41% of state inspections result in ambulances being pulled from service

PROVIDENCE, R.I. (WPRI) – More than one-third of emergency vehicles that faced a state-mandated inspection have been pulled off the road for “critical deficiencies” since 2012, according to data reviewed by the Target 12 Investigators.

There are 515 emergency vehicles in Rhode Island, both public and private. Since 2012, the R.I. Department of Health (RIDOH) conducted 1,462 vehicle inspections, and of those 600 vehicles – or 41 percent – had at least one critical deficiency, for issues like missing equipment or expired medication, according to data from the agency. If a vehicle is found to have a critical deficiency during an inspection, it is immediately pulled from service until the issue is corrected.

Not all emergency vehicles – including ambulances and fire trucks equipped with medical equipment – were inspected during that time period, according to the data. The state has one full-time inspector on the payroll.

Many vehicles had more than one critical deficiency found during inspections. In the years of data reviewed by Target 12, the worst inspection report revealed nine critical deficiencies on a single vehicle.

“While the ambulance services check the equipment themselves, mostly on a daily basis, we provide that backup,” explained Jason Rhodes, the chief of emergency medical services for RIDOH.

“We’re most concerned about what we call critical deficiencies,” Rhodes added. “If you’re missing a critical medication or your cardiac monitor and or a defibrillator is not functional, you don’t have any oxygen on the truck, those are certainly considered to be critical deficiencies.”

The state’s lone inspector also checks for less serious problems.

“If you’re missing some gauze or some band-aids or something lower level, we’ll give you some time to correct that deficiency,” Rhodes said.

“Sometimes mistakes are made or dates are missed,” Rhodes said. “Those things can certainly happen, but I think the services are doing a much better job, especially on the critical side where we’re starting to see those trickle down.”

The rate of critical deficiencies is nowhere close to the Department of Health’s stated goal, which was to reach a critical deficiency rate of just five percent by 2014. Rhodes said he believes it is realistic to reach a five percent critical deficiency rate within a few years.

“We were aggressive in identifying that number,” Rhodes said. “We were hoping that the drop would be more precipitous than what it was. I think it’s a good goal moving forward.”

The path to a 5 percent 

Rhodes said increased spot inspections at hospitals are possible.

“In the past we’ve done some spot inspections, ensuring that all five-point restraints on the stretcher are secure,” Rhodes said. “We’ll look at specific things like that to make sure that the crews are doing what they’re supposed to be doing.”

Electronic self-reporting may also be on the horizon.

“We’re upgrading our system now, so we’re waiting for that checklist functionality to come into the new system from our vendor, and having the services self report more often to us,” Rhodes said. “That will also help us in the long run doing post-inspection.”

Ahead of the Curve

The Warwick Fire Department’s fleet has one of the best track records in the state. It’s led by Jason Umbenhauer, the city’s Chief of Emergency Medical Services.

“A big part of it is, this position exists in the Warwick Fire Department,” Umbenhauer said. “A lot of departments don’t think it’s serious enough where they have to hire someone full time.”

“It’s my job to make sure the equipment is there, the equipment is working correctly, that way when these trucks roll out and they go to save somebody’s life, something catastrophic doesn’t happen,” he added.

Crews in Warwick are also responsible to check each vehicle at the beginning of each shift.

“When they use a piece of equipment or equipment expires, they make sure they get it replaced immediately,” Umbenhauer said.

But he admits, even his fleet has had some minor blemishes on inspection reports.

“Once in a while a truck will come in that a light will go out that day and we didn’t obviously foresee that,” Umbenhaur said. “We’ve never had any critical deficiencies where a serious piece of equipment was either missing, broken, or expired.”

That’s the state’s ultimate goal for all emergency vehicles, both public and private.

“You never know when something is going to happen,” Rhodes said. “Stuff needs to be on the truck, it needs to be ready to go and you need to know how to use it.”

RIDOH does not levy fines for deficiencies, but there is a charge for re-inspections for private services that have four or more critical deficiencies, according to Rhodes.

Susan Campbell (scampbell@wpri.com) is the Call 12 for Action and Target 12 consumer investigator for WPRI 12 and Fox Providence. Follow her on Twitter and on Facebook.