Monica Yant Kinney: A bumpy ride with city EMS

Mary Gallagher and Don Dietrich had just fastened their seatbelts when fate postponed their vacation to Vieques. Mary noticed her husband fighting for his life.

"His eyes were like saucers, his face was white as a sheet, and he was gasping for air," said Gallagher, an anesthesiologist trained to recognize cardiac arrest. "I knew in an instant he was dying."

Thus began an odyssey that left the Pennsport couple grateful for modern medicine, but highly critical of the city's EMS system.

She lodged three alarming complaints in a letter to Fire Department officials and Mayor Nutter.

First, Gallagher said, paramedics insisted on taking Dietrich to a community hospital rather than the Hospital of the University of Pennsylvania, the region's top cardiac center.

Then, she said, the ambulance crew seemed to disregard the ABCs of advanced life support - "airway, breathing, circulation" - further endangering Dietrich's life.

Lastly, Gallagher accused paramedics of stealing $200 in cash from a dying man's pocket.

I'm most intrigued by the alleged theft, reminiscent of the 2001 scandal involving morgue workers stealing from corpses. Fire Commissioner Lloyd M. Ayers said such charges have been leveled before.

It was pure luck that the USAirways flight to San Juan hadn't taken off when Dietrich suffered his attack at 7:30 a.m. Jan. 31.

An EMT and two nurses on board performed basic life support on the 60-year-old computer consultant until EMS arrived.

Two male paramedics whisked Dietrich into the back of the ambulance, instructing Gallagher to sit in front by the driver.

"One of the paramedics insisted we go to Mercy Fitzgerald Hospital," said Gallagher, 57, "because it was closest." (Curiously, a Mapquest check showed minimal difference in travel time or mileage from the airport to HUP.)

Gallagher trained at HUP, which offers hypothermia treatment shown to double the rate of survival and brain recovery among patients suffering cardiac arrest, according to Benjamin Abella, the clinical research director of the hospital's Center for Resuscitation Science.

Frantic as she was, Gallagher also knew that some cities, including New York, require patients like Dietrich to be taken to cooling centers regardless of distance.

"I said, 'I want to go to HUP. I'm his wife and I'm a doctor.' "

The driver relented.

"I looked back several times," said Gallagher, "but it was hard to see everything. They didn't have an oxygen mask on him. They should have secured his airways and had means to breathe for him."

In a dangerous moment, Dietrich aspirated, inhaling his own vomit.

At HUP, the patient was sedated, intubated, and cooled. A stent opened up his clogged artery, letting blood flow resume to the heart.

After he'd been stabilized, a nurse had Gallagher collect his clothes, which had been cut off in the trauma room. Searching his pants, Gallagher couldn't find the $200 he withdrew the night before.

"I fold the bills over in the same direction and put them in my right front pants pocket," Dietrich explained later. "I've done that for about 50 years."

So where did the money go?

Gallagher acknowledged she had no proof to support her allegations, but insisted "there was absolutely no opportunity for anyone to steal from him on the plane."

And in the hospital?

"In a serious medical situation like that, nobody's thinking about rolling the victim," she contended. "Plus, they'd be stealing from him in front of 20 other people."

Gallagher might have written off the loss had a coworker not shared that a relative's ring disappeared on an EMS ride.

What finally set Gallagher off was getting a "rude, threatening" $655 EMS bill from the city. Dietrich was even charged $40 for oxygen his wife swore he never received.

The charges are serious and under investigation, said Ayers, who could not comment about the specific allegations.

"After all the letters we get about the good things paramedics do," he told me yesterday, "it's always disappointing to receive a letter like this."

Ayers couldn't remember the outcome of previous theft investigations, but said, "If they're founded, we always take action."

The fire chief called Gallagher. "He apologized for the treatment we received," she relayed. "He asked how my husband was doing."

Gallagher was happy to report that Dietrich is doing fine.