FULTON COUNTY, Ga. -- The Fulton County emergency call system has long been plagued by delays and errors such as the one that may have contributed to the death of a Johns Creek woman this month, the county's ambulance providers and some 911 users say.
Darlene Dukes died Aug. 2 from a blood clot in her lungs after waiting more than an hour for an ambulance. Dukes, a 39-year-old mother of two who worked for Verizon in Alpharetta, was to be buried Saturday in New York.
Fulton County operator Gina Conteh, a 12-year veteran of the Fulton 911 call center, was fired after officials discovered she sent an ambulance to Wells Street in southwest Atlanta instead of Wales Drive in Johns Creek.
Bob Fowler of Johns Creek, a retired volunteer firefighter, said he saw first-hand the effects of a mishandled Fulton County call two years ago. Fowler, who is trained in emergency medical response, said he called 911 on July 15, 2006, after seeing an SUV overturn in North Fulton. With no ambulance in sight, he said, he called twice more, each time specifying the accident location.
On his fourth call, after waiting 20 minutes for an emergency crew, he was told that the ambulance could not find the accident, he said. Emergency units were at the opposite entrance to a condominium complex.
Though it's unclear whether response time was a factor, both the driver and a passenger later died.
"No one's perfect," Fowler said. "But that's not about being perfect. That was about not listening."
A report furnished to Fulton County last July, by Rural/Metro Ambulance service, warned that "serious deficiencies" in the county's call-taking and dispatch system could lead to "potentially life-threatening delays." Rural/Metro is a private company that provides emergency medical service to all of Fulton County except the city of Atlanta.
The report, obtained by The Atlanta Journal-Constitution, describes 19 specific errors from January through July 7 last year, including a 50-minute delay in dispatching a call off Ga. 400 on Jan. 31, a radio operator not responding to calls multiple times --- once for more than nine minutes --- on the night of July 1, several "technical errors" that listed the wrong ambulances as in or out of service, and five "lost calls."
"We've known in the medical community that that dispatch center has been seriously under-performing for 10 years," Dr. Eric Ossmann, medical director for Grady Health System's ambulance service, said Wednesday. Grady's 911 ambulance calls went through the Fulton County center until last year.
Fulton officials would not comment directly on the report this week but county manager Zachary Williams has promised an outside audit of the county's 911 system. Williams said by e-mail Saturday that any information Rural/Metro could furnish "is appreciated" and "we will take their comments and observations seriously."
Both Williams and Alfred "Rocky" Moore, Fulton's 911 director, stressed Tuesday in a recorded statement that they believed the Dukes tragedy was an isolated incident.
A 'fragmented system'
Chris Person, of Mableton, who worked for Fulton County's 911 service from 2004 until 2006, said the same Fulton employees must take calls for fire, police, medical emergencies and monitor police radios, and they are often overwhelmed.
"I'm surprised this didn't happen long before now," he said.
County commissioner Lynne Riley, whose district includes Johns Creek, said she has asked for details of how emergency calls are handled in different parts of the county.
The "fragmented system" caused by the number of separate political jurisdictions in the county contributes to communications problems, according to the report.
Rural/Metro prepared the report in response to concerns about ambulance delays raised by Fulton commissioners. Rural/Metro Division General Manager Reg P. James III would not comment on the report last week.
Riley, the commissioner from North Fulton, recalled receiving the report, which was marked "confidential," but said the commission took no action in response.
In November, the commission voted to cut off county funds to ambulance service in incorporated areas, leaving patients, their insurance companies and the cities to pick up the entire tab.
A life-or-death situation
On Aug. 1, the day before Dukes made her 911 call, Alpharetta's emergency call center began an arrangement that put Rural/Metro dispatchers in its center to dispatch ambulances to Alpharetta, Milton and Johns Creek.
"The moment an Alpharetta 911 dispatcher logs in an emergency call, the Rural/Metro ambulance staff immediately receives the information," said Alpharetta police spokesman George Gordon.
But when the call comes into the Fulton center as Dukes' cellphone call did, the Fulton County operator must dial a 10-digit number to reach the dispatcher.
In Dukes' case, "there was a huge lapse of time from Fulton County to us," Gordon said. "We took immediate action when we got the call."
Grady Health System, which furnishes emergency ambulance service to Atlanta, opened its own call center inside Grady Memorial Hospital last year to take the Fulton 911 center out of its dispatch process.
The change in procedure "saves us a good three or four minutes in most cases," said James Bothwell, executive director of Grady's EMS and trauma service, "and three or four minutes can be the difference between life and death in some situations."
In both DeKalb and Gwinnett counties, ambulances are county-operated.
MetroAtlanta, a private ambulance service, provides emergencymedical response to unincorporated Cobb County and Marietta. Other cities in Cobb have their own arrangements.
"The less the call is handled, the less the response time and the less the margin of error," said Pete Quinones, president and CEO of MetroAtlanta.
Tom Wilson is familiar with that margin of error.
Wilson said his mother suffered from mistakes several months apart in 2006. Wilson and his brother each called Fulton's 911 center for an ambulance for their mother, who lives in North Fulton and had dislocated an artificial hip. Both times, Wilson said, they gave the address as Providence Road. Both times ambulances went to New Providence Road.
Wilson said the situation was not life-threatening but his mother was in pain.
"It doesn't leave me with a whole lot of confidence in the 911 system," he said.
AJC staff writers Chandler Brown and Rosalind Bentley contributed to this story.