The 7 minute 15 second 911 call is horrifying in its apparent callousness.

Updated March 5, 8:44 pm

You can listen to the entire call here

The 7 minute 15 second 911 call is horrifying in its apparent callousness. Updated March 5, 8:44 pm You can listen to the entire call here

    It transpires like this:

  • An 87 year old independent living resident at Glenwood Gardens in Bakersfield, California collapses in the dining room.  Someone, by the name of Anna calls 911.
  •  A  care supervisor is also summoned (and was assumed to be a nurse in earlier news reports.
  •  The 911 dispatcher walks the caller through an initial assessment and about ½ through the tape a care supervisor, Colleen, takes charge.
  • The dispatcher has the care supervisor check the resident’s pulse and respiration rate.  The care supervisor reports the pulse as weak and respiration rate of around 5 per minute.
  • The dispatcher implores the care supervisor to start CPR.  The care supervisor refuses, saying it is against the policy of the senior housing community to do CPR.  The dispatcher implores her to find someone else to do it.  It sounds as if the “manager” of that building confirms she is not to start CPR.
  • First responders arrive and the call ends.
  • A short time later the woman is transported to the hospital where she dies.

Some additional “facts”:

  • The senior community did not have on file a Do Not Resuscitate”  order which would be likely the case in most independent living senior communities.
  • According to the executive director at Glenwood Gardens the policies, procedures and admission agreement says states they will call 911 in the event of an emergency (unlike for the assisted living and skilled nursing components on the same campus.)
  • The 911 dispatcher does say the EMS system will take all the legal responsibility for performing CPR.
  • The daughter of the woman who collapsed and died apparently has not complaints with how the situation was handled.  In fact, she has come out strongly supporting the senior communities decision.
  • Politicians, the public  and elderly advocates are screaming for action.
  • Glenwood Gardens has at last count close to 150 ratings on Yelp, most hateful and negative.

But  .  .  . After listening to the entire call, I find myself wondering how the care supervisor could refuse to do CPR and how apparently someone above her would confirm she should not do CPR.   I am quite sure I would have started CPR if I had been there.  Upon further reflection and an understanding that what happened was in accordance with the resident’s and family’s wishes, I am less certain I would have instituted CPR.  And yet, I don’t think it is quite as simple as it is being portrayed.  Here are some things to think about:

  • The survival rate for someone in that situation even is CPR is very poor (not in and of itself a good reason to not do CPR).
  • If the care supervisor or someone who worked for Glenwood Gardens had begun CPR and the woman had survived needing significant medical intervention, would the community have been on the hook for the cost of that care.  I seriously doubt the EMS system would own that liability.
  • While slightly different circumstances, just this week, my father-in-law is moving is being moved from an acute hospital, to skilled nursing, he his wife and my wife were very careful to make sure he has DNR orders in place.  The outrage would be for someone to do CPR on him if he were to stop breathing.  He is ready and wants to die.
  • Perhaps the worst thing the community did was to summon a nurse creating a potential conflict.
  • I find myself puzzled at why city EMS officials released this inflammatory tape to the public.  I wonder if they have created their own liabilities for the damages this senior community will suffer from the release of this tape.
  • This one is touchy to even bring up, but I find myself wondering about the culture on that particular community where perhaps policy has become more important than the residents . . . . but again maybe there is more to it than that.

To see a good summary of the outrage: Glenwood Gardens CPR Case: Independent Living Home Defends Nurse Who Refused To Help Ailing Patient More balanced reporting here:

California woman denied CPR wanted no intervention, family says

For those of you in the trenches how do you see this?  What are the issues, where did it go wrong? How would you recover from this?   

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Finally: If you know anyone who is looking at emergency call systems I would appreciate the opportunity to talk with them about Vigil Health Solutions.