Emergency airlift to hospital goes awry due to miscommunications, lack of available ambulance

Baptist Health Medical Center in Little Rock in May (Credit: Arkansas Nonprofit News Network)

On Sunday, April 4, around 4:30 p.m., Little Rock 911 received an emergency call placed from the campus of Baptist Health Medical Center. The caller, Rowdie Adams, was a flight paramedic on a medevac helicopter transporting a patient to Baptist, the state's largest hospital.

Though the helicopter had landed in the hospital’s southeast parking lot — no more than a few hundred yards from the building — the crew could not get help transporting their patient inside.

“I need an ambulance to our location,” Adams told the 911 dispatcher (the Arkansas Nonprofit News Network obtained a recording of the call with a Freedom of Information Act request). “They are not able to come get us from the parking lot of the hospital, and I need a stretcher to get this patient to the hospital quickly, because we are running out of oxygen.”

The helicopter, operated by a service called Air Evac, had landed in the parking lot because the hospital’s sole helipad was occupied at the time by Baptist’s in-house helicopter, MedFlight. Though MedFlight is based at the hospital, the aircraft has been owned and operated since 2018 by a contractor, Air Methods.

The incoming flight contacted Air Methods’ dispatch service at least 15 minutes before it arrived, as required by protocol. Typically, Air Methods would then relocate its helicopter. This time, however, there was a miscommunication.

“Initial en route communications from Air Evac inquired if the ‘area was clear,’ ” Air Methods spokesman Doug Flanders said in an email. Air Methods’ dispatch service then verified the air space was clear for the approaching flight. But the dispatch service did not verify the helipad itself was clear.

“Unfortunately, the approaching aircraft intended [to ask], but did not specifically ask, if the landing pad was clear,” Flanders said.

With the pad occupied, the Air Evac crew chose to land in a designated “alternate landing zone” in the parking lot and await an ambulance. According to Baptist Health spokeswoman Cara Wade, a ground ambulance is usually required to transport patients the short distance from the helicopter to the building.

“Due to the clinical condition of most air ambulance patients,” Wade said, “our alternate landing site is not located in close enough proximity to the Emergency Department for the patient to be transferred by stretcher without ambulance transport.” Typically, she said, “an ambulance (MEMS) is called by the transferring helicopter service.”

MEMS, or Metropolitan Emergency Medical Services, serves Pulaski County and other parts of Central Arkansas. But on the afternoon of April 4, it too was unable to assist the anxious flight crew. When Adams explained the situation to a MEMS dispatcher, she was told there were no ambulances in the area immediately available.

“We’ve already got a call for it, and we’ve got somebody at destination at Baptist,” the dispatcher said, referring to a MEMS ambulance that was in the process of offloading a patient at the hospital emergency room.

“OK, I’m — ” Adams began to protest.

“Ma’am, we don’t have anybody else to send,” the dispatcher interrupted. “Everybody’s on emergencies, so we’ve got to wait for them to offload their patients.”

Mack Hutchison, the quality assurance manager for MEMS, said it was “very uncommon” for MEMS to not have an ambulance immediately available in the area at that time of day. “I think what the dispatcher was telling the medic from Air Evac was, ‘I’ve got one at Baptist. As soon as they unload, they’re coming to get you,’” he said.

“Her concern was, ‘Well, I’m running out of oxygen.’ Well, that’s not our problem. Poor planning on your part doesn’t cause an emergency on mine,” Hutchison said. (A spokesperson for Air Evac did not respond to a question regarding the amount of oxygen its flight was carrying on April 4.)

Still, the patient was stranded in the parking lot, and the minutes were ticking by. The Little Rock Fire Department eventually dispatched a truck to the location with “a bottle of O2” to assist a patient “in distress,” according to an incident report obtained by the Arkansas Nonprofit News Network. Wade confirmed the fire department was on hand, along with Baptist Health Security, “to assist with additional oxygen if needed.”

By that point, Air Methods, the Baptist helicopter operator, had gotten word that they needed to move their aircraft. “Only after it was determined that ground medical transport was not readily available was there a specific request to clear the air pad,” Flanders, the Air Methods spokesman, said.

Once the other helicopter lifted off, the Air Evac helicopter moved from the parking lot to the pad with its patient. The patient was unloaded and finally transferred to the care of Baptist, some 30 minutes after arriving at the hospital.

Around the same time, a MEMS ambulance finally became available and was dispatched, emergency records show. When it became clear the situation had been resolved, the trip was canceled, at 5:04 p.m.

MEMS’ goal is to be on the scene of 90% of life-threatening emergency calls within eight minutes and 59 seconds. In this case, records show, the call was taken at 4:38 p.m., but the ambulance was not en route until 22 minutes later.

Wade said the patient was admitted, treated and discharged from Baptist Health, but declined to provide any further information about the patient or the nature of his or her medical emergency.

Emergency communication records from the Arkansas Department of Health show that only one Air Evac flight arrived at Baptist between 2 p.m. and 6 p.m. on April 4. It departed from Howard Memorial Hospital in Nashville, Ark., at 3:48 p.m., embarking on a roughly 42-minute trip to Little Rock.

We are not aware of an event like this ever happening before, and are reviewing all procedures and protocols to ensure it doesn’t happen again. The safety and proper care of emergent patients is of our utmost importance,” Wade said.

Hutchison emphasized that MEMS had ambulances on hand at the time of the request on April 4 — just not within the service district that includes Baptist Health Medical Center. “We had them in Conway and Sheridan and Cabot and Sherwood and southwest Little Rock and North Little Rock. But by the time you run across districts, lights and siren, to that patient, you’re going to have the [ambulance] available there at Baptist unloaded,” he said.

Asked if MEMS has seen any recent increase in the number of delayed responses to emergency calls on a typical day, Hutchison said no. He added that demand for emergency services can fluctuate dramatically according to outside events, such as the winter storms that hit Arkansas in February. “If you look back at Snowmageddon, as we called it, and for a week we’re doing 511 calls in a day, there are some delays,” he said. Being maxed out in Little Rock on a Sunday afternoon in April, however, was “really weird,” he said.

Still, Hutchison acknowledged that emergency medical services everywhere are facing recruitment and retention challenges, made worse by the COVID-19 pandemic. 

“A lot of people leave the industry because of COVID: ‘I’m not doing this anymore — I’m not getting sick.’ So it’s a constant battle with staffing, just like nursing,” Hutchison said.

This story is courtesy of the Arkansas Nonprofit News Network, an independent, nonpartisan news project dedicated to producing journalism that matters to Arkansans.

The Arkansas Nonprofit News Network is an independent, nonpartisan news organization dedicated to producing journalism that matters to Arkansans. Our work is re-published by partner newsrooms across the state.