Sunday, July 23, 2000

Conflict strains rescue

Ill woman dies; family bitter at firefighter

By Robert Anglen
The Cincinnati Enquirer

Cathy Tubbs in 1998
        All her life, Cathy Tubbs wanted to be a writer. The story of her death depends on whom you believe.

        Her family tells it with scorn and agony: How Ms. Tubbs, struggling to breathe in her final hours, argued and pleaded with a Cincinnati firefighter to take her to the hospital. They say the stress of that confrontation hastened her death.

        Firefighters tell it with trained detachment: Ms. Tubbs did not appear in need of an ambulance, and they delayed only minutes before taking her to the hospital. They say there is no evidence the delay contributed to her death.

        But an internal fire department report obtained by the Enquirer found that Firefighter Steven Hoog, the officer in charge, did not act professionally, failed to “err on the side of mercy” and violated city policy when he declared a non-emergency.

        “Steve Hoog messed up,” says Capt. Darrell Stamm, who wrote the internal report. “I don't think that contributed to (Ms. Tubbs') death, but it made her family uncomfortable.”

(Craig Ruttle photo)
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        Whatever happened during those 15 minutes, the city's emergency response broke down. A family would lose a daughter and sister; a respected firefighter faces a disciplinary hearing and a stain on his six-year record.

        By all accounts, the events of Memorial Day, May 29, were an anomaly. The Cincinnati Fire Division responds to more than 70,000 emergency calls a year, transporting people to hospitals for maladies ranging from hangnails to headaches to severed limbs and gunshots.

        But records in the Tubbs case, and interviews with people involved, show that things can go wrong when judgments, emotion and adrenaline mix in a crisis.

        Dispatch logs state that at 2:49 p.m. a fire engine and rescue unit were sent to a house in East Walnut Hills where Ms. Tubbs, 44, was having trouble breathing. Four minutes later, the rescue unit was called off.

  Dispatch records show how emergency units responded May 29 to an East Walnut Hills residence, where Cathy Tubbs, who had a 13-year history of heart trouble, was having difficulty breathing:
2:49 p.m.: 911 call.
2:49 p.m.: Dispatcher radios Engine Co. 23 and Rescue Unit 14.
2:50 p.m.: Both engine and rescue unit signal they are en route. (Neither unit signals when it arrives on scene).
2:53 p.m.: Rescue 14 signals it is “available on radio,” meaning it has been called off the scene and can take other calls.
2:57 p.m.: Ambulance 23 is dispatched to the scene.
2:58 p.m.: Ambulance 23 signals it is en route.
2:59 p.m.: Ambulance 23 signals it has arrived on scene.
3:08 p.m.: Ambulance 23 signals it is en route to Bethesda North Hospital in Montgomery.
3:09 p.m.: Engine 23 signals it is “available on radio.”
3:30 p.m.: Ambulance 23 signals it has arrived at the hospital.
3:52 p.m.: Ambulance signals it is “available on radio.”
3:52 p.m.: Dispatcher notes the case is closed.
        Four more minutes passed, and another unit was called to the house. At 3:08 p.m., 15 minutes after the first rescue unit was called off, Ms. Tubbs was transported to Bethesda North Hospital, where she died six hours later. Cause of death was cardiac arrhythmia, an irregular heartbeat, the death certificate says.

        Ms. Tubbs' mother says that before the ambulance left, she found herself on her knees, begging for help.

        “That man told me it wasn't an emergency and they weren't going to take her to the hospital,” Janie Samuel says. “My daughter was crying, "Mama, they don't want to touch me, they don't want to touch me.'”

        Suffering a heart condition that kept her dependent on oxygen, Ms. Tubbs was in an upstairs bedroom when firefighters arrived.

        They worked fast. Her vital signs — respirations 28, pulse 104, blood pressure 112/palp — were slightly elevated, not alarming. A pulse-oxygen reading couldn't be taken because Ms. Tubbs had on red nail polish and it fouled the finger-clip machine. But her breath sounded normal, and she was alert.

        With her mother and two of her sisters anxiously watching, Ms. Tubbs answered firefighters' questions. No, she didn't have any chest pain. Yes, she felt groggy and weak, had felt that way for five days. Yes, she wanted to go to the hospital.

        Suddenly, activity slowed. There were more questions, this time to the family. Mr. Hoog asked why Ms. Tubbs wasn't hooked up to a home oxygen unit in the bedroom. He suggested that family members could take her to the hospital in their own car.

        “He said, "We're not taking her, you're gonna have to,'” Ms. Samuel says. “She wasn't on the oxygen because we'd just picked her up and carried her to the bathroom. She needed help.”

        Ms. Samuel says she tried to explain that the 4-foot-long oxygen container was too big for the car.

        Tensions then mounted, the family and internal report say. Candice Tubbs, one of Cathy's eight siblings, shouted at the firefighters.

        “If we were white, there wouldn't be a problem,” she said, sparking an argument with Mr. Hoog that Cathy Tubbs' aunt could hear from downstairs. Cathy Tubbs began to cry.

        Sitting in her mother's living room two months later, Candice Tubbs is the one crying. She's angry, and so is her family.

        “This goes to prove that racism is alive and well in Cincinnati,” she says.

        Mr. Hoog, 35, is white. He declined repeated interview requests. But Capt. Stamm says there is no evidence that Mr. Hoog acted out of racial bias.

        Mr. Hoog denied to internal affairs officers that he refused to transport Ms. Tubbs. He said he only “suggested” that she was stable enough to be transported by her family.

        He also suggested that instead of taking the 20-minute drive to Bethesda North Hospital in Montgomery, where Ms. Tubbs' doctor practiced, that she be transported to a facility nearby.

        Mr. Hoog said Ms. Tubbs told him she didn't want to go to the hospital.

        Her mother says that's not entirely true, that her daughter was just trying to make peace between her family and firefighters — the same way she did in any conflict.

        “She said, "Forget it, Mama. Just go ahead and take me,'” Ms. Samuel says. “Of course she wanted to go to the hospital. She begged to go.”

        The internal affairs report makes no medical finding about possible complications of the delay. Firefighter Mark Greene, an attendant inside the ambulance, said Ms. Tubbs was able to talk and seemed to relax during the ride.

        “She was also oriented to person, place and time,” Mr. Greene told investigators.

        Capt. Stamm says he's convinced the delay did not contribute to Ms. Tubbs' death. But in his internal affairs report released July 12, he found that “several issues were improperly handled” by Mr. Hoog.

        Based on interviews with Candice Tubbs, Mr. Hoog and three other firefighters on the scene, Capt. Stamm found that Mr. Hoog:

        • “Did not behave in a professional and courteous manner during the incident” by becoming involved in “a verbal exchange of words with the patient's sister.”

        • Did not perform a proper assessment of Cathy Tubbs' condition before calling off the first rescue unit, and his documentation on the rescue report “was very vague.”

        • Hesitated before agreeing to transport Ms. Tubbs to the hospital. The Cincinnati Fire Division operations manual states that “the emergency is in the eyes of the caller.” It also says any time a firefighter uses “diagnostic skills to determine the extent or severity of a malady, we are required to err on the side of mercy and transport the patient.”

        The investigation was made after Ms. Tubbs' family complained. Because investigators determined the allegations had merit, Mr. Hoog is scheduled for a disciplinary hearing on Aug. 9.

        Mr. Hoog also has been called a hero.

        In 1996, he received a commendation for helping to rescue three adults, four children and a puppy from a burning building at 55 York St. After fire cut off escape to those on the second floor, firefighters used a straight ladder to reach a window and get residents out.

        Since he was hired in 1994, Mr. Hoog's personnel record has been unblemished. He has received “superior marks” on evaluations, never getting any score below “normal.” Last year, Fire Capt. Thomas Lakamp called Mr. Hoog “an excellent employee and an asset to the division.” His record has never been marred by charges of racism.

        Ms. Samuel, who at 61 runs two houses for the mentally ill, says she has called ambulances several times for those in her care. But this is the only time she'd called 911 for one of her children.

        “My one regret is all of this argument happened in front of (Cathy),” she says. “If this had happened on the first floor and not upstairs, Cathy wouldn't have been all stressed.

        “I don't know if my daughter would still be alive. But they put stress on her, and what that stress did, I don't know.”

        Adds Candice Tubbs: "I really do think stress killed her. I really do.”

        While Ms. Tubbs' official cause of death is listed as natural, her mother has yet to open the death certificate. To do so, she says, would make “everything too final.”

        In her living room, family and friends hold hands and talk of the things Cathy Tubbs wanted to do.

        Her sister, Crystal Ferguson, says Cathy had just been certified as a Hamilton County day-care provider. Her best friend, Cynthia Finley, talks about Ms. Tubbs' love of cooking and traveling.

        They say that at 4-foot-11 and 110 pounds, she was small but a big inspiration.

        Ms. Tubbs in turn, was inspired by her family and friends, and used them as models for fictional heroes.

        Her stories are about African-American families, sometimes funny, sometimes hauntingly poignant.

        “The way I see it is that you live a series of different lifetimes all in the same life span,” she wrote in the opening line of an untitled manuscript.

        The way her family sees it, she had a lot more lifetimes to live.



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