Iowa man grateful for fire, EMS crews that assisted in on-site amputation
"They all saved my life," recounted Derek Oldfather, whose leg became trapped in a conveyor belt on a job site
Moline Dispatch and Rock Island Argus, Ill.
ELDRIDGE, Iowa — Derek Oldfather has a stump where his left leg used to be.
He is happy — and many say lucky — to be alive.
From his hospital bed in Iowa City, Oldfather recounted how he became trapped in a conveyor belt on Dec. 28. More people than he could count or remember helped him live through a horrifying four-hour ordeal that ended with an amputation in a sand-filled pit at King's Material in Eldridge, which supplies concrete, masonry and other landscaping products and services.
The 30-year-old is alive today because of the quick actions of co-workers, as well as the incredible effort of the Eldridge Fire Department, Eldridge Police officers, paramedics from Medic EMS, Scott County sheriff's deputies, AirCare Emergency Transport medical staff and a two-man surgical team from University of Iowa Hospitals & Clinics.
"I think about what all those people did for me," Oldfather said. "I think about how they all saved my life. I think about it everyday."
The day after he told his story, Oldfather was released from University of Iowa Hospitals & Clinics.
Thursday, Dec. 28, just after 1 p.m.
Oldfather had been working at King's Material for just a month or more.
"It wasn't my first time working there," he said. "I had worked there on a project about eight years ago. But that project was all outdoors. This time I was inside. And I spent a lot of time in the pits.
"That's what we call the spots where the trucks come in and dump. They dump rock in one pit, and sand in the other. I was down in the sand pit because the conveyor belt kept getting jammed up. I was going down and digging the belt free, so it would run."
Oldfather didn't mind his time in the pits. He spent most of Wednesday, Dec. 27, digging out the conveyor belt. When more digging was required the next day, he enlisted the help of a co-worker named Freddie.
It was just after 1 p.m. when Oldfather and Freddie descended three flights of stairs into the pit.
"We were down there, each of us on a different side of the belt, and I was explaining to him what we were doing," Oldfather said. "And that's when the toe of my boot got caught in the belt.
The conveyor belt pulled in his boot, then his ankle. He screamed out to Freddie, who grabbed him around his shoulders and tried to pull him free of the conveyor belt. But it was too strong.
"I remember thinking, 'I'm going to die' and then I told Freddie to go get help," he said.
Oldfather remembered something else happening in the moments his leg was being dragged into the middle of the conveyor belt and crushed.
"I don't know how to tell this, really, but there was a moment where I went completely calm, and I knew what I needed to do," he said. "I reached up and pulled the emergency string that is over the entire belt. That stopped the belt. Then I got on my radio and I screamed for help."
At the same time Oldfather was screaming for his life, Freddie ran the three flights of stairs that lead out of the pit and into the main floor. There he found Eddie the maintenance man, who just heard Oldfather's frantic plea on the radio.
Eddie called 911. It was 1:17 p.m. From there, he made his way to Oldfather.
"Eddie saw me, and he just burst out crying. But he helped me. He got it together and told me I would be OK," Oldfather said. "I felt all this warmth on my leg, and I realized it was blood. I realized I was going to bleed to death.
"I said to Eddie, 'I'm going to die down here, aren't I?' and he said, 'No.' And then I realized we needed to stop the blood. I asked him to put his belt around my leg, and that is what he did."
Freddie and Eddie were the first of many people to help save Oldfather's life that afternoon.
Thursday, Dec. 28, 1:17 p.m.
Seconds after Eddie made the 911 call from his cellphone, officers from the Eldridge Police Department, Scott County Sheriff's Department deputies, and firefighters from the Eldridge Fire Department were dispatched to King's Material, 3800 S. 1st St.
Oldfather had somehow remained conscious after his lower leg was dragged into the conveyor belt. He said he could lean up and look down at the bottom of his boot. He knew he was in big trouble.
What the first responders found at the scene was described by Chuck Gipson as, "something I don't think any of us had ever seen."
Gipson is a quality and education manager for Medic EMS. He is 48 years old, has spent 28 years as a paramedic and has served as Medic EMs's scene manager that day.
"You always think you've seen it all — then you haven't seen it all," Gipson said. "My job, once I got there, was to make sure the scene was safe for the first responders. We were essentially underground, so my job was to find out that the air was safe and there weren't any conditions that were going to endanger the police, firefighters or paramedics down there with the young man."
What struck Gipson was the level of coordination between the various agencies that responded to the 911 call.
"An Eldridge police officer immediately called in AirCare. The paramedics and firefighters were making the young man comfortable. They had placed multiple tourniquets to stop blood flow, and an IV was established," Gipson said. "We were able to talk with Oldfather. He was conscious, so that helped a lot. And then the Eldridge fire chief made an important call."
A chance connection
Chief Keith Schneckloth, 42, has been a part of the all-volunteer Eldridge Fire Department for two decades. He was working in Stockton, Iowa, when he heard the emergency call and an Eldridge police officer call for a helicopter transport.
"I knew something was up, and I made the decision to get to the scene," Schneckloth said. "When I got there, the patient had been stabilized; they had stopped the bleeding.
"The discussion, at that point, was disassembling the machine to free the patient. I asked everyone to step back for a second and regroup because when I looked at the scene, my first impression was that a medical procedure would be required to free the patient. Fairly quickly it was evident that a field amputation would be required."
After climbing the three flights out of the pit because he couldn't get cell phone reception, Schneckloth caught his breath and called Genesis Health System in Davenport. He spoke to some physicians he knew.
"They needed some pictures," Schneckloth said. "So we made another trip down the stairs and another trip back to send them. The discussion quickly turned to what they called the Med1 Surgical Team out of the University of Iowa Hospitals.
"The doctors at Genesis texted me a number, so I called it."
Schneckloth was connected to Dr. Azeemuddin Ahmed and Dr. Patrick McGonagill, the men who would amputate Oldfather's left leg below the knee at about 4 p.m.
Ahmed graduated from Pleasant Valley High School in 1992, specializes in emergency medicine and serves as a clinical professor in the University of Iowa Hospitals' Department of Emergency Medicine.
McGonagill is an acute-care physician and is a clinical associate professor at University of Iowa Hospitals & Clinics.
The two physicians were roughly 45 minutes from King's Material. While Oldfather and his rescuers waited, paramedics administered pain medication and did what they could to prepare for a field amputation.
Gipson marveled at how fortunate it was that Schneckloth called Genesis and the fact the doctors there knew about a mobile-surgical team out of University of Iowa Hospitals & Clinics.
"From the first responders, to making that call, to the surgical team that showed up, all of the things went right that day to save that young man's life," Gipson said. "A lot of trained people did their jobs and worked together.
"It was pretty amazing."
'I was in another world. I was in a cube'
Oldfather didn't feel the pain of being trapped in the conveyor belt until after the paramedics arrived.
"It seemed like only five minutes, maybe less, from the time Eddie came down until the paramedics and firemen got there," Oldfather said. "We had tried to get my leg loose before they got there and the pain was unbelievable.
"I started freaking out. I couldn't help it. I knew if I didn't get out from there, I was going to bleed out right there. I kept saying 'I'm going to die down here' and Eddie kept trying to tell me things would be OK."
The paramedics administered 25 cubic centimeters of fentanyl to try to ease his pain.
"They hit me with 25 cc's again," Oldfather said. "Then they were out of pain meds for the next 35 or 40 minutes. I started begging them to just cut me out of the belt. I just wanted out.
"Then they hit me with some ketamine. I went to another world. I thought I was in a cube. They alternated the ketamine with the fentanyl. I was really hallucinating."
At one point, he thought he was being carried up the stairs. He hallucinated that the paramedics had somehow freed his leg.
"When I was clear, I knew that leg was coming off," Oldfather said. "I'm pretty sure I was begging for them to just cut it off."
Oldfather saw Ahmed and McGonagill arrive.
"By that time, I think I was cracking jokes," Oldfather said. "I remember, I looked at one of those doctors (McGonagill) and thought I recognized him.
"I said, 'Dude, you're the guy who delivered my daughter.' He just tried to talk to me. The last thing I remember was they put a gas mask over my face. And the next thing I knew, I had a breathing tube down my throat and I was in the hospital."
No knights in shining armor
Ahmed and McGonagill were contacted separately around 2:30 p.m., informed about a man trapped in a conveyor belt and the need for a field amputation.
They immediately contacted each other, and by 2:50 p.m. they were on the road to King's Material. Ahmed and McGonagill rode in a vehicle fully equipped for emergencies like Oldfather's predicament.
As they made what amounted to a 40-minute drive, they talked about what they knew. And they stayed in contact with Schneckloth and the Medic EMS personnel at King's Material.
The doctors were briefed and ready. There was just one catch: While McGonagill had a sizable number of amputations under his belt, all of those procedures were performed in a clinical setting.
"I had never done an amputation in the field," McGonagill said. "The circumstances down in what amounted to a dark shaft were austere. The challenge is trying to keep things sterile, keep things clean. There was the challenge of space and access to instruments."
Despite the lack of in-the-field experience, the surgical team of Ahmed and McGonagill had been preparing for an on-site amputation for more than a year.
"We had actually sat down and talked about this exact scenario," McGonagill said. "And we were trained on these scenarios. We were prepared and ready."
Ahmed said he was impressed with the work done by Eldridge firefighters, Medic EMS paramedics and the medical staff from AirCare Emergency Transport. He and McGonagill found Oldfather had been saved by tourniquets applied to the leg. He had been stabilized.
"I cannot stress enough the work that was done before we even got there," Ahmed said. "All of the good work made it even possible for us to go in and do the amputation. The work really was first-rate. The AirCare people had even managed to put in a breathing tube when we got there."
Once they reached Oldfather, they had to find a way to further sedate him.
"The breathing tube was in, and we all worked together to make him comfortable," McGonagill said. "We had a fireman under the conveyor belt, squeezing a bag to help the patient breathe, and we had firefighters and EMS personnel using torches to light the area."
McGonagill needed between five and 10 minutes to remove Oldfather's left leg from below the knee.
"We cut down to the bone, then used a saw to get through the bone," McGonagill said. "That was quick. Then we had to control the bleeding by tying off blood vessels."
After clearing the surgical obstacles, there was one last mountain to climb.
"EMS and the firefighters had to get him up those stairs," Ahmed said. "That was an incredible effort. It was amazing. We weren't the knights in shining armor who rode in to save the day.
"The patient was saved because of the efforts of a lot of people. I know we keep saying this, but it is very true."
After eight days in Iowa City, where his left knee was removed, Oldfather was released from the hospital Friday and soon will begin rehabilitation.
"I'm ready," Oldfather said. "I was walking the floor at the hospital one day after my last surgery. I'm ready to get on with this."
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