Deadly delay? Friend questions what could have saved man who died after ambulance wait

Paul Anderson, 80, died earlier this month after suffering a stroke inside his Marco Island home.

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Paul Anderson, 80, died earlier this month after suffering a stroke inside his Marco Island home.

Video from NBC-2

Bob Rowe doesn’t know what more he could have done to save his friend’s life.

Paul Anderson, 80, died earlier this month after suffering a stroke inside his Marco Island home. But it was the 40-minute wait for an ambulance, after Rowe dropped Anderson off at Marco Island Urgent Care, that has Rowe questioning if his friend died due to squabbles between NCH Healthcare System and Collier County EMS.

“I was all that he had, and I let him down,” Rowe said.

Rowe said he got a call from Anderson, a seasonal resident, just before 8 a.m. on Oct. 2. Anderson told him he was dizzy and didn’t feel well.

Rowe dropped off Anderson at Marco Island Urgent Care sometime after 8:30 a.m. Over the next 40 minutes, at least three EMS ambulances were called to the scene and then canceled. 911 recordings indicate that at least one Collier dispatcher believed NCH would transport Anderson to the hospital. Two other recordings indicated EMS would handle the transport.

As he waited, Anderson’s condition deteriorated into unconsciousness.

“I believe in my heart of hearts it cost the man his life,” Rowe said of the delay.

Rowe is digging for answers about whether NCH Healthcare System’s reported unpaid bills to Collier County EMS, policy disputes about transporting NCH patients from one hospital to another, poor communication to ambulance drivers and a late driver that day may have led to Anderson’s death.

“If I had called 911 instead of taking him to Marco Island Urgent Care, he would still be alive,” Rowe said.

At about 8:45 a.m. Rowe ran across the street to a Marco Island fire station looking for an ambulance to take Anderson to the nearest hospital in Naples. At the same time Marco Island Fire Rescue Deputy Chief Chris Byrne reported that dispatch requested transport of Anderson from Marco Urgent Care to NCH Downtown Naples Hospital.

A rescue unit responded, but was immediately canceled, Byrne reported. It was not stated in Byrne’s report or discussed in dispatch recordings why the ambulance was canceled, but another EMS unit was then dispatched several minutes later, at 9:19 a.m.

MedFlight was also on standby and, according to county records, another EMS unit from Isles of Capri was dispatched.

All the while, an ambulance, normally operated by NCH beginning at 9 a.m., sat without a driver in front of Marco Island Urgent Care.

That NCH driver finally arrived, and, according to Rowe, was not only late but seemed to have little care for Anderson.

“She (the NCH driver) sashayed across the parking lot at 9:22 a.m … getting her snacks together,” Rowe recalled.

Rowe told the arriving driver his friend really needed her help. He was dying.

“She told me to back off or she wouldn’t be taking anyone, anywhere.”

When the Isles of Capri ambulance arrived, the NCH ambulance was already leaving with Anderson, records said.

Anderson died the next day. His family flew his body home to Minnesota, and is continuing to learn what happened.

Rowe said he isn’t vindictive, but he said he isn’t going to let this issue die.

“My passion is my dedication to my friend,” he said. “At the very least, no one will die at the hands of the incompetent fools that managed (Anderson’s) life so poorly.”

In a prepared statement, NCH spokeswoman Debbie Curry said the hospital considers all lives precious, and extends its sympathy to Anderson’s family.

“We are currently reviewing every aspect of this matter to determine what can be done to continue to ensure excellent care is provided at all times,” she said in the statement.

Questions about the ambulance response to the Marco center coincides with a county decision to stop helping NCH when patients need to be transported from one hospital to another, effective Oct. 1.

That new policy did not affect how EMS handled the 911 call to the Marco center, county spokesman John Torre said.

EMS interim operations chief Walter Kopka spoke twice to NCH’s transport manager and was told NCH’s ambulance would take the patient to the hospital, Torre said.

The hospital system has had a limited ambulance license since 2004 for transferring patients from one NCH hospital, including the Marco center, to another NCH hospital. EMS would help out when asked by the hospital.

“I can only presume if NCH wasn’t handling it, EMS would have been there in a matter of minutes,” Torre said.

The dispute over “intra-facility” trips arose when NCH stopped paying for the help. NCH owes the county $178,742 from July 2010 to the present.

County Manager Leo Ochs made the decision, with EMS, after meetings with NCH to try and solve the billing dispute.

“Their lawyers have said that the county should be billing Medicare, Medicaid or the patient (instead of the county),” Torre said.

Och informed Dr. Allen Weiss, president and chief executive officer of NCH, of his decision in a Sept. 9. letter. Ochs’ letter said the county had been agreeable in the past to providing occasional assistance as long as NCH paid.

A county resolution passed in 2008 says hospitals that request ambulance service from EMS will be billed on a monthly basis.

“We regret being forced into this action, but we regret even more having to use public tax dollars to subsidize these transports,” Ochs wrote to Weiss.

So far, the county has turned over to an outside collection agency $138,606 that NCH owes, Ochs said in a Sept. 14 email to county commissioners.

Weiss could not be reached for comment.

Anderson’s only local family member, grandson David Anderson, 30, of Goodland, described his grandfather as an active 80-year-old. David had cooked his grandfather’s dinners the last four nights of his life.

Paul Anderson frequently went fishing and played golf, family members said. He had just bought a new laptop to take classes in Naples.

“He had 10 years left in him, or at least he thought he did,” said Kathy Rauth, one of Paul Anderson’s four surviving children.

“Someone has to tell us what happened and why,” she said. “We’re not litigious people, but someone has to tell us what the hell happened. What if this was an 11-year-old or a 16-year-old hit by a car?”

“And to hear that it was a squabble over money between these two entities (EMS and NCH),” Rauth said. “Let’s get them to talk.”

NCH is not alone in owing money to the county; Physicians Regional Healthcare System owes $431,853 for ambulance service between its hospitals at Pine Ridge and Collier Boulevard, Ochs’ email told commissioners .

Physicians Regional paid invoices from January 2010 to June 2010 totaling $313,904, then stopped paying until August 2011 when it made two payments of $12,500, the email said.

Physicians Regional has not received a letter that the county would stop transports from one hospital to another, spokeswoman Taylor Hamilton said.

“Our leadership received a letter from the County last month expressing concerns related to intra-facility transports,” Taylor said in an email. “Since that time, we have spent many hours in productive conversations with the Collier County administrators and remain hopeful that a positive resolution is imminent.”

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Comments » 7

Northerner writes:

“Our leadership received a letter from the County last month expressing concerns related to intra-facility transports,” Taylor said in an email. “Since that time, we have spent many hours in productive conversations with the Collier County administrators and remain hopeful that a positive resolution is imminent.”

So how many more people will die while these "productive conversations" go on! Depending on the type of stroke, Mr. Anderson suffered (ischemic or hemorrhagic) he could have been a candidate for a clot busting agent that could have saved his life. Time is of the utmost importance, however. There is a 2-3hr window from the onset of symtoms for this drug to be administered for an ischemic stroke. I can't help but wonder why the doctor didn't do anything to get Mr. Anderson to the hospital ASAP?? And to you Mr. Rowe; you did ALL you could to help save your dear friend. You are the epitome of a true friend. My heart goes out to you and the Anderson family.

woods311 writes:

Mr. Rowe; you did ALL you could to help save your dear friend.

Without trying to minimize your loss, and grief, consider the possibility of a blessing.

An 80 year old who suffered a stroke, avoided sitting in a health care facility, for who knows how long, while his bank account is cleaned out.

There are worse things than dying.

Blessed be.

blondie writes:

A needless death is due to the question of who was responsable before 9 am when their work shift started and which responder should be sent. This whole affair needs a really close review, repremand those who where involved and solve this issue once and for all.

grunt writes:

I for one am incenced by what happened here. If we as a community let this go unpunished then we deserve what we get. I feel criminal charges should be brought against the NCH driver, the one that said “back off or I wouldn’t be taking anyone, anywhere.”

I have never hear anything more callious or irresponsible. This person should be immediately fired and put in jail. We can not have someone like this anywhere near our community. Secondly, the official from NCH should be brought up on charges for allowing an importance function be totally controlled by the dollar and be further ill managed by such blatant incompenancy.

RayNetherwood writes:

“She (the NCH driver) sashayed across the parking lot at 9:22 a.m … getting her snacks together,” Rowe recalled.

Rowe told the arriving driver his friend really needed her help. He was dying.

“She told me to back off or she wouldn’t be taking anyone, anywhere.”

If the above can be substantiated ... that's one driver that needs to be canned ... ASAP.

It's difficult to say whether Mr. Anderson would be alive even if he had been promptly popped in a buggy ..... to what, then be on life-support somewhere? Tough issues.

Northerner writes:

"It's difficult to say whether Mr. Anderson would be alive even if he had been promptly popped in a buggy ..... to what, then be on life-support somewhere? Tough issues.

MarcoBiker,
Perhaps had Mr. Anderson been given the chance to get medical attention, we would know the answer to that! Many people including the ederly have survived strokes and have lived productive lives long after.

RayNetherwood writes:

Uhhh, wasn't he at an urgent care center ... staffed??

After all the hand wringing, any lessons to be learned? Maybe.

1. Heart attack or stroke, getting someone, if conscious, to then slowly chew a 325 mg aspirin is probably a good idea .... (thoughts?)

2. Don't try to take a stroke or heart attack victim anywhere ... call 911. That's what they're there for.

3. The EMS service and medical facilities really need to sit down and address/resolve the billing issues.

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