. The caller, crying as she reported that her 59-year-old mother passed out after experiencing chest pains, answered, “414 Oglethorpe Street Northeast.”
“I’m sorry, can you repeat that?” asked the call taker. The daughter replied, “414 Oglethorpe Street Northeast, Washington, D.C.” At 3:58 p.m., the address was entered into OUC’s event log as 414 Oglethorpe St. NW. That's about 1.5 miles away in a different quadrant of the city, according to Google Maps.
About five and a half minutes into the 911 call, the daughter said her mother was gasping for air and asked if the call taker knew how long it would take responders to arrive. “I can't give an absolute ETA, but they're en route,” the operator replied. “You should be seeing them shortly.” Less than a minute later, the caller said her mom stopped breathing. The call taker instructed her to start CPR and began counting one to four to assist with the timing of the chest compressions. That continued for much of the rest of their approximately 20-minute conversation before paramedics arrived.
Responding to a D.C. Freedom of Information Act request, OUC sent us written logs and audio recordings of 911 calls and dispatcher radio communications of this and three other events from May to July. Communications Daily has listened to and reported on radio traffic of many other incidents over many months involving responders sent to incorrect addresses and other apparent errors that have caused delays in medical and other emergencies. We have submitted more requests for information on those and additional incidents, which OUC doesn't routinely release of its own volition. The local firefighters union and others say these incidents appear frequently, dispute OUC sometimes pointing to caller errors, and have called for OUC improvement. Although multiple D.C. advisory neighborhood commissioners have raised concerns, no citywide official with public safety oversight has yet done so. Such reports led to an audit by the city and Capitol Hill questions.
The OUC audit should reveal if reported errors are isolated or show systemic problems. The Office of the D.C. Auditor chose Federal Engineering for the audit Tuesday (see 2011170065). OUC earlier said it welcomed the audit, set to be finished in May (see 2009250069). OUC says it gets 3.5 million emergency and nonemergency calls annually, with a FY 2019 error rate of 0.004%, which would be 140 errors.
OUC "remains firmly committed to serving District residents and fulfilling its critical role in coordinating the most appropriate responses to all the city's 911 calls, which top 1.4 million annually," an OUC spokesperson emailed Wednesday. "Last summer, immediately after these incidents occurred, as is our typical practice these calls were reviewed, and our findings were shared with officials that provide oversight to our agency, and corrective actions were taken where appropriate. We continue to acknowledge our willingness to work with the DC Auditor on a thorough review of OUC’s performance."
OUC and emergency responders are “going to make mistakes,” and they “need to be highlighted,” said a Fire and EMS Department spokesperson, citing COVID-19 as a complicating factor. “We’re all doing our best under increasingly intense and unique circumstances.” Before the pandemic, the fire-rescue agency responded to about 550 calls a day; that has dropped to about 500 daily amid the virus.
The FOIA'd cases showed that errors, made in some cases by OUC and in one case by the caller, led to long waits. In one incident, help didn't arrive for 30 minutes after the first 911 call was made; in another, it was 21 minutes. In a third case, dispatchers sent firefighters on several unnecessary emergency runs to a fallen tree even though the firefighters kept telling them it was the same tree. Two incidents illustrated the stressful conditions faced by callers and 911 professionals.
The paramedics “just pulled up,” the call taker said about eight minutes into the 911 call at Oglethorpe Street. Four minutes later, she asked if the daughter could hear them. The answer was no.
One recording of radio traffic between OUC and responders captured a man from Engine 11 asking the dispatcher, “Can you confirm the address? We are at 414 Oglethorpe. The caller says this is not the proper address.”
Back on the 911 call, about 13 minutes in, the call taker paused her CPR counting to ask, “And can you confirm the address for me just so I know that they're at the right place?” The daughter repeated the Northeast quadrant address. At 4:13 p.m. in the written log, the address was corrected. Another entry at about 4:19 p.m. described Engine 11 and an ambulance “GOING TO CORRECT LOCATION.”
The anxious caller reported her mom still not breathing about 18 minutes into the call as CPR continued. Sirens became audible seconds later. The daughter said she heard the paramedics. At about the recording’s 21-minute mark, one paramedic who had come inside asked, “How long has she been out?”
The patient was transported to the hospital, the Fire and EMS spokesperson said.
Both the caller and OUC appeared to make mistakes in a May 17 incident involving an unexpected childbirth at an apartment in northwest Washington. The call taker repeatedly asked questions about the baby’s status while trying to direct the distracted adults.
At about 3:30 a.m., a man reported his 26-year-old “lady friend” just gave birth. It sounded like he gave 3100 Massachusetts Ave. NW as the address, but the written log showed 3100 Wisconsin Ave. NW. “I’ve got them both in the tub,” the man said. “Come immediately, ma’am, please.”
“Hold on, I’ve got somebody coming,” the call taker replied.
About seven minutes into the call, the operator said the paramedics had arrived and were coming up. About five minutes later, the operator asked, “They at the door?” No, he replied.
The call taker asked for the apartment number again, then the street address. This time, the caller said 4100 Massachusetts Ave. NW, 10 blocks from the location he originally gave and a different street from what was in the written log. The address was corrected in the log shortly afterward.
“We are going to 3100 Wisconsin, correct?” a responder asked. That's about 1.1 miles from 4100 Massachusetts Ave. NW.
About 21 minutes into the 911 call, the man put the new mother on the phone while still waiting for paramedics. “How are you?” the call taker asked. She replied, “In pain right now, but I’m OK.” The operator asked, “Do you know when you were due?” The woman responded, “No, I do not. ... To be honest, ma’am, I did not know I was pregnant.”
About two minutes later, the mother reported feeling dizzy, so the operator told her to sit. “Don’t try to walk around.” The call taker asked a minute later if she was walking around, and the man -- back on the line -- replied, “Yeah, it’s OK.” The dispatcher said it wasn’t OK. A couple of minutes later, the man can be heard telling the mother to sit down: “Why do you keep getting up?”
About 30 minutes into the call, paramedics were heard arriving. “Be advised, Ambulance 20 has CPR in progress on a newborn child," said a dispatcher on a separate recording of a radio dispatch. The baby was transported in priority-one critical condition to a nearby hospital, the Fire EMS spokesperson said.
On July 21 at about 5:50 p.m., a woman called 911 to report a man having a seizure near the AT&T store at the Gallery Place Metrorail station in northwest Washington. The log showed the phone reporting the call coming from 650 Massachusetts Ave. NW, less than two blocks from that store. The call taker asked if the cross streets were Seventh and H. The caller said yes. The written log shows Seventh Street Northeast and H Street Northeast entered, which is the wrong quadrant for Gallery Place and 1.7 miles away.
A written entry at 5:57 p.m. reported the caller no longer on scene. A first responder asked the dispatcher if the location was Northeast, “because the caller address came up as Northwest.” The dispatcher later reported that a callback to the person who dialed 911 went to voicemail. The responder said they would check the Northwest quadrant, and a 5:58 written entry notes that Ambulance 3 “IS GOING TO THE NW SIDE.”
The address remained Northeast in the log until 6:32 p.m., when it was corrected to Northwest. About five minutes earlier, the log showed requests for medic and EMS units. One radio recording captured a rescuer asking if the address was Northwest or Northeast. A new dispatcher responded it was Northeast. Then OUC asked Ambulance 3 in which quadrant it was located, and the ambulance replied Northwest. The medic unit then reported itself as heading to Northwest.
The written log noted a transport at about 6:54 p.m. to 2041 Georgia Ave. NW, the address of Howard University Hospital. The patient was transported in priority-three stable condition, the Fire and EMS spokesperson said.
Dispatchers sent the same firetruck six times to a downed tree near Texas Avenue and B Street Southeast July 6-7, after the same number of 911 calls about the tree.
“This is our third time coming out,” someone from Truck 17 reported in one radio recording July 6. “Please contact [the Department of Public Works]. ... We're unable to remove the tree from the roadway.”
"We were just dispatched to the 4600 block of Texas Avenue ... for a tree down,” reported Truck 17 in a second recording. “We've already been out three times to that same tree and reported the same each time.”
"So, Truck 17 keeps going out to the same call on Texas, and it's a big tree that's down,” a person from the truck reported in a third recording. “We've been four times now, and I've called for Urban Forestry.”