Halifax County Manager Tony Brown will ask state emergency management officials to investigate a concern registered by a Warren County man on response times in August.

Patrick Card’s 37-year-old son, Jeffrey, a sinus cancer patient, died while being transported to the hospital after unexpectedly hemorrhaging from his nose and mouth.

Although the Cards live in Warren County, Halifax EMS provides emergency medical response to one-fourth of Warren under a reimbursable contract agreement, Card explained.

Card noted observations by himself, his wife and neighbor on August 16, the day his son, just shortly before 4:45 p.m., began hemorrhaging. “My wife immediately called 911 and I attended to Jeffrey as this was clearly a life threatening situation,” he told the board of commissioners today. “Although the (Warren County Rescue Squad) at 672 Enterprise Church Road is less than 3 miles from our home, it took what seemed like an excessive amount of time for the paramedic to arrive.”
As they waited, three phone calls were made by Card’s wife, one to 911, another to a neighbor and one received from a Halifax County dispatcher several minutes after the initial 911 call. “I later learned that when the Warren County dispatcher received the initial 911 call, it took 1.5 minutes for the Halifax County dispatcher to receive the call. The rescue squad did not receive the call to respond until approximately 5 minutes from the initial call.”

Ten minutes after the initial 911 call, the ambulance arrived. “As the ambulance traveled up our street, there were no lights or sirens energized and the vehicle approached our house at a slow speed. My wife was standing on the front porch (and) motioned for the ambulance to hurry and they quickened the pace.”

When the paramedic got in the house, some 11 minutes later from the first 911 call, Jeffrey was on the bathroom floor and his father was standing over him trying to stop the bleeding by pinching his nose, instructions given by the dispatcher. “At this point, Jeffrey had been bleeding profusely from the nose for many minutes, he was vomiting blood and the bathroom floor was literally covered in blood.”

Card told the board the paramedic stood behind him for several minutes. “I asked him what he was waiting for and he replied, ‘a suction machine is coming.’ There was no sense of urgency in the paramedic’s actions and he appeared confused as to how he should address the situation.”

Card said the ambulance driver appeared to be panicked and went in the living room to make a call after three minutes on the scene. “I later learned the driver was arranging to have the Halifax County EMS supervisor meet the ambulance in route to the hospital. By this time I removed myself from the bathroom and told the paramedic to take over.

“I saw no attempt by the paramedic to determine the source of the bleeding or to figure out why suddenly the bleeding from his mouth and nose stopped.”

Card said EMS Supervisor Phil Ricks told him the paramedic decided to use load and go protocol. “When they placed Jeffrey on the gurney, he head was tilted back and he complained of not being able to breath.”

Card said he learned this was normal to keep the tongue from blocking the airway. “Although I am not a medical professional, it seems to me that the greatest threat to Jeffrey’s life at that point was the large volume of bleeding potentially entering the lungs.”

The exit from the house, Card noted, was casual, and a neighbor noted Jeffrey was turning blue. “The ambulance left our driveway approximately 9 minutes after arrival on scene. We noted that the ambulance was leaving at a normal speed and with no lights or siren. The last time I saw my son alive was when they loaded him into the back of the ambulance.”

In the ambulance, Card said his son said he needed to sit upright because he couldn’t breathe and collapsed as he was apparently attempting to get off the cot.

This was the first time, Card maintains, his son’s vital signs were taken. None were found and CPR was done. “The record shows that the only treatment provided by the (Warren County Rescue Squad) paramedic was to suction Jeffrey’s airway several times before he collapsed. Further, the ambulance experienced poor radio reception with Halifax Regional Medical Center so remote assistance was not available from HRMC.”

When Ricks met the ambulance at Highway 903 and Highway 158 he helped in the CPR effort, Card said. He also began an infusion in his son’s tibia which injects fluids directly into the bone marrow. “The EMS supervisor administered epinephrine. In Jeffrey’s case, his breathing stopped after significant blood loss and it was highly likely that much of the blood flowed into his lungs after the paramedic arrived and before the EMS supervisor was present. We will never know because there was no autopsy performed.”

The ambulance arrived 22 minutes after leaving the scene and Jeffrey died during the transport.

“I am deeply concerned about the timeliness of the emergency response and the quality of emergency medical care in this incident,” Card told commissioners. “Further, I am more concerned about other life threatening incidents involving future patients.”

County officials, Card said, told him appropriate care was administered. “The facts would suggest otherwise. I come here today with no malice in my heart for anyone nor I am seeking retribution for my loss. Nothing said or done will ever bring my son back. However, we have a clear opportunity for an independent entity to fully investigate the details of this incident, evaluate the extenuating circumstances of this incident and determine if further actions are necessary to save other patients’ lives during future life threatening situations.”