Firefighters who refused to enter a nursing home over COVID-19 concerns while a cardiac arrest victim was stricken inside drew fierce criticism from a city-commissioned report.
The patient died soon after. His family has filed a $100 million lawsuit against the city.
Nursing home staff called 911 when Joseph Angulo went into arrest inside Rialto Post Acute Care Center in Rialto, CA. But when firefighters arrived, they refused to go inside, claiming it was against state law. They asked staff to bring Angulo outside for them to treat, which staff did; as they pushed the gurney toward the exit, one staff member sat on top of the victim performing chest compressions.
A policeman who did go inside the facility told investigators that one of the firefighters told the staff they were already doing what the firefighters would have done had they entered. The policeman added that one of the paramedics told him that if the nursing staff did not appreciate what the firefighters were doing, “they should call their congressman.”
Angulo died at a nearby hospital shortly after the incident. Two of the firefighters were fired and a third suspended; all three are appealing their discipline, according to local media, which obtained the report with a public records request.
“Had the firefighters responded reasonably, they would have become aware that, among other issues, that fire dispatch was actively instructing staff at the (post-)acute-care facility to perform CPR on Angulo and wait for the paramedics to come to them, as was standard practice and reasonable,” said the report.
“The three subjects of the investigation clearly sought to minimize the level of concern and even panic expressed by the nursing facility staff by this incident. It appears extremely unlikely that they did not hear any of the staffs’ pleas for help or sense their panic and concern.”
Firefighters never prohibited from entering
The firefighters insisted they were following COVID-era protocols but the fire chief told a different story. The report said that “there can be no delay or unnecessary distractions in providing patient care and transport.”
“The fire personnel charged with that responsibility in this instance failed to provide reasonable and professional patient care — or even adequate customer service — to the patient and facility staff,” the report said. “Whether this was because they were frustrated with having to handle so many calls there previously, or whether they were just having a bad day, it was inappropriate and inexcusable.”
Rialto Fire Chief Brian Park told local media that local or state emergency medical service providers were never prohibited from entering skilled nursing facilities to provide care, especially for high-acuity patients or facilities needing assistance.
He added that by the time of the incident, many COVID-related mandates had been lifted, all prior to the omicron variant. Park said the August 2020 policy also directed all fire department personnel to wear personal protective equipment prior to entry into a licensed medical facility.
“The goal was to reduce cross-contamination during the extremely high percentage of low-acuity incidents; the goal was not to prevent personnel from entering to assist in high-acuity situations or when requested for aid,” Park said. “This direction was reinforced in departmental training, briefings, emails, and meetings. There was a continuous emphasis to take care of our patients, our community, and each other.”
The report said the Riverside County Fire Chiefs Association gathered a task force at the beginning of the pandemic to visit nursing homes to analyze their needs and help them determine appropriate responses for firefighters and paramedics. The taskforce and facilities agreed that, to limit exposure to COVID, only one paramedic should enter and assess the situation before sending in other personnel.
The Rialto Fire Department adopted the guidelines and shared them and its own drafted coronavirus protocol with all department personnel, according to the report.
“No policy or guidelines, either state or local, ever prohibited fire personnel from entering a skilled nursing facility to treat a patient due to Covid,” the report stated.
Attorneys for the three firefighters did not respond to a request for comment. Angulo’s daughter Bridgette Angulo, filed a $100 million wrongful death claim against the city in August.
