PHILADELPHIA -- Brenda Orr of Doylestown, Pa., was trapped in a burning bed, immobilized by multiple sclerosis, when she dialed 911 on Jan. 29.
Twenty-eight seconds passed before a Bucks County dispatcher answered Orr's call.
Then he put her on hold.
It took 26 more seconds for a second dispatcher to pick up.
"911. The bed is on fire," Orr, 53, yelled into her phone.
By then a minute had elapsed since Orr had first dialed. A half-minute later, she spoke her final words before the phone went dead.
"The bed is fully inflamed," she said.
Bucks County officials, acknowledging that Orr's call had been mishandled, announced yesterday that 11 dispatchers and four supervisors had been disciplined for their roles in dealing with it.
Orr died in the quick-moving house fire. While a faster response by the dispatchers would not have saved her, "mistakes were made, and for those mistakes we are truly sorry," said James F. Cawley, chairman of the Board of County Commissioners.
Under county regulations, the phone should have been answered within 10 seconds, and Orr should not have been placed on hold.
In a dispatch center where answering the phone is a basic duty, 10 unoccupied dispatchers sat by and let it ring. Orr's call finally was taken by a frustrated dispatcher who already was juggling an ambulance call.
"While the phone was ringing six times, there were 10 people on duty who were capable of answering the phone call who failed to do so," Cawley said. "That was wrong."
Had one of them answered, there would have been no need to put Orr on hold.
All 10 were disciplined, along with the dispatcher who, by taking the call, violated rules by trying to handle two calls at once.
"911. Can you hold one second please?" the dispatcher is heard saying to Orr on a recording of the call.
"I can't," Orr responds. "This is an emergency, 911 emergency. . . . Bed on fire."
The dispatcher then summoned another dispatcher, who did not get to the phone for 25 seconds. The second dispatcher, who had been occupied with receiving a fax, has not been disciplined.
Citing privacy concerns, Cawley would neither identify the disciplined workers nor specifically describe their punishments.
The first dispatcher had picked up the call "out of frustration," said Brent Wiggins, the county's director of emergency services. He said none of the 10 idle dispatchers could explain why the call was not answered right away.
"They were off-base. They weren't paying attention to their job. They were just not doing their job properly," Wiggins said. "That's the bottom line. . . . One or two said they thought someone else was going to pick up the phone."
Of four supervisors on duty, three had gone to a meeting -- on training fire dispatchers. That left just one to monitor the room. And that supervisor was "working on reports," according to the county's investigative summary. "No supervisor was actively monitoring the dispatch floor at the time of the call."
All four supervisors were disciplined.
The county's findings came after Doylestown Borough police reviewed the 911 call as part of their investigation into the fire. Alerted by police, borough officials demanded an explanation from the county.
Det Ansinn, president of the Borough Council, yesterday applauded county officials for investigating.
"We're encouraged by it," Ansinn said. "Our folks have been looking for a response to the issues raised by how the call was handled."
Police and firefighters arrived at Orr's house in better-than-average time, Cawley said. The first rescuers were there less than four minutes after Orr's call, but by then the fire was too intense for them to reach her.
Long afflicted by multiple sclerosis, she died of smoke and soot inhalation. Fire officials said it was impossible to determine the cause of the fire, though careless smoking and a jumble of electrical devices in her bedroom are among the suspects.
Orr's mother, Martha Orr of Doylestown, declined to comment yesterday.
Cawley called the mistakes an aberration among the 900,000 calls handled annually by county dispatchers.
Still, every dispatcher has been required to sit with a supervisor, listen to the tape of Orr's call, and discuss what happened. They were also played a tape in which a dispatcher gave "exemplary service" to a caller, Wiggins said.
Department policy now requires at least two supervisors to monitor the dispatch floor at all times. And a policy that implied that 911 calls were never to be put on hold has now been made explicit, he said.
County dispatchers are expected to relocate this summer to a modernized facility in Ivyland. One improvement of that center will be a phone system that automatically routes an incoming call to the dispatcher who has been idle for the longest time.
"There will be no more 'Who's going to answer this call?' " Wiggins said.
911 Call From 340 Doyle St.
0:00 (sound of dialing, followed by series of rings)
0:23 (seventh ring)
0:28 Male dispatcher: "911. Can you hold one second, please?"
0:29 Brenda Orr: "I can't. This is an emergency, 911 emergency. Three four zero Doyle. Bed on fire."
0:54 Female dispatcher: "Thanks for holding. 911. Where's your emergency?"
0:56 Orr: "911."
0:58 FD: "Hello?"
0:59 Orr: "911. The bed is on fire. Three four zero Doyle. Three four zero Doyle."
1:05 FD: "What township or borough are you in?"
1:07 Orr: "Three forty Doyle."
1:09 FD: "What township or borough are you in?"
1:10 Orr: "The borough."
1:11 FD: "What borough?"
1:12 Orr: "Doylestown!"
1:17 FD: "Are you still in the house?"
1:19 Orr: "What?"
1:20 FD: "Are you still in the house?"
1:22 Orr: "Yes."
1:23 FD: "All right. Well, you want to get out of the house?"
1:24 Orr: "No. I'm disabled."
1:31 Orr: "The bed is fully inflamed."
1:37 FD: "Ma'am, you still there?" (sounds of typing)
1:43 FD: "Hello?"
1:59 FD: (speaking to a coworker) "She won't get out of the house. She says she's disabled . . ."
2:09: Doylestown and Plumsteadville Fire Companies dispatched to scene.
(Phone line remains open with no conversation)
2:46 FD: (to a coworker) "The line's open, but I can't hear anything. I can hang up and try calling her back, right? ... I don't know if I should hang up or stay here and see if she comes back to me. It sounds like she was trying to put the fire out in the bed."
3:42: (call ends)
SOURCE: Recording made by Bucks County Emergency Services.
Listen to the 911 tape and read reports on the case at http://go.philly.com/brendaorrContact staff writer Larry King at 215-345-0446 or firstname.lastname@example.org.