Major Incidents, Operations, Terrorism & Active Shooter

Training, Instinct & Careful Decision-Making Key to Active Shooter Response

Issue 9 and Volume 42.

On April 30, 2017, crews from the San Diego Fire Department (SDFD) and American Medical Response were dispatched to a shooting at an apartment complex in La Jolla, an upscale seaside community in San Diego not typically associated with violent crime.

Early citizen reports to dispatchers didn’t paint a clear picture of what crews would be called upon to manage: a hostile and dangerous active shooter incident at a poolside birthday party.

Active shooter incidents seem to have become the norm in the U.S. and other countries, occurring at soft targets such as a movie theatre in Aurora, Colo., an elementary school in Newtown, Conn., and this year’s shooting at the practice for the Congressional Baseball Game in Alexandria, Va.

SDFD and the San Diego Police Department (SDPD) have an active shooter policy and has been training for these types of incidents for several years. In addition, the San Diego fire and police departments utilize a state-of-the-art active shooter training center that allows fire, EMS and law enforcement to train side by side to ensure true on-scene coordination.


One of the shooting victims is transported by San Diego Fire Department EMTs and paramedics.
Video screenshot KFMB/CBS 8

‘The Scene Came to Us’

The La Jolla Crossroads apartment complex is a multibuilding, five-story development that spans several blocks and houses thousands. The pool party—celebrating one of the resident’s birthdays—had 40–50 people in attendance, but there was one stranger sitting at the pool who had evil intentions.

The birthday guest of honor walked over to the man, apologized if the party was too noisy, and invited him to join the party, offering food and drinks. The man thanked him, but declined.

Six minutes later, while still seated calmly in a poolside lounge chair, the stranger pulled out a weapon and began firing at the crowd. The birthday guest of honor was one of the first victims.

As the assailant shot at the crowd, he was on the phone with his ex-girlfriend, reportedly telling her that this was all her fault. Most of the event was caught on video from surrounding apartment balconies.

The first 9-1-1 calls were received in the SDPD communications center at 6:07 p.m., with callers reporting that two people had been shot. The callers provided no further details. Dispatchers and first responders initially thought it might be a murder-suicide or two combatants involved in a fight or domestic violence incident.


Smartphones captured images and video of the scene and also included images of the alleged assailant. Video screenshots KFMB/CBS 8

Police personnel as well as fire and EMS crews were rapidly dispatched, with fire/EMS crews told to stage a safe distance from the incident until cleared by on-scene police commanders to respond once they indicated it was secured.

SDFD paramedic Engine 35, staffed by Captain Jon Frichtel, EMT, engineer/paramedic Steve Asaro, EMT-P, firefighter/paramedic Ryan Ferguson, EMT-P, and firefighter Bryan Bujarski, EMT, were on the road, and closer to the incident than the assigned unit, so they asked to be assigned to the call.

As dispatched, the call fell into a category similar to a stand-by, allowing the crew to determine use of lights and siren. Frichtel felt that, even though they were just a short distance from the scene, they should respond with lights and siren.

Ferguson suggested a second paramedic unit be dispatched because of the nature of the event and the reported shooting of two individuals. Frichtel agreed and requested an additional ambulance. A seemingly small decision at the time, this choice ended up having a huge impact.

Engine 35 arrived within minutes and staged two blocks away from the address initially provided to them. However, due to a confused caller, the initial dispatch address was wrong, and unbeknownst to them, they were in direct line of sight to the incident.

The actual shooting occurred about two blocks from Engine 35’s staging location. Still unaware that they were at an active shooter incident, the crew began to realize that it was an unusual call when the security guard’s car pulled up and began unloading the partygoers.

The Crossroads security guard reacted instinctively by going into rescue mode and getting as many people as he could into his vehicle, speeding a safe distance away and dropping them off about 100 yards from Engine 35 so he could return to the scene. The security guard’s early, heroic actions undoubtedly saved lives.

“Six or seven people jumped out in swimsuits and it seemed like an Uber ride gone wrong,” Frichtel recalled.

Several of the partygoers started getting on their cellphones. At this point, Frichtel and his crew began to get uneasy about the situation. Firefighter Bujarski brought up SDPD’s tactical radio channel on the engine’s radio system and everything began to fall into place.

Just as they heard that it was an active shooter incident and SDPD was still looking for the gunman, the security guard returned with another carload of people.

This time, however, he did a high-speed U-turn, stopping directly in front of the engine and unloading the people who would become the first of the shooting victims. Bujarski noted, “The scene was brought to us.”

Frichtel confirmed to dispatch that the scene wasn’t secure and called for more resources. The first-in paramedic unit, Medic 41, arrived shortly thereafter in the same staging area as Engine 35.

SDFD Truck 35, the original apparatus assigned to the incident, was also monitoring the assigned police frequency and, upon hearing what was unfolding, placed their apparatus back on the call and began to respond. This decision got additional SDFD medical personnel to the scene very quickly.

The crew of Engine 35 worked rapidly to care for and load the three initial gunshot victims into Medic 41, which left the scene within minutes, taking engineer/paramedic Asaro with them to assist in the continuum of care for the three initial victims.

The closest trauma center to the incident scene, Scripps La Jolla Medical Center, was about two miles away. Ferguson quickly contacted medical command and alerted them that they would soon have three major traumas arriving at once, allowing the ED staff to prepare for the arrival of one patient with a significant chest wound, another with multiple wounds to extremities and the third with a gunshot wound to the arm.


San Diego Fire Department crewmembers who played key roles at the incident included (from left): Mike Culver, Javier Ucha Lassalle, Bryan Bujarski, Steve Asaro, Jon Frichtel and Ryan Ferguson.
Photo courtesy San Diego Fire Department

Rescue Group & Transport

As Scripps was being notified of their incoming patients, SDPD was able to engage and kill the shooter. They were greatly aided by the early overhead scan of the scene by the SDPD Airborne Law Enforcement (ABLE) helicopter crew, which precisely directed officers to the shooter’s location. The valiant work of the ABLE crew and the SDPD officers swarming the scene saved countless lives.

Once the shooter was neutralized, Truck 35 was cleared to move forward, enter the pool area and establish a rescue group.

Medic Rescue 9, staffed by Captain Brian Graddon, EMT-P, and firefighter paramedic Paul Maestas, EMT-P, arrived, and Ferguson and Bujarski from Engine 35 jumped into the ambulance and proceeded to the pool area to begin patient triage.

Upon their arrival, SDPD was performing CPR on the shooter. The gentleman who had kindly approached the shooter just before he began shooting was laying wounded behind a nearby planter. Two other victims were laying by the pool. An additional patient was laying on an area of grass outside the pool with a fractured arm he’d sustained while trying to escape the gunfire.

Firefighter paramedic Mike Culver, EMT-P, appropriately triaged the shooter as deceased, and instructed the police to cease CPR and move on to triage patients deemed capable of surviving.

Firefighter Javier Ucha Lassalle, EMT, and Bujarski began to apply tourniquets and pressure dressings while Culver applied QuikClot and chest seals to the most critical victim who had been alert and talking, but was gravely injured and decompensated quickly.

The two most serious victims were quickly moved to Medic Rescue 9 and sent to the next closest trauma center, Sharp Memorial Hospital. The entire triage and loading process took just three minutes.

In addition to the QuikClot and chest seals applied during triage, the most seriously injured patient received bilateral needle thoracostomy, high-flow oxygen and IV fluids en route.

The most critically wounded patient, Monique Clark, a 35-year-old mother of three, tragically died as a result of her injuries. The remaining patients were taken to Scripps Mercy Hospital and had good outcomes.

Additional resources arrived as all patients were treated and transported from the scene and the crowd of pool area occupants, witnesses, apartment residents and bystanders quickly grew to the hundreds—another logistical challenge that police investigators, patrol units and fire/EMS personnel had to contend with.

After-Action & Debriefing

After the incident, one of the victims, Thomas Blea, praised the first responders saying, “It’s a terrible experience that we went through. I was alone at one point and [the responders] comforted me. They didn’t just treat me like a patient.”

The crews involved gathered the night of the incident for a critical incident stress debriefing. All were affected by the death of Monique Clark.

After the debriefing and gathering the details on this large-scale event spread over multiple blocks, it was determined that a multitude of small decisions led to a very well-run incident response:

  • Engine 35 assigning themselves to the call due to their close location, and responding with lights and siren, allowed them to receive the initial patients from the security guard.
  • Requesting an additional medic unit early on led to two acute patients getting off scene quickly.
  • The decision to monitor the police tactical channel led to a much earlier and clearer understanding of the magnitude and ongoing threat of the event.
  • The crew’s early actions and rapid assessment and care facilitated getting the initial three victims off scene immediately.
  • Having Truck 35 continue to monitor the call after being cancelled, and realizing the need to respond, provided valuable resources to a rapidly evolving scene.
  • Frichtel’s decision to stop the crews from advancing into an unknown incident and confirming from the police when fire and EMS personnel were clear to enter the pool area, prevented any fire or medic crews from rushing in without proper PD clearance.
  • The quick triage decision to pronounce the CPR patient and redirect resources and care to the salvageable patients.

Conclusion

The response of the SDFD crews was a proactive one.

“Everyone did the kind of unique things that made a significant impact on this call,” Frichtel observed.

The years of training for active shooter incidents enabled the responding crews to instinctively react and snap all the pieces of the complex active shooter scene into place.

Frichtel summed up the actions of the crews best by noting, “Believe in your system and the people in your system. The people that were there did what they should’ve done. It was [successful because of] good decisions and good fundamentals.”