Hillsborough asking why rescue captain stayed back as patient’s friends performed CPR

Paramedics from Hillsborough Fire Rescue Station 16 in Riverview were responding to a call about a man not breathing when they held back to await the arrival of law enforcement. The incident is under investigation. [JAMES BORCHUCK   |   Times]
Paramedics from Hillsborough Fire Rescue Station 16 in Riverview were responding to a call about a man not breathing when they held back to await the arrival of law enforcement. The incident is under investigation. [JAMES BORCHUCK | Times]
Published September 24 2018

TAMPA — It was almost 4 a.m. when the man’s friends found him unconscious in a Riverview home and called 911.

His breath was shallow and he was turning blue. With the 911 call-taker giving instructions, his friends performed CPR and waited.

Ten minutes passed, then 15, then 20.

"Where are these people? Where are they?" the friends pleaded with the voice on the other end of the phone.

They didn’t know Hillsborough County Fire Rescue paramedics were parked just a mile away.

Two fire department vehicles idled at a nearby street corner for 16 minutes because Capt. Joshua Tichenor decided it was unsafe for his crew to enter a neighborhood he believed was riddled with gangs and drugs. Tichenor wanted the Sheriff’s Office to secure the scene first.

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When paramedics finally did pull up to the house on Fawn Dale Drive, 28-year-old Tyler Craig Finch had been revived by deputies who took over CPR from his traumatized friends. Paramedics examined Finch but he refused a trip to the hospital.

Hillsborough County is now conducting an investigation that could result in Tichenor’s suspension, demotion or even dismissal. Fire department rules say first responders should only "stage" — the term for waiting close by an incident scene — when there is a hostile situation.

Officials say this was a medical call only and there was no grounds for Tichenor’s caution.

Another question about the response time is part of the investigation: Why did a medical assessment of the patient indicate the fire crew examined him within 11 minutes of the 911 call when evidence shows it took them 27 minutes to arrive?

• • •

The investigation comes after another Hillsborough case made headlines when four paramedics failed to take the vital signs of a stroke victim who later died. The county is still considering whether to fire the paramedics in that case.

During fact-finding meetings held by the county, Tichenor defended his actions.

He was wary about why a patient became unconscious at 4 a.m. and he wanted more details. But 911 dispatch failed to provide it, he said. He also had been told the Sheriff’s Office was responding, which raised concerns given his 25 years of experience working calls in Riverview. Some areas have poor street lighting.

When he asked dispatch if he should stage, he said he heard hesitation. Fire department rules advise staging when there is potential for hostilities, he noted, and it’s his responsibility to keep his crew safe.

"Four o’clock in the morning, 28-year-old people don’t just go unconscious," Tichenor told county human resources investigators. "We’re not trained and we don’t have protection to deal with violence of any kind."

Tichenor also said he had concerns that the 911 center is sometimes as much as 10 percent understaffed and doesn’t always distribute information quickly enough.

"A lot of times, you get to a call and they’re telling you to stage as you’re going into the doorway," he said. "It’s extremely unsettling."

The 911 call was placed at 3:51 a.m. on March 28, fire department records show. Finch’s friends found him unconscious and were unsure if he was breathing. It was coded by a 911 call-taker as "unknown problem, unconscious, fainting."

The 911 call-taker, identified only as Robbins, remained on the line for 22 fraught minutes, talking the friends through CPR.

On the way to the scene, Tichenor sought more details from fire dispatch. He was told there was "no need to stage at this time."

But at 4:01 a.m., he ordered the two vehicles responding — a fire truck and rescue vehicle — to park and wait at the corner of Balm Riverview and McMullen roads, in a semi-rural area of Riverview.

Rik Pardo, a fire dispatch official, let the Sheriff’s Office know.

"Our units decided to stage," Pardo told investigators. "I’m not sure why."

At 4:06 a.m., dispatchers told Tichenor the patient was receiving CPR. Tichenor stayed put, waiting for word that deputies had arrived.

At 4:13 a.m., Sgt. Bryan Morgan of the Sheriff’s Office called the fire department and asked why the rescue crew was waiting.

"We’ve got someone that needs medical assistance," Morgan said. "There could have been several minutes you could have been in there providing medical aid."

Eighteen minutes into the 911 call, the friends were still performing CPR and growing frantic and angry, suggesting they take the man to the hospital themselves, a transcript of the call shows.

"Did they drink their coffee and are they on their way here yet?" one friend said.

"You guys are keeping him going," the call-taker said. "I need you guys to stay calm and keep going with the CPR alright?"

The phone call finally ended when deputies arrived. Deputy Joe Conteh said the patient’s face was purple and his breathing was labored and shallow. Conteh administered CPR for five minutes until the patient gasped and sat upright.

Finch, the patient, was listed on Sheriff’s Office records as homeless. He could not be reached for comment.

• • •

The fire department investigation was launched in April after an inquiry from the Sheriff’s Office into the decisions made during the call.

County rules say an agency officer like Tichenor should stage when responding to call where there is a hostile scene or the potential of a hostile scene. Hostile is defined as assault, shooting, stabbing, domestic violence, traumatic suicide or a civil disturbance.

A disciplinary letter sent to Tichenor said the involvement of the Sheriff’s Office did not mean that the call was anything other than a routine medical run. Deputies are required to respond to 911 calls when the patient is not breathing.

Tichenor, who joined the fire department in 1996 and is paid about $93,500 a year, was scheduled to have a pre-disciplinary hearing last week but it was rescheduled. He is being represented by the International Association of Firefighters Local 2294.

Union President Derrik Ryan said he does not know why this case has prompted potential disciplinary action. Staging is a routine part of responding to 911 calls, Ryan said.

As to the discrepancy on the medical assessment time stamp, 11 minutes or 27 minutes to arrive, Tichenor was not the lead paramedic on the call so he was not responsible for the information, Ryan said. County officials said Tichenor signed off on the assessment. They believe the discrepancy was "human error."

No other fire department staff are facing discipline in the incident.

The union has frequently asked the county to formalize in department operating procedures the authority for crew captains to decide when to stage. The county has refused to do so, he said.

"Our officers need to have that final decision," Ryan said. "If my officers cannot self-stage ever, someone is going to get killed and then the responsibility will be directly on the county."

Contact Christopher O’Donnell at [email protected] or (813) 226-3446. Follow @codonnell_Times.