The RI Ambulance Services with the Most Health + Safety Violations
Thursday, May 21, 2015
Stephen Beale, GoLocalProv News Contributor
Just over 41 percent of ambulances and other emergency service vehicles in Rhode Island in 2014 had violations of state inspection standards, an improvement from a high point of 56 percent in the previous year but still falling far short of the Health Department’s goal of just 5 percent, according to data provided in response to a public records request.
Each year, the Rhode Island Department of Health conducts routine annual inspections of more than 300 ambulances and other emergency vehicles that provide emergency medical services. The inspections are necessary in order for the ambulances and other vehicles to remain licensed. Both municipally operated emergency medical services and private companies must undergo the inspections.
(UPDATE: The department released additional documents today in response to this report. See below for more information.)
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The inspections turn up two kinds of violations, technically known as deficiencies. Immediate failures result in the vehicle being taken out of service until they are fixed. An immediate failure would be something like the absence of a cardiac defibrillator or lack of oxygen cylinder.
None of the ambulance services listed in the data provided by the Health Department were noted as having any immediate failures.
However, most of them had the second type of deficiency, what are called ‘correctable failures.’ Ambulance services are given a certain period of time—up to 10 days—to fix those problems. The most serious of these have to be fixed immediately. The ambulance services with the highest average number of immediate deficiencies per vehicle are listed in the below slides.
Examples of immediate deficiencies would be the lack of blood pressure cuffs, cervical collars, or the wrong dosage of critical medication, such as epinephrine and glucose. Other less serious deficiencies run the gamut from mechanical problems to a light bulb that has burned out.
The service with the highest average of immediate deficiencies was the Ashaway Volunteer Fire Association, which had six of them on one of its fire trucks and five on another. Next highest was Lifestar Ambulance, which had five immediate deficiencies on one vehicle inspected. Third was the Pawtucket Fire Department, which had an average of 4.8 immediate deficiencies per vehicle, according to the data.
Emergency services weigh in on state inspection process
The state Department of Health has announced that it is ‘improving’ its inspection process with an eye towards reducing the number of immediate deficiencies.
Several local emergency medical service directors told GoLocalProv that they believed that the current system is fair. “They’re very professional in the way they handle things,” said Lance Dumont, the EMS director for the Pawtucket Fire Department. “They’re very fair.”
When asked about his inspection results, Dumont noted that he had not had any immediate failures—which would have resulted in one of his vehicles taken out of service. His own records show that there were three deficiencies, one of which was corrected so quickly it was crossed out in his own files.
Joe Baginski, the owner of Professional Ambulance, a private service in Providence, also said that he felt that he had been treated fairly by the state. He also noted that circumstances are different for private services as opposed to municipal ones. Private services, he said, have more of an incentive to comply because the future of their business is at stake.
“If I don’t comply, they’ll take my truck off the road,” Baginski said. “They can put me out of business.”
For ambulance services, the process is also a transparent one, Baginski added. It’s no secret what’s needed to pass the minimum requirements—they are published in a 34-page state inspection manual, which was also provided to GoLocalProv.
Even so, there are so many requirements that it can be difficult to keep track of everything, which might help explain while Baginski’s ambulance service still had a few immediate deficiencies that had to be corrected on its last inspection. Baginski gave the example of a burned out light bulb. His business has 17 ambulances with 100 light bulbs per vehicle. “I’ve got 1,700 light bulbs—it’s hard to stay on top of everything,” Baginski said.
In Cumberland, a local fire official offered a different explanation for why one of their ladder trucks had run up four immediate deficiencies during an inspection last year. Assistant Fire Chief Brian Jackvony told GoLocalProv that it was the first time the department had attempted to get the truck licensed as an emergency service vehicle with the Department of Health.
Health Department provides data, but withholds inspection reports
GoLocalProv requested an interview with Jason Rhodes, the chief of the EMS division at the Health Department but he was not available in time for publication, according to department spokeswoman Christina Batastini.
In its original public records request, GoLocalProv asked for copies of the actual inspection reports produced by the Department of Health. Those reports would list what the actual deficiencies are for each ambulance service.
For example, they would identify whether a particular ambulance service was cited for an immediate deficiency because it lacked the correct dosage of a vital medication, or because it was missing a piece of equipment.
The Health Department provided a list of all licensed ambulance vehicles and the number of deficiencies for each one. But it denied the request for the actual inspection reports, invoking an exception under the state public records law for investigatory reports of violations of state laws, rules, and regulations.
GoLocalProv has appealed that denial to the state Attorney General, contending that it is in the public’s interest to know the specific deficiencies for each ambulance and also arguing that by the department’s own admission, the reports are of inspections, not investigations, and concern deficiencies, not actual legal violations.
Yesterday, Lisa Pinsonneault, the Special Assistant Attorney General for the Open Government Unit, confirmed receipt of the appeal. She did not give a timeframe on when she would rule on the appeal. “Every case is different and this Department attempts to resolve each case as quickly as possible, but this Department’s overarching responsibility is to issue a finding that is legally and factually correct,” Pinsonneault wrote in an e-mail.
UPDATE: Department releases inspection reports
Late today, the Rhode Island Health Department released 194 pages of final inspection reports from 2013 and 2014 for local ambulance services. The inspection reports detail the exact nature of the deficiencies turned up by inspections of local ambulances services.
GoLocalProv’s request for the reports had been previously denied. The denial was appealed to the state’s Attorney General earlier this week, but, prior to the publication of this report, the department had continued to withhold the reports.
Late today, the legal counsel for the department informed GoLocalProv that the department had changed its position and decided that the reports could be made public. “We have deemed that the signed affidavit section within the inspection reports renders them final actions in regard to the ambulance inspections and thus are responsive to your APRA request,” wrote the legal counsel, Thomas Corrigan. (APRA is the Access to Public Records Act.)
The reports were provided in four PDF documents. Links to each one are provided below. They appear under the green banner for the slideshow at the bottom of this page. The reports appear to be loosely ordered in alphabetical order based on the name of the ambulance or emergency medical service.
Related Slideshow: RI Ambulance Service Violations
Below are the local ambulance and emergency medical services that had state Health Department inspection violations in 2014. Data was provided by the Health Department. Inspections are routine and conducted annually. They result in two main types of violations. An immediate failure results in an ambulance or other vehicle being taken out of service. The other type of violation is a correctable failure. Only correctable failures are listed below. Note: That means that although the below services had violations those violations should now have been fixed.
Correctable failures, also known as deficiencies, are divided into two categories. The most serious ones have to be fixed immediately. The others can be corrected within 24 hours to 10 days. Emergency medical services are listed by those that had the highest average number of serious correctable failures per vehicle, starting with the lowest average and ending with the highest.
To find out what the possible deficiencies are, click here to view the state ambulance inspection manual and scroll to page 12. A deficiency is a requirement that has not been met. Requirements vary according to the type of the vehicle. The formal vehicle types in each ambulance service are listed below in parentheses. (The options for vehicle types are: A-1 A-1A A-2 C-1 C-1A C-2.) Note that services that did not have immediate deficiencies are not listed below.
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48.
Coastline Emergency Medical Services
Inspection Dates: January, March, June, July, September, November 2014
Vehicle Type: Ambulance ( A-1, A-1A)
# Vehicles Inspected: 19
Average # of Serious Deficiencies: 0.16
Average # of Other Deficiencies: 0.53
Note: Averages are average number per vehicle.
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47.
Harrisville Fire Department
Inspection Dates: August 2014
Vehicle Type: Ambulance and Fire trucks (A-1, C-2)
# Vehicles Inspected: 4
Average # of Serious Deficiencies: 0.25
Average # of Other Deficiencies: 1.00
Note: Averages are average number per vehicle.
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46.
Warwick Fire Department
Inspection Dates: May, June, November 2014
Vehicle Type: Ambulance and Fire trucks (A-1, C-1, C-1A, C-2)
# Vehicles Inspected: 16
Average # of Serious Deficiencies: 0.25
Average # of Other Deficiencies: 1.94
Note: Averages are average number per vehicle.
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45.
North Kingstown Fire Department
Inspection Dates: August 2014
Vehicle Type: Ambulance (A-1)
# Vehicles Inspected: 4
Average # of Serious Deficiencies: 0.25
Average # of Other Deficiencies: 2.50
Note: Averages are average number per vehicle.
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44.
Med Tech Ambulance
Inspection Dates: All months except June and August 2014
Vehicle Type: Ambulance (A-1, A-1A)
# Vehicles Inspected: 23
Average # of Serious Deficiencies: 0.26
Average # of Other Deficiencies: 0.65
Note: Averages are average number per vehicle.
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43.
Professional Ambulance LLC
Inspection Dates: January, July, November, December 2014
Vehicle Type: Ambulance (A-1, A-1A)
# Vehicles Inspected: 11
Average # of Serious Deficiencies: 0.27
Average # of Other Deficiencies: 0.91
Note: Averages are average number per vehicle.
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42.
Access Ambulance
Inspection Dates: January, April, November 2014
Vehicle Type: Ambulance (A-1, A-1A)
# Vehicles Inspected: 7
Average # of Serious Deficiencies: 0.29
Average # of Other Deficiencies: 1.00
Note: Averages are average number per vehicle.
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41.
Alert Ambulance Service Inc.
Inspection Dates: January, February, October 2014
Vehicle Type: Ambulance (A-1A, A-2)
# Vehicles Inspected: 22
Average # of Serious Deficiencies: 0.32
Average # of Other Deficiencies: 1.41
Note: Averages are average number per vehicle.
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40.
West Greenwich Fire and Rescue
Inspection Dates: October 2014
Vehicle Type: Ambulance and Fire Trucks (A-1A, C-1A)
# Vehicles Inspected: 3
Average # of Serious Deficiencies: 0.33
Average # of Other Deficiencies: 0.33
Note: Averages are average number per vehicle.
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39.
Narragansett Fire Department
Inspection Dates: June 2014
Vehicle Type: Ambulance and Fire Truck (A-1, C-1)
# Vehicles Inspected: 6
Average # of Serious Deficiencies: 0.33
Average # of Other Deficiencies: 1.67
Note: Averages are average number per vehicle.
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38.
Westerly Ambulance Corps
Inspection Dates: August 2014
Vehicle Type: Ambulance and Fire Trucks (A-1, A-1A, C-1, C-2)
# Vehicles Inspected: 6
Average # of Serious Deficiencies: 0.33
Average # of Other Deficiencies: 1.17
Note: Averages are average number per vehicle.
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37.
Naval Station Fire Department
Inspection Dates: July 2014
Vehicle Type: Ambulance and Fire Truck ( A-1, C-2)
# Vehicles Inspected: 5
Average # of Serious Deficiencies: 0.40
Average # of Other Deficiencies: 0.20
Note: Averages are average number per vehicle.
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36.
Barrington Fire Department
Inspection Dates: December 2014
Vehicle Type: Ambulance and Fire Truck (A-1, C-1A, C-2)
# Vehicles Inspected: 7
Average # of Serious Deficiencies: 0.43
Average # of Other Deficiencies: 0.14
Note: Averages are average number per vehicle.
Photo courtesy of Barringtonfire.com
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34.
University of Rhode Island EMS
Inspection Dates: December 2014
Vehicle Type: Ambulance (A-2)
# Vehicles Inspected: 2
Average # of Serious Deficiencies: 0.50
Average # of Other Deficiencies: 0.50
Note: Averages are average number per vehicle.
Photo courtesy of uri.edu
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33.
RI USAR TF-1
Inspection Dates: August 2014
Vehicle Type: Fire Truck (C-1A)
# Vehicles Inspected: 2
Average # of Serious Deficiencies: 0.50
Average # of Other Deficiencies: 1.50
Note: Averages are average number per vehicle.
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32.
North Providence Fire Department
Inspection Dates: November 2014
Vehicle Type: Ambulance and Fire Truck (A-1, C-2)
# Vehicles Inspected: 7
Average # of Serious Deficiencies: 0.57
Average # of Other Deficiencies: 1.43
Note: Averages are average number per vehicle.
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31.
Johnston Fire Department
Inspection Dates: July, September 2014
Vehicle Type: Ambulance and Fire Trucks (A-1, C-1, C-1A, C-2)
# Vehicles Inspected: 13
Average # of Serious Deficiencies: 0.62
Average # of Other Deficiencies: 1.00
Note: Averages are average number per vehicle.
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30.
Coventry Fire District
Inspection Dates: June 2014
Vehicle Type: Ambulance (A-1)
# Vehicles Inspected: 3
Average # of Serious Deficiencies: 0.67
Average # of Other Deficiencies: 0.67
Note: Averages are average number per vehicle.
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29.
Woonsocket Fire Department
Inspection Dates: June, October, November 2014
Vehicle Type: Ambulance and Fire Truck (A-1, C-1A)
# Vehicles Inspected: 3
Average # of Serious Deficiencies: 0.67
Average # of Other Deficiencies: 0.67
Note: Averages are average number per vehicle.
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28.
Cumberland Rescue Service
Inspection Dates: September 2014
Vehicle Type: Ambulance and Fire Truck (A-2, C-2)
# Vehicles Inspected: 2
Average # of Serious Deficiencies: 1.00
Average # of Other Deficiencies: 1.00
Note: Averages are average number per vehicle.
Photo courtesy of Cumberland Rescue
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27.
Kingston Fire District
Inspection Dates: August 2014
Vehicle Type: Fire Truck (C-2)
# Vehicles Inspected: 3
Average # of Serious Deficiencies: 0.67
Average # of Other Deficiencies: 1.33
Note: Averages are average number per vehicle.
Photo Courtesy of Kingston Fire
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26.
West Warwick Fire Department
Inspection Dates: April 2014
Vehicle Type: Ambulance and Fire Truck (A-1, C-2)
# Vehicles Inspected: 11
Average # of Serious Deficiencies: 0.73
Average # of Other Deficiencies: 0.82
Note: Averages are average number per vehicle.
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25.
Newport Fire Department
Inspection Dates: August 2014
Vehicle Type: Ambulance and Fire Truck (A-1, C-1)
# Vehicles Inspected: 7
Average # of Serious Deficiencies: 0.86
Average # of Other Deficiencies: 1.86
Note: Averages are average number per vehicle.
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24.
Exeter Fire Department
Inspection Dates: June 2014
Vehicle Type: Ambulance (A-1 ALS & BLS)
# Vehicles Inspected: 1
Average # of Serious Deficiencies: 1.00
Average # of Other Deficiencies: 0.00
Note: Averages are average number per vehicle.
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23.
Cumberland Fire District
Inspection Dates: February 2014
Vehicle Type: Ambulance and Fire Truck (A-2, C-2)
# Vehicles Inspected: 2
Average # of Serious Deficiencies: 1.00
Average # of Other Deficiencies: 1.00
Note: Averages are average number per vehicle.
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22.
Providence College EMS
Inspection Dates: July 2014
Vehicle Type: Fire Truck C-2 (BLS No-transport)
# Vehicles Inspected: 1
Average # of Serious Deficiencies: 1.00
Average # of Other Deficiencies: 1.00
Note: Averages are average number per vehicle.
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21
South Kingstown EMS
Inspection Dates: June 2014
Vehicle Type: Ambulance and Fire Truck (A-1, A-1A, C-1, C-1A)
# Vehicles Inspected: 5
Average # of Serious Deficiencies: 1.00
Average # of Other Deficiencies: 1.00
Note: Averages are average number per vehicle.
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20.
Providence Fire Department
Inspection Dates: October 2014
Vehicle Type: Ambulance (A-1 ALS & BLS)
# Vehicles Inspected: 1
Average # of Serious Deficiencies: 1.00
Average # of Other Deficiencies: 3.00
Note: Averages are average number per vehicle.
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19.
Cranston Fire Department
Inspection Dates: January 2014
Vehicle Type: Ambulance and Fire Truck (A-1, C-2)
# Vehicles Inspected: 15
Average # of Serious Deficiencies: 1.40
Average # of Other Deficiencies: 1.13
Note: Averages are average number per vehicle.
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18.
Brewster Ambulance
Inspection Dates: March 2014
Vehicle Type: Ambulance (A-1A, A-2)
# Vehicles Inspected: 2
Average # of Serious Deficiencies: 1.50
Average # of Other Deficiencies: 1.50
Note: Averages are average number per vehicle.
Photo courtesy of Brewster Ambulance Service
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17.
Smithfield Fire Department
Inspection Dates: July 2014
Vehicle Type: Ambulance (A-1A)
# Vehicles Inspected: 3
Average # of Serious Deficiencies: 1.67
Average # of Other Deficiencies: 1.50
Note: Averages are average number per vehicle.
Photo courtesy of Smithfield Fire
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16.
Dunns Corner Fire Department
Inspection Dates: September 2014
Vehicle Type: Fire Truck (C-2 BLS No-transport)
# Vehicles Inspected: 1
Average # of Serious Deficiencies: 2.00
Average # of Other Deficiencies: 0.00
Note: Averages are average number per vehicle.
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15.
Salve Regina University EMA
Inspection Dates: April, September 2014
Vehicle Type: Fire Truck (C-2)
# Vehicles Inspected: 2
Average # of Serious Deficiencies: 2.00
Average # of Other Deficiencies: 0.50
Note: Averages are average number per vehicle.
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14.
Hope Jackson Fire Company
Inspection Dates: October 2014
Vehicle Type: Fire Truck and Ambulance (A-1, A-1A, C-2)
# Vehicles Inspected: 3
Average # of Serious Deficiencies: 2.00
Average # of Other Deficiencies: 1.33
Note: Averages are average number per vehicle.
Photo Courtesy of Hope Jackkson Fire
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13.
Blackstone Fire Department
Inspection Dates: November 2014
Vehicle Type: Ambulance (A-1 ALS & BLS)
# Vehicles Inspected: 1
Average # of Serious Deficiencies: 2.00
Average # of Other Deficiencies: 2.00
Note: Averages are average number per vehicle.
Photo courtesy of Town of Blackstone
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12.
Hope Valley Ambulance Squad
Inspection Dates: October 2014
Vehicle Type: Ambulance and Fire Truck A-1A, C-1A
# Vehicles Inspected: 4
Average # of Serious Deficiencies: 2.00
Average # of Other Deficiencies: 2.00
Note: Averages are average number per vehicle.
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11.
Eascare Ambulance Service
Inspection Dates: September 2014
Vehicle Type: Ambulance (A-1, A-2)
# Vehicles Inspected: 3
Average # of Serious Deficiencies: 2.00
Average # of Other Deficiencies: 2.67
Note: Averages are average number per vehicle.
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10.
East Providence Fire Department
Inspection Dates: March, May 2014
Vehicle Type: Ambulanc and Fire Truck (A-1, C-1A)
# Vehicles Inspected: 14
Average # of Serious Deficiencies: 2.14
Average # of Other Deficiencies: 1.64
Note: Averages are average number per vehicle.
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9.
Central Coventry Fire Department
Inspection Dates: November 2014
Vehicle Type: Ambulance (A-1, C-1, C-1A)
# Vehicles Inspected: 4
Average # of Serious Deficiencies: 2.50
Average # of Other Deficiencies: 1.75
Note: Averages are average number per vehicle.
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7.
Nasonville Fire Department
Inspection Dates: September 2014
Vehicle Type: Ambulance and Fire Truck (A-1A, C-2)
# Vehicles Inspected: 3
Average # of Serious Deficiencies: 2.67
Average # of Other Deficiencies: 2.00
Note: Averages are average number per vehicle.
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6.
New England Ambulance Service
Inspection Dates: May 2014
Vehicle Type: Ambulance (A-1, A-1A)
# Vehicles Inspected: 12
Average # of Serious Deficiencies: 3.58
Average # of Other Deficiencies: 3.92
Note: Averages are average number per vehicle.
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5.
Cumberland Fire Department
Inspection Dates: December 2014
Vehicle Type: Fire Truck (C-2 BLS No-transport)
# Vehicles Inspected: 1
Average # of Serious Deficiencies: 4.00
Average # of Other Deficiencies: 1.00
Note: Averages are average number per vehicle.
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4.
Pascoag Fire Department
Inspection Dates: July, September 2014
Vehicle Type: Ambulance and Fire Truck (A-1, C-2)
# Vehicles Inspected: 2
Average # of Serious Deficiencies: 4.00
Average # of Other Deficiencies: 1.00
Note: Averages are average number per vehicle.
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3.
Pawtucket Fire Department
Inspection Dates: August 2014
Vehicle Type: Ambulance and Fire Truck (A-1, C-2)
# Vehicles Inspected: 2
Average # of Serious Deficiencies: 4.00
Average # of Other Deficiencies: 1.00
Note: Averages are average number per vehicle.
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2.
Lifestar Ambulance
Inspection Date: April 2014
Vehicle Type: Ambulance (A-1A Reserve Only)
# Vehicles Inspected: 1
Average # of Serious Deficiencies: 5.00
Average # of Other Deficiencies: 3.00
Note: Averages are average number per vehicle.
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1.
Ashaway Volunteer Fire Association
Inspection Date: June 2014
Vehicle Type: Fire Truck (C-2)
# Vehicles Inspected: 2
Average # of Serious Deficiencies: 5.50
Average # of Other Deficiencies: 6.00
Note: Averages are average number per vehicle.
Photo Courtesy of Ashaway Fire
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