The pace is rarely slow at emergency rooms in Los Angeles County during weekends. But it was heart-poundingly faster when Live Nation Entertainment's Hard Summer music festival came to town two weekends ago, with ambulances sending overdosing concertgoers from the county fairgrounds.
In all, 49 people were taken by ambulance to seven emergency rooms across the region. Two young women died.
At Pomona Valley Hospital Medical Center, Dr. Bradford Hardesty saw one man so combative that he had to be sedated to keep him safe, as well as the nurses and doctors. His heart rate was up to more than 200 beats per minute — double the normal rate. "It had taken multiple police officers to hold him down. It took almost five or six staff members here," Hardesty said.
Quite a few ravegoers came in with drug-induced seizures, Hardesty said. Some couldn't answer questions because they were so drugged.
What happened at the rave is generating debate about whether more can be done to keep those who attend these events safe. L.A. County supervisors are considering a temporary ban on raves on county property until an investigation into what happened is complete.
"We've seen this all around the nation ... in L.A., it popped up in Chicago, in San Francisco, in New York," said Dr. Marc Futernick, emergency services medical director at Dignity Health California Hospital Medical Center in downtown Los Angeles. "There's something about these events that leads to this rampant drug abuse ... and young adults are really getting hurt and paying the price."
Officials spent months planning for the Hard Summer festival, which brought in about 122,000 people for two days of dance music. Live Nation Entertainment said it set up two primary medical tents at the fairgrounds, paid for three emergency room doctors, 13 registered nurses and 63 emergency medical technicians, and even deployed drug-sniffing dogs. The company also hired 23 firefighters and 184 police officers and employed 950 people for private security.
Still, it was not enough.
The Pomona Valley hospital saw 28 patients in its 50-bed emergency room, according to Laurie Sepke, a registered nurse and the hospital's liaison with the fire department. "You have heat, you have a lot of energy drinks, alcohol, drugs that induce euphoria but also increase temperature, and heart rate and blood pressure," Sepke said.
Some rave patients come into hospitals comatose and requiring ventilatory support, said Futernick, the Dignity Health doctor. "Temperatures I've never seen with infections, only with this kind of drug abuse. Temperatures, literally, 107, 108, 109 degrees, the kind of temperatures that there's no other way to describe it other than it will melt your organs and do damage to your organs to the point you will die."
Dehydration can pose a problem. But so can drinking too much water, causing sodium levels to crash. That has triggered lengthy seizures that block oxygen to the brain, Futernick said.
The two deaths happened on the rave's first day, both from apparent overdoses. UCLA student Tracy Nguyen, 18, suffered a seizure and became pulseless. She was rushed to a hospital, where she was declared dead.
A couple of hours later, Cal State Channel Islands student Katie Dix, 19, went into respiratory and cardiac distress after witnesses saw her drinking alcohol and taking a drug orally. Doctors tried to resuscitate her for half an hour at the Pomona Valley hospital before she was declared dead.
Some big California venues, such as the Los Angeles Memorial Coliseum and the state-run Cow Palace near San Francisco, have stopped hosting raves. But they have continued elsewhere, including at the Los Angeles County fairgrounds.
"If the county wants to make money while people are dying and medically compromised ... they should come out and say it," said Dr. Philip Fagan Jr., emergency department director at Good Samaritan Hospital in Los Angeles.
Other types of music festivals don't pose as severe a problem, said Dr. Brian Johnston, chairman of the emergency medicine department at White Memorial Medical Center in Los Angeles. From raves, teens have come into his ER suffering heart attacks. "You don't see that from other events. This is a different animal. When they were doing them in the Coliseum, they had so many casualties that they hired their own ambulances to wait. They know it's going on."
There have been at least 20 drug-related deaths among people who went to raves nationwide run by Los Angeles-area companies since 2006, according to a Los Angeles Times review of coroner records and interviews.
Live Nation has been a big investor in electronic dance music festivals. In a filing with the U.S. Securities and Exchange Commission in 2013, Live Nation said it expected to roughly double its electronic dance music attendance that year from the previous year.