Texas chief stands by medics in aftermath of head-on

By Brian Chasnoff
San Antonio Express-News

SAN ANTONIO, Texas — Four paramedics who responded to a head-on collision over the weekend did not treat a critically injured victim in a car that police said was struck by a drunken driver, Fire Chief Charles Hood said Monday.

Instead, the paramedics, working to "save the most savable victims," he said, took two others who'd been in the Honda Accord to Brooke Army Medical Center, leaving Erica Smith — alive, suffering from a head injury and in critical condition — inside the car, covered with a yellow tarp.

Officials believed that she was dead. However, she clung to life until 2 p.m. Monday.

About two hours passed from the time the wreck had occurred before a second wave of paramedics returned to the scene at Loop 410 near Rigsby Road to treat her, according to a police report. A medical examiner's investigator had been called to the scene to examine the body and noticed that Smith was breathing.

Standing before news cameras Monday, Hood spoke mostly in generalities, citing confidentiality laws he said prevented him from providing details about the incident that outraged at least one of Smith's relatives. Declining to clarify how the paramedics determined Smith's condition, he said paramedics generally check for vital signs, which can be compromised in cold weather.

The low temperature Sunday — the wreck occurred just before 4 a.m. — was 29 degrees.

"The paramedics, when they were doing their job, they didn't think they were missing anything," Hood said.

But according to a police officer familiar with the incident, police told paramedics at least twice that the woman was still breathing.

"They kept telling everybody, 'No, she's not. ... She'll die in a few minutes,"' said the officer, who requested anonymity because he is not authorized to speak about the case.

Smith, a 23-year-old senior at Texas State University, was at BAMC on Monday, where she died at about 2 p.m., according to the Bexar County medical examiner's office.

Kimberly McGuire, a cousin of Smith's, characterized the incident as a severe mistake.

"It is unfathomable to me that my little cousin sat, bleeding, under a tarp and in the cold while receiving no medical attention," McGuire wrote in an e-mail. "I can't help but wonder if her injuries would be less severe had she received the prompt medical treatment she deserved."

Emergency medical personnel often cite the "golden hour," the 60 minutes between a person's critical injury and the moment before the body begins to shut down. A nonfiction television show on Discovery Health Channel, "The Critical Hour," documents such cases, showcasing the fast-action pace of medical attention in the first hour after a severe injury and the chances of survival as the minutes tick on.

Hood, who became fire chief in April, said he visited Smith's family at BAMC for half an hour Monday to express his sympathy.

"It was difficult, man. I was in tears," Hood said. "You can't describe the amount of grief in there."

Yet Hood would not accept responsibility on behalf of Emergency Medical Services, a branch of the Fire Department, for the apparent mistake. He said the incident is under review and the paramedics involved are expected to return to work Wednesday for their regular shifts. He said the review's findings likely would remain confidential in accord with current law.

"I don't foresee any discipline for (the paramedics)," Hood said, adding, "There's nothing to apologize for. We weren't driving the vehicle that hit the car."

The driver of the other vehicle, Jenny Ann Ybarra, 28, was charged with intoxication assault in the wreck and released Sunday from Bexar County Jail after posting $5,000 bond.

Police said Ybarra's gray Pontiac GS veered into an oncoming lane on Loop 410, striking the Honda Accord. Sabrina Shaner, 22, the Accord's driver, and back-seat passenger Amber Wilson, 22, suffered serious but non-life-threatening injuries.

All three people in the Accord were taken to BAMC. Police had said Smith was in critical condition Sunday afternoon.

Timeline of response and medical care at crash scene:

--3:50 a.m.: First wave of paramedics notified of the wreck

--4:29 a.m.: Medical examiner called to the scene

--5:14 a.m.: Medical examiner arrives at the scene

--5:55 a.m.: Second wave of paramedics arrives at the scene

--6:17 a.m.: Officers leave the scene