Date: 1/24/2009
By BRETT BARROUQUERE and WILL GRAVES
Associated Press Writers
LOUISVILLE, Ky. (AP) — Football players know them as “gassers” — sprints up and down the field to build stamina.
Sophomore Max Gilpin and his Pleasure Ridge Park teammates spent the tail end of a three-hour practice on a sweltering August day in Louisville running the drill that is a coaching staple across the country, hoping to impress enough to earn varsity playing time that fall.
They sprinted 12 times in what felt like 94-degree heat, sometimes with helmets and pads, as the coaches pushed them to go harder and harder. It was a drill like those on many high school football fields, until Gilpin, a 6-foot-2, 220-pound offensive lineman, collapsed to the turf just 15 minutes after a teammate went down.
Three days later, the 15-year-old Gilpin was dead from heat stroke, with authorities saying his body temperature was 107 degrees when he reached the hospital. Five months later, his first-year head coach David Jason Stinson is facing a reckless homicide charge, with a prosecutor saying the coach should have realized a player could get heat stroke in such broiling weather.
Harold Jarrard, whose grandson played on the offensive line, was there Aug. 20 and said coaches were shouting at the players, encouraging them to pick it up as practice wound down.
“It was just a normal day of practice,” he said. “They always run gassers at the end. It’s a daily activity. Nothing was different that day. I never heard anything out of the ordinary.
“You hear them being threatened every day, stuff like ‘If you don’t straighten up, you’re out of here.’ It was just regular,” he said.
Interviews with witnesses and a review of filings in a civil lawsuit brought by Gilpin’s parents against the coaching staff, including depositions, Stinson’s handwritten notes and weather logs filed with the school, shed some light on what happened that day.
For Brian Bale, who was watching his daughter play soccer on an adjacent field during most of football practice, the way coaches were yelling at players was “appalling,” he said in an e-mail to the school district two days later. Bale declined an interview request from The Associated Press on Friday.
But he wrote in the e-mail: “Those coaches thought that they were training young teenagers for the Navy SEALS team instead of a football team. I never once in the time I was there saw anyone offered a water break. I did, however, hear the coach say numerous times that all he needed was one person to say that they quit the team and all of the suffering and running and heat would be over.”
That’s exactly what Kim Englert’s son, David, did — quit that day.
David Englert said “Coach Stinson made the team run sprints until someone quit,” Gilpin’s mother, Michele Crockett, said in court filings.
Heat exposure deaths happen occasionally in football from the sandlot to the pros, the most famous example being Minnesota Vikings offensive lineman Korey Stringer in 2001. Lawsuits have been filed in many of those cases, but it doesn’t appear that a coach has ever been criminally charged.
Commonwealth’s Attorney Dave Stengel declined to say why he chose this case for a grand jury. Stinson, a technical teacher at the school who has been reassigned pending the outcome of the case, is scheduled to be arraigned on Monday.
His attorney, Alex Dathorne, did not return calls from The Associated Press on Friday.
Jarrard said Gilpin’s death weighed heavily on Stinson throughout the season as the Panthers finished with a 4-4 record. The coach brought Gilpin’s jersey to each game in tribute, though he made no changes to his team’s practice routine, according to his notes.
“He’s a real gentleman, he’s got kids of his own,” Jarrard said. “He lost a boy that day, too.”
Stinson is no stranger to hot August football training camps. The former high school and college offensive lineman played briefly with the NFL’s New York Giants. At the 1,900-student Pleasure Ridge Park, he spent three years as the offensive line coach before taking over the team in January 2008.
Stinson’s weather log showed a heat index of 94 degrees as practice started at 2:30 p.m. The index is a measure of how hot it feels based on temperature and humidity.
A small group watched the workout, including Gilpin’s father, Jeff Gilpin, who sat next to Jarrard for most of the final two hours of the session, according to Jarrard and court documents.
Practice began with players congregating in the locker room before moving on to weights and film review. They took the field at 3:45 p.m. The team went through a variety of stretches and drills for about an hour before being given three water breaks in a 30-minute period, the log shows.
Then at 5:30 p.m. came the gassers.
About a half-hour later, the first player collapsed, and Stinson sent him to a nearby tree for shade and treated him with water and ice packs, according to the coach’s notes.
Gilpin collapsed 15 minutes later, at about 6:10 p.m., as the rest of the team headed for the shade tree for an end-of-practice meeting.
Assistant coach Steve Deacon called 911 when Gilpin stopped responding to ice packs and water. In the call, made at 6:17 p.m., Deacon describes Gilpin as pale, with a “big rapid pulse.”
“Yes … he’s breathing … yeah … he’s going … kinda going in and out on us though,” Deacon said.
Christina Spiva, the mother of another Pleasure Ridge Park student, called Gilpin’s mother a few minutes later.
“You need to get here quick. He’s been down here for a while and I don’t think they are moving fast enough,” Spiva said.
Crockett arrived at the school at 6:27 p.m. and found her son limp, with bloodshot eyes staring straight ahead, an ice pack behind his neck and a hose spilling water over the pack. Two people were pumping his legs to “keep Max’s circulation going,” Crockett said. Crockett did not return calls to The Associated Press and a phone number found for Jeff Gilpin was not his.
Paramedics arrived about the same time and made an unsuccessful attempt at putting a tube down Max Gilpin’s throat before rushing him to the hospital, where he remained for three days before he died of septic shock, multiple organ failure and heat stroke. His teammate who collapsed was released several days later.
Gilpin was one of six heat-related deaths in high school and college athletics in 2008, said Dr. Frederick Mueller with the National Center for Catastrophic Injury Research at the University of North Carolina.
More than 120 athletes have died under similar circumstances since 1931.
Copyright 2009 The Associated Press.
Prosecutor: Ky. coach should have known heat risk
Date: 1/23/2009
By BRETT BARROUQUERE
Associated Press Writer
LOUISVILLE, Ky. (AP) — A high school football coach should have realized a player could collapse from heat stroke in the broiling weather during practice, a prosecutor said in announcing reckless homicide charges in a youth’s death.
A grand jury indicted David Jason Stinson on Thursday in the death of Max Gilpin, 15, a sophomore offensive lineman at Louisville’s Pleasure Ridge Park High School. It was Stinson’s first year as head coach when the player collapsed and had trouble breathing.
Heat exposure deaths happen occasionally in football from the sandlot to the pros, the most famous example being Minnesota Vikings offensive lineman Korey Stringer in 2001. Lawsuits have been filed in many of those cases, but no evidence can be found that a coach has ever been charged in the deaths.
The heat index, used to measure how hot it feels based on temperature and humidity, reached 94 degrees during the Aug. 20 practice. Gilpin’s temperature reached 107 degrees at the hospital, authorities said. He died three days later.
No autopsy was performed, but the coroner’s office said it appeared Gilpin died of complications from heat stroke.
From 1960 through 2007, there were 114 heat stroke cases in all levels of football that resulted in death, according to a report compiled by Dr. Frederick Mueller at the University of North Carolina for the American Football Coaches Association in February 2008.
He attributed 16 deaths to heat stroke from 2003 to 2007, and both cases in 2007 were in high school. A report on the past season wasn’t included, and Mueller did not return a call from The Associated Press on Thursday.
Assistant coach Steve Deacon called 911 and told a dispatcher that Gilpin was semiconscious and that his father was nearby, according to a transcript of the call.
“He’s just overheated … and we’ve got water on him … he’s responsive and he’s got a big rapid pulse but …” Deacon said.
In the background, someone is urging Gilpin: “Come on get them eyes open … keep them eyes open … there you go … get them eyes all the way up … get them eyes open … there you go.”
The reckless homicide charge means grand jurors didn’t find that Stinson’s actions were intentional or malicious, said Jefferson County Commonwealth’s Attorney Dave Stengel, but that “a reasonable man should have realized something like this could have occurred.”
The grand jury declined to hear Stinson testify, listening only to a Louisville Metro Police detective, Stengel said.
Gilpin’s parents sued Stinson and five assistant coaches in state court accusing them of negligence and “reckless disregard.” The five assistants were not charged in the indictment, and Stengel said they didn’t commit a crime.
Stinson’s attorney, Alex Dathorne, told The Associated Press that the coach maintains his innocence and looks forward to “bringing out the whole story.”
Stinson spent his first three years at Pleasure Ridge Park as an assistant football coach, before taking over last season and going 4-4. A school spokeswoman said he has been reassigned pending the outcome of the case. The school has been investigating but has not released results.
Stinson will surrender Monday at his arraignment and likely will remain free pending trial, Stengel said.
Attorneys representing Gilpin’s divorced parents, Michele Crockett and Jeff Gilpin, said in a statement that the school system and high school haven’t provided information on the player’s death to the family.
“But what we have learned about the coaches’ conduct at the football practice that led to Max’s collapse and death is inexcusable, as was the lack of urgency and the delay in seeking medical treatment after Max collapsed and never regained consciousness,” the statement from attorneys Todd Thompson and Mike Cooper said.
Copyright 2009 The Associated Press.
By BRETT BARROUQUERE
Associated Press Writer
LOUISVILLE, Ky. (AP) — A high school football coach should have realized a player could collapse from heat stroke in the broiling weather during practice, a prosecutor said in announcing reckless homicide charges in a youth’s death.
A grand jury indicted David Jason Stinson on Thursday in the death of Max Gilpin, 15, a sophomore offensive lineman at Louisville’s Pleasure Ridge Park High School. It was Stinson’s first year as head coach when the player collapsed and had trouble breathing.
Heat exposure deaths happen occasionally in football from the sandlot to the pros, the most famous example being Minnesota Vikings offensive lineman Korey Stringer in 2001. Lawsuits have been filed in many of those cases, but no evidence can be found that a coach has ever been charged in the deaths.
The heat index, used to measure how hot it feels based on temperature and humidity, reached 94 degrees during the Aug. 20 practice. Gilpin’s temperature reached 107 degrees at the hospital, authorities said. He died three days later.
No autopsy was performed, but the coroner’s office said it appeared Gilpin died of complications from heat stroke.
From 1960 through 2007, there were 114 heat stroke cases in all levels of football that resulted in death, according to a report compiled by Dr. Frederick Mueller at the University of North Carolina for the American Football Coaches Association in February 2008.
He attributed 16 deaths to heat stroke from 2003 to 2007, and both cases in 2007 were in high school. A report on the past season wasn’t included, and Mueller did not return a call from The Associated Press on Thursday.
Assistant coach Steve Deacon called 911 and told a dispatcher that Gilpin was semiconscious and that his father was nearby, according to a transcript of the call.
“He’s just overheated … and we’ve got water on him … he’s responsive and he’s got a big rapid pulse but …” Deacon said.
In the background, someone is urging Gilpin: “Come on get them eyes open … keep them eyes open … there you go … get them eyes all the way up … get them eyes open … there you go.”
The reckless homicide charge means grand jurors didn’t find that Stinson’s actions were intentional or malicious, said Jefferson County Commonwealth’s Attorney Dave Stengel, but that “a reasonable man should have realized something like this could have occurred.”
The grand jury declined to hear Stinson testify, listening only to a Louisville Metro Police detective, Stengel said.
Gilpin’s parents sued Stinson and five assistant coaches in state court accusing them of negligence and “reckless disregard.” The five assistants were not charged in the indictment, and Stengel said they didn’t commit a crime.
Stinson’s attorney, Alex Dathorne, told The Associated Press that the coach maintains his innocence and looks forward to “bringing out the whole story.”
Stinson spent his first three years at Pleasure Ridge Park as an assistant football coach, before taking over last season and going 4-4. A school spokeswoman said he has been reassigned pending the outcome of the case. The school has been investigating but has not released results.
Stinson will surrender Monday at his arraignment and likely will remain free pending trial, Stengel said.
Attorneys representing Gilpin’s divorced parents, Michele Crockett and Jeff Gilpin, said in a statement that the school system and high school haven’t provided information on the player’s death to the family.
“But what we have learned about the coaches’ conduct at the football practice that led to Max’s collapse and death is inexcusable, as was the lack of urgency and the delay in seeking medical treatment after Max collapsed and never regained consciousness,” the statement from attorneys Todd Thompson and Mike Cooper said.
Copyright 2009 The Associated Press.
Debris kills boy in stands at monster truck show
Date: 1/18/2009
TACOMA, Wash. (AP) — Debris flew into the grandstands at a monster truck show in Washington state, killing a 6-year-old boy and injuring another spectator, witnesses and city officials said Saturday.
A red truck came apart while doing doughnuts during the freestyle competition of Friday night’s Monster Jam show, the witnesses said. Debris from the truck flew 30 to 50 feet over a safety barrier into the stands.
“Parts were falling off and a piece flew up and hit a little boy,” Christine Moe told King Television of Seattle.
Police Officer Mark Fulghum said officers serving as security at the Tacoma Dome investigated the accident.
“At this point, there’s nothing to indicate that there’s anything criminal,” Fulghum told The Associated Press on Saturday night. “Right now it looks like a tragic accident.”
The Pierce County medical examiner’s office identified the boy killed as Sebastian Hizey of Puyallup.
The boy’s father, Jessie Hizey, issued a statement to KIRO-TV on Saturday that said his son was hit in the head by a Frisbee-sized piece of metal, weighing between 7 and 12 pounds.
“I cannot get the images” out of my head, the father said.
The man who was injured was taken to a hospital Friday night, but Robert McNair-Huff, community relations manager for the city, said the man’s identity was not available Saturday.
Some spectators told the TV station they had to throw cups off the stands to get the attention of medics. The show continued after the two were hurt, and many spectators left.
“They just kept going,” Moe said. “We grabbed our kids and just bee-lined out of there.”
Laurie Deranleau, 32, a nurse from Westport, told The News Tribune, “Everybody sitting around thought they should have dropped the show and gave the family some respect. Nobody was paying attention to the show.”
The Tacoma Dome was continuing with four Monster Jam shows on Saturday and Sunday.
McNair-Huff said the promoter, Feld Motor sports, promised more inspections of trucks in the show and that the truck involved in the accident would be withdrawn.
“All of us at Feld Motor Sports are saddened by the accident that occurred last night at the Monster Jam Show in Tacoma when two of our customers were seriously injured,” the Aurora, Ill., company said in a statement Saturday to the AP. “Feld Motor Sports is looking into this tragic accident as the safety of all our customers is our top priority and this type of incident has never happened before in the history of Monster Jam events.”
Copyright 2009 The Associated Press.
TACOMA, Wash. (AP) — Debris flew into the grandstands at a monster truck show in Washington state, killing a 6-year-old boy and injuring another spectator, witnesses and city officials said Saturday.
A red truck came apart while doing doughnuts during the freestyle competition of Friday night’s Monster Jam show, the witnesses said. Debris from the truck flew 30 to 50 feet over a safety barrier into the stands.
“Parts were falling off and a piece flew up and hit a little boy,” Christine Moe told King Television of Seattle.
Police Officer Mark Fulghum said officers serving as security at the Tacoma Dome investigated the accident.
“At this point, there’s nothing to indicate that there’s anything criminal,” Fulghum told The Associated Press on Saturday night. “Right now it looks like a tragic accident.”
The Pierce County medical examiner’s office identified the boy killed as Sebastian Hizey of Puyallup.
The boy’s father, Jessie Hizey, issued a statement to KIRO-TV on Saturday that said his son was hit in the head by a Frisbee-sized piece of metal, weighing between 7 and 12 pounds.
“I cannot get the images” out of my head, the father said.
The man who was injured was taken to a hospital Friday night, but Robert McNair-Huff, community relations manager for the city, said the man’s identity was not available Saturday.
Some spectators told the TV station they had to throw cups off the stands to get the attention of medics. The show continued after the two were hurt, and many spectators left.
“They just kept going,” Moe said. “We grabbed our kids and just bee-lined out of there.”
Laurie Deranleau, 32, a nurse from Westport, told The News Tribune, “Everybody sitting around thought they should have dropped the show and gave the family some respect. Nobody was paying attention to the show.”
The Tacoma Dome was continuing with four Monster Jam shows on Saturday and Sunday.
McNair-Huff said the promoter, Feld Motor sports, promised more inspections of trucks in the show and that the truck involved in the accident would be withdrawn.
“All of us at Feld Motor Sports are saddened by the accident that occurred last night at the Monster Jam Show in Tacoma when two of our customers were seriously injured,” the Aurora, Ill., company said in a statement Saturday to the AP. “Feld Motor Sports is looking into this tragic accident as the safety of all our customers is our top priority and this type of incident has never happened before in the history of Monster Jam events.”
Copyright 2009 The Associated Press.
Keeping home life-support up when power goes out
Date: 1/12/2009
By LAURAN NEERGAARD
AP Medical Writer
WASHINGTON (AP) — For many of the growing millions who depend on home medical equipment, a power outage goes way beyond the inconvenience most of us feel. It could be deadly.
It’s an issue that snuck up on emergency officials as better medical treatments over the past decade have helped more critically ill people not only survive but move out of nursing homes.
The Associated Press found emergency planners around the country struggling to find new ways to identify people at risk before the lights go out, to ensure they will have the aid they need to survive small outages or big ones.
How serious is the problem?
When ice downed electric lines in Epping, N.H., last month, police found 60-year-old Richard Lapoint dead, hooked to his powerless oxygen machine. The town’s rescue workers hadn’t known he was power-dependent.
A generator and stack of batteries couldn’t keep up with Gatlan Graham’s ventilator and other life-supporting equipment when Hurricane Ike knocked out power to his Houston home for 14 days in September. The family fled in search of electricity, spending more than $1,500 to keep the 17-year-old alive.
When Hurricane Gustav hit Louisiana, dozens of people with home oxygen machines in tow evacuated to government medical shelters, where surprised officials had to scramble to find enough old-fashioned oxygen tanks when back-up generators in Baton Rouge failed.
Utilities in every state operate “medical priority lists” designed to track who depends on power for life. But an AP survey found huge state-to-state variations that suggest only a fraction of patients know they could sign up. Illinois’ biggest utilities together report 10,000 patients on critical-care lists, for example. Neighboring Indiana’s biggest list carries just 2,000 names.
Even if patients did sign up, in large outages companies don’t have the ability to restore power to one home before another down the street. The lists may offer false hope.
“The power companies don’t get on the phone and dial 911 for their customers,” said Dr. David Prezant, chief medical officer for the New York City Fire Department, who is pushing for medical registries of the power-dependent. “When there’s a blackout, citywide, nationwide, we are really unprepared with any structured database, knowledge of who these people are and where they are.”
Registries are starting to form — from Benton County, Ark., to North Dakota, which begins a statewide Web-based registry this month.
A pilot project in northwest Ohio is giving cards to life-support users to hang in their windows during a flood or tornado, signaling to rescuers if they need help or are OK.
San Diego Gas & Electric says it recently met with each of its 700 known power-dependent customers to discuss emergency plans for outages, and offers advance warning when wildfires trigger rolling blackouts.
In contrast, this is the advice from Idaho’s Public Utilities Commission: “If someone has a power requirement for life and health, the individual is responsible for coming up with their own back-up plans.”
To help people prepare, the Food and Drug Administration this spring plans to issue the first checklist for device recipients to receive when leaving the hospital.
Emergency workers feel the clock ticking.
“It’s incumbent upon us over the next 4½ months, before we get into hurricane season again, to have a better plan than we had going into Ike,” said Terry Moore, Houston’s deputy emergency management coordinator.
Under consideration are mobile “charging stations” that could rotate through Houston neighborhoods for patients to recharge depleted batteries, or perhaps evacuating the power-dependent.
“This is a huge vulnerability,” added Dr. Lewis Rubinson of the University of Washington, who advises the government on disaster preparations and separately is preparing guidelines for emergency oxygen supplies. “This is something that patients should demand.”
___
It’s a growing population. Roughly 2 million people use home oxygen machines, mostly “concentrators” that make oxygen on the spot as long as electricity flows. Just a few years ago, oxygen-gas tanks that don’t require home electricity were the norm.
At least another 10,000 people breathe with home ventilators, and thousands more have implanted heart pumps called VADs, or ventricular assist devices.
There even are a few remaining users of those body-encasing iron lungs infamous from the polio era; Moore counts 19 in Houston-area homes. Last May, a Tennessee woman who spent nearly 60 years in an iron lung after childhood polio died when the power went out and her family couldn’t get an emergency generator working.
Millions more use other at-home equipment: dialysis machines, nebulizers, IV and nutrition pumps, CPAP breathing masks. But power failures bring the most immediate risk for users of ventilators, heart pumps and oxygen.
Ventilators and heart pumps have internal batteries that last 45 minutes to a few hours, time to put on longer-lasting batteries or get to help. Some portable oxygen concentrators can run on batteries for three hours or four hours or be plugged into a car adapter, but patients typically depend on oxygen suppliers to deliver old-fashioned tanks of the gas for emergency use.
No one knows how often a power outage means death for such patients. Typically, death certificates note just the underlying disease, said disabilities specialist Lex Frieden of the University of Texas at Houston, who tried to track down the power-dependent during Ike’s prolonged outage to see who needed help.
Back-ups sometimes fail even in short outages.
Last summer, 15-year-old Fernando Vargas died when a Boston power outage silenced his ventilator early one morning.
When the power went out in Carpentersville, Ill., the implanted pump powering Jack Bostwick’s heart stopped, too, a week after the 60-year-old’s optimistic discharge from the hospital in May 2007. The device’s internal emergency battery somehow had dislodged, apparently giving him no time to insert longer-lasting ones. His family asks why Bostwick, newly registered on the utility’s critical-care list, wasn’t warned about a planned outage for pole repair. The utility declined comment because of a pending lawsuit.
But long outages are the big threat because batteries don’t last and oxygen tanks need repeated refills.
“I thought I was prepared,” said Houston’s Kristin Graham. Before Hurricane Ike, she readied a generator, gasoline and rechargeable batteries that could run son Gatlan’s ventilator for six hours to nine hours on a charge, and his oxygen machine for another few hours.
But the outage lasted so long, Graham said: “We couldn’t afford to buy the highest-powered generator on the market. You can’t run that generator 24 hours. You run it a couple of hours, you let it rest a couple of hours. I could never get all the batteries recharged.”
Graham signed up for her utility’s priority list and Houston’s 211 emergency service, but said no one checked if she needed aid. Ultimately she loaded Gatlan, his medical equipment and his 4- and 8-year-old siblings into the family van and checked into a hotel room, first in a less hard-hit Houston area and later in cheaper Austin, to get electricity.
“I don’t know what people would do if they didn’t have a way to get out on their own,” she said. “No one cared this time if you were on a critical list. They couldn’t. It was too broad.”
_____
The 2003 Northeast blackout, the nation’s largest power failure, was a wake-up call for New York City’s Prezant. In a study published in the journal Critical Care Medicine, Prezant tracked citywide 911 calls plus emergency room visits at his own large hospital, Monte fiore Medical Center, during the nearly 29-hour blackout.
The falls and heart attacks doctors had expected didn’t materialize. But paramedics and the ER had a surge in patients with at-home oxygen, ventilators and other respiratory equipment who needed help or feared they soon would. Moreover, frail patients often were admitted to the hospital because doctors couldn’t be sure a power failure was the only problem, a huge expense fraught with the risk of medical errors, said Prezant, a lung specialist.
When it comes to oxygen, many home health-care companies “bend over backward” to race tanks to customers during power outages, noted Washington’s Rubinson. In fact, after Hurricane Katrina, the American Association for Home Care asked the government to designate oxygen providers as “first responders” for easier movement in disaster zones.
Medicare requires home oxygen suppliers to have customized emergency back-up plans for customers.
But if roads are impassable or the disaster’s too big, home oxygen may not be delivered.
Yet there are no overarching recommendations on how many back-up tanks patients should keep on hand. Nor is there agreement about home generators, which have their own risk — deadly carbon monoxide poisoning if operated wrong — and can’t always adequately power energy-hogging medical equipment. The FDA isn’t advising generators in its patient checklist due out this spring, and the disabled often can’t afford one.
But the AP survey found utilities frequently advise generators, such as Wisconsin utility We Energies, which also doesn’t keep a list of power-dependent customers.
“There’s a danger to keep the list and give a false hope you might be able to turn that power on sooner,” said company spokesman Brian Manthey. “We feel more comfortable telling people you need to have a back-up plan,” including generators or batteries.
Whatever a family’s back-up plan, Rubinson and Prezant stress that local emergency officials must know how many power-dependent patients they might have to rescue, and getting utilities and home-care companies to share customer lists is a good start.
That’s happening in northern Arizona. In Coconino County, home of Flagstaff, the emergency office gets a regularly updated medical-priority list from the state’s largest utility, and records GPS coordinates for those homes so they can be found fast.
“We probably don’t have 100 percent of everyone. There are people who slip through those cracks,” said emergency planner Sherrie Collins.
Federal patient-privacy rules limit sharing, cautioned Bill Desmarais, a co-owner of Home Care Specialists Inc. in Haverhill, Mass., which had about 800 oxygen-dependent customers using back-up tanks when last month’s Northeast ice storm cut power.
He does a home-safety assessment for new customers and offers a tank in advance, to keep for emergencies. Such tanks can be over 4 feet tall, weigh 80 pounds, “they’re green and they’re ugly,” Desmarais said. “A lot of people don’t like it as ornaments in their living room. … You can’t force them.”
Even the federal government was surprised by the demand during Hurricane Gustav, when nearly 1,400 people were housed in special medical shelters in Louisiana and Texas, 20 percent to 40 percent of whom required powered medical equipment. When generators failed in Baton Rouge shelters, an oxygen supplier hired to refill patients’ oxygen tanks couldn’t keep up with the unanticipated need.
“We had some nervous wringing of hands as some of the oxygen tanks started going down to low levels,” said Dr. Allen Dobbs, chief medical officer of the National Disaster Medical System — although enough eventually was found. “We have to have reliable contingency back-up plans for these folks.”
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
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©Attorney Gordon S. Johnson, Jr. 2009
By LAURAN NEERGAARD
AP Medical Writer
WASHINGTON (AP) — For many of the growing millions who depend on home medical equipment, a power outage goes way beyond the inconvenience most of us feel. It could be deadly.
It’s an issue that snuck up on emergency officials as better medical treatments over the past decade have helped more critically ill people not only survive but move out of nursing homes.
The Associated Press found emergency planners around the country struggling to find new ways to identify people at risk before the lights go out, to ensure they will have the aid they need to survive small outages or big ones.
How serious is the problem?
When ice downed electric lines in Epping, N.H., last month, police found 60-year-old Richard Lapoint dead, hooked to his powerless oxygen machine. The town’s rescue workers hadn’t known he was power-dependent.
A generator and stack of batteries couldn’t keep up with Gatlan Graham’s ventilator and other life-supporting equipment when Hurricane Ike knocked out power to his Houston home for 14 days in September. The family fled in search of electricity, spending more than $1,500 to keep the 17-year-old alive.
When Hurricane Gustav hit Louisiana, dozens of people with home oxygen machines in tow evacuated to government medical shelters, where surprised officials had to scramble to find enough old-fashioned oxygen tanks when back-up generators in Baton Rouge failed.
Utilities in every state operate “medical priority lists” designed to track who depends on power for life. But an AP survey found huge state-to-state variations that suggest only a fraction of patients know they could sign up. Illinois’ biggest utilities together report 10,000 patients on critical-care lists, for example. Neighboring Indiana’s biggest list carries just 2,000 names.
Even if patients did sign up, in large outages companies don’t have the ability to restore power to one home before another down the street. The lists may offer false hope.
“The power companies don’t get on the phone and dial 911 for their customers,” said Dr. David Prezant, chief medical officer for the New York City Fire Department, who is pushing for medical registries of the power-dependent. “When there’s a blackout, citywide, nationwide, we are really unprepared with any structured database, knowledge of who these people are and where they are.”
Registries are starting to form — from Benton County, Ark., to North Dakota, which begins a statewide Web-based registry this month.
A pilot project in northwest Ohio is giving cards to life-support users to hang in their windows during a flood or tornado, signaling to rescuers if they need help or are OK.
San Diego Gas & Electric says it recently met with each of its 700 known power-dependent customers to discuss emergency plans for outages, and offers advance warning when wildfires trigger rolling blackouts.
In contrast, this is the advice from Idaho’s Public Utilities Commission: “If someone has a power requirement for life and health, the individual is responsible for coming up with their own back-up plans.”
To help people prepare, the Food and Drug Administration this spring plans to issue the first checklist for device recipients to receive when leaving the hospital.
Emergency workers feel the clock ticking.
“It’s incumbent upon us over the next 4½ months, before we get into hurricane season again, to have a better plan than we had going into Ike,” said Terry Moore, Houston’s deputy emergency management coordinator.
Under consideration are mobile “charging stations” that could rotate through Houston neighborhoods for patients to recharge depleted batteries, or perhaps evacuating the power-dependent.
“This is a huge vulnerability,” added Dr. Lewis Rubinson of the University of Washington, who advises the government on disaster preparations and separately is preparing guidelines for emergency oxygen supplies. “This is something that patients should demand.”
___
It’s a growing population. Roughly 2 million people use home oxygen machines, mostly “concentrators” that make oxygen on the spot as long as electricity flows. Just a few years ago, oxygen-gas tanks that don’t require home electricity were the norm.
At least another 10,000 people breathe with home ventilators, and thousands more have implanted heart pumps called VADs, or ventricular assist devices.
There even are a few remaining users of those body-encasing iron lungs infamous from the polio era; Moore counts 19 in Houston-area homes. Last May, a Tennessee woman who spent nearly 60 years in an iron lung after childhood polio died when the power went out and her family couldn’t get an emergency generator working.
Millions more use other at-home equipment: dialysis machines, nebulizers, IV and nutrition pumps, CPAP breathing masks. But power failures bring the most immediate risk for users of ventilators, heart pumps and oxygen.
Ventilators and heart pumps have internal batteries that last 45 minutes to a few hours, time to put on longer-lasting batteries or get to help. Some portable oxygen concentrators can run on batteries for three hours or four hours or be plugged into a car adapter, but patients typically depend on oxygen suppliers to deliver old-fashioned tanks of the gas for emergency use.
No one knows how often a power outage means death for such patients. Typically, death certificates note just the underlying disease, said disabilities specialist Lex Frieden of the University of Texas at Houston, who tried to track down the power-dependent during Ike’s prolonged outage to see who needed help.
Back-ups sometimes fail even in short outages.
Last summer, 15-year-old Fernando Vargas died when a Boston power outage silenced his ventilator early one morning.
When the power went out in Carpentersville, Ill., the implanted pump powering Jack Bostwick’s heart stopped, too, a week after the 60-year-old’s optimistic discharge from the hospital in May 2007. The device’s internal emergency battery somehow had dislodged, apparently giving him no time to insert longer-lasting ones. His family asks why Bostwick, newly registered on the utility’s critical-care list, wasn’t warned about a planned outage for pole repair. The utility declined comment because of a pending lawsuit.
But long outages are the big threat because batteries don’t last and oxygen tanks need repeated refills.
“I thought I was prepared,” said Houston’s Kristin Graham. Before Hurricane Ike, she readied a generator, gasoline and rechargeable batteries that could run son Gatlan’s ventilator for six hours to nine hours on a charge, and his oxygen machine for another few hours.
But the outage lasted so long, Graham said: “We couldn’t afford to buy the highest-powered generator on the market. You can’t run that generator 24 hours. You run it a couple of hours, you let it rest a couple of hours. I could never get all the batteries recharged.”
Graham signed up for her utility’s priority list and Houston’s 211 emergency service, but said no one checked if she needed aid. Ultimately she loaded Gatlan, his medical equipment and his 4- and 8-year-old siblings into the family van and checked into a hotel room, first in a less hard-hit Houston area and later in cheaper Austin, to get electricity.
“I don’t know what people would do if they didn’t have a way to get out on their own,” she said. “No one cared this time if you were on a critical list. They couldn’t. It was too broad.”
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The 2003 Northeast blackout, the nation’s largest power failure, was a wake-up call for New York City’s Prezant. In a study published in the journal Critical Care Medicine, Prezant tracked citywide 911 calls plus emergency room visits at his own large hospital, Monte fiore Medical Center, during the nearly 29-hour blackout.
The falls and heart attacks doctors had expected didn’t materialize. But paramedics and the ER had a surge in patients with at-home oxygen, ventilators and other respiratory equipment who needed help or feared they soon would. Moreover, frail patients often were admitted to the hospital because doctors couldn’t be sure a power failure was the only problem, a huge expense fraught with the risk of medical errors, said Prezant, a lung specialist.
When it comes to oxygen, many home health-care companies “bend over backward” to race tanks to customers during power outages, noted Washington’s Rubinson. In fact, after Hurricane Katrina, the American Association for Home Care asked the government to designate oxygen providers as “first responders” for easier movement in disaster zones.
Medicare requires home oxygen suppliers to have customized emergency back-up plans for customers.
But if roads are impassable or the disaster’s too big, home oxygen may not be delivered.
Yet there are no overarching recommendations on how many back-up tanks patients should keep on hand. Nor is there agreement about home generators, which have their own risk — deadly carbon monoxide poisoning if operated wrong — and can’t always adequately power energy-hogging medical equipment. The FDA isn’t advising generators in its patient checklist due out this spring, and the disabled often can’t afford one.
But the AP survey found utilities frequently advise generators, such as Wisconsin utility We Energies, which also doesn’t keep a list of power-dependent customers.
“There’s a danger to keep the list and give a false hope you might be able to turn that power on sooner,” said company spokesman Brian Manthey. “We feel more comfortable telling people you need to have a back-up plan,” including generators or batteries.
Whatever a family’s back-up plan, Rubinson and Prezant stress that local emergency officials must know how many power-dependent patients they might have to rescue, and getting utilities and home-care companies to share customer lists is a good start.
That’s happening in northern Arizona. In Coconino County, home of Flagstaff, the emergency office gets a regularly updated medical-priority list from the state’s largest utility, and records GPS coordinates for those homes so they can be found fast.
“We probably don’t have 100 percent of everyone. There are people who slip through those cracks,” said emergency planner Sherrie Collins.
Federal patient-privacy rules limit sharing, cautioned Bill Desmarais, a co-owner of Home Care Specialists Inc. in Haverhill, Mass., which had about 800 oxygen-dependent customers using back-up tanks when last month’s Northeast ice storm cut power.
He does a home-safety assessment for new customers and offers a tank in advance, to keep for emergencies. Such tanks can be over 4 feet tall, weigh 80 pounds, “they’re green and they’re ugly,” Desmarais said. “A lot of people don’t like it as ornaments in their living room. … You can’t force them.”
Even the federal government was surprised by the demand during Hurricane Gustav, when nearly 1,400 people were housed in special medical shelters in Louisiana and Texas, 20 percent to 40 percent of whom required powered medical equipment. When generators failed in Baton Rouge shelters, an oxygen supplier hired to refill patients’ oxygen tanks couldn’t keep up with the unanticipated need.
“We had some nervous wringing of hands as some of the oxygen tanks started going down to low levels,” said Dr. Allen Dobbs, chief medical officer of the National Disaster Medical System — although enough eventually was found. “We have to have reliable contingency back-up plans for these folks.”
Copyright 2009 The Associated Press.
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Purple Heart won’t be awarded for PTSD
Date: 1/8/2009
By PAULINE JELINEK
Associated Press Writer
WASHINGTON (AP) — The Pentagon on Thursday sought to assure troops that it takes post-traumatic stress seriously despite the recent decision not to award the Purple Heart to those with the disorder.
An advisory committee concluded that troops coming home from the wars with combat stress cases collectively known as post-traumatic stress disorder will not qualify for the prestigious medal awarded to service members wounded in action.
“I don’t think anybody should assume that that decision is in any way reflective on how seriously we take the problem of PTSD,” Defense Department press secretary Geoff Morrell said. He noted that the military is budgeting money for research, development, treatment and preventive measures.
“Just because an awards committee believes this particular injury does not qualify for this award does not in any way reflect that we don’t take this problem seriously and aren’t committed to doing everything we possibly can toward preventing it, toward treating it, toward taking care of those who are suffering with it,” he told a Pentagon press conference.
Troops with post-traumatic stress can have flashbacks of their time at war, nightmares, sleeplessness and other debilitating symptoms.
Nearly 20 percent of military service members who have returned from Iraq and Afghanistan — 300,000 in all — are estimated to have symptoms of PTSD or major depression, according to a study last year by the RAND Corp. research organization.
Though full-blown symptoms may not surface immediately, doctors say symptoms can be lessened and controlled with early treatment and that most people can return to their duties.
The Pentagon decided in November that troops with the disorder cannot be awarded the Purple Heart, but the decision was not known until it appeared Monday on the Web site of Stars and Stripes newspaper.
“The Purple Heart recognizes those individuals wounded to a degree that requires treatment by a medical officer, in action with the enemy or as the result of enemy action where the intended effect of a specific enemy action is to kill or injure the service member,” Defense Department Eileen Lainez said of the decision. “PTSD is an anxiety disorder caused by witnessing or experiencing a traumatic event.” It is not “a wound intentionally caused by the enemy from an outside force or agent,” but is a secondary effect caused by witnessing or experiencing a traumatic event.
Veterans diagnosed with PTSD “still warrant appropriate medical care and disability compensation, Lainez said, and the department “is working hard to encourage service members and their families to seek care for PTSD by reducing the stigma and urging them to seek professional care.”
___
On the Net:
Defense Department: http://www.defenselink.mil/
Copyright 2009 The Associated Press.
By PAULINE JELINEK
Associated Press Writer
WASHINGTON (AP) — The Pentagon on Thursday sought to assure troops that it takes post-traumatic stress seriously despite the recent decision not to award the Purple Heart to those with the disorder.
An advisory committee concluded that troops coming home from the wars with combat stress cases collectively known as post-traumatic stress disorder will not qualify for the prestigious medal awarded to service members wounded in action.
“I don’t think anybody should assume that that decision is in any way reflective on how seriously we take the problem of PTSD,” Defense Department press secretary Geoff Morrell said. He noted that the military is budgeting money for research, development, treatment and preventive measures.
“Just because an awards committee believes this particular injury does not qualify for this award does not in any way reflect that we don’t take this problem seriously and aren’t committed to doing everything we possibly can toward preventing it, toward treating it, toward taking care of those who are suffering with it,” he told a Pentagon press conference.
Troops with post-traumatic stress can have flashbacks of their time at war, nightmares, sleeplessness and other debilitating symptoms.
Nearly 20 percent of military service members who have returned from Iraq and Afghanistan — 300,000 in all — are estimated to have symptoms of PTSD or major depression, according to a study last year by the RAND Corp. research organization.
Though full-blown symptoms may not surface immediately, doctors say symptoms can be lessened and controlled with early treatment and that most people can return to their duties.
The Pentagon decided in November that troops with the disorder cannot be awarded the Purple Heart, but the decision was not known until it appeared Monday on the Web site of Stars and Stripes newspaper.
“The Purple Heart recognizes those individuals wounded to a degree that requires treatment by a medical officer, in action with the enemy or as the result of enemy action where the intended effect of a specific enemy action is to kill or injure the service member,” Defense Department Eileen Lainez said of the decision. “PTSD is an anxiety disorder caused by witnessing or experiencing a traumatic event.” It is not “a wound intentionally caused by the enemy from an outside force or agent,” but is a secondary effect caused by witnessing or experiencing a traumatic event.
Veterans diagnosed with PTSD “still warrant appropriate medical care and disability compensation, Lainez said, and the department “is working hard to encourage service members and their families to seek care for PTSD by reducing the stigma and urging them to seek professional care.”
___
On the Net:
Defense Department: http://www.defenselink.mil/
Copyright 2009 The Associated Press.
Vets sue CIA, Defense over military experiments
Date: 1/7/2009
By PAUL ELIAS
Associated Press Writer
SAN FRANCISCO (AP) — Six veterans who claim they were unwittingly exposed to dangerous chemicals and germs during government-sponsored Cold War experiments have sued the CIA, Department of Defense and other agencies.
The vets volunteered for military experiments they say were part of a program started in the 1950s to test nerve agents, biological weapons and mind-control techniques. They allege in their federal lawsuit filed Wednesday in San Francisco that they are in poor health today because of the experiments. They are demanding health care and a court ruling that the program was illegal.
The organization Vietnam Veterans of America is also part of the lawsuit, which seeks class action status on behalf of all participants who were allegedly exposed to unhealthful experiments without their knowledge.
Copyright 2009 The Associated Press.
By PAUL ELIAS
Associated Press Writer
SAN FRANCISCO (AP) — Six veterans who claim they were unwittingly exposed to dangerous chemicals and germs during government-sponsored Cold War experiments have sued the CIA, Department of Defense and other agencies.
The vets volunteered for military experiments they say were part of a program started in the 1950s to test nerve agents, biological weapons and mind-control techniques. They allege in their federal lawsuit filed Wednesday in San Francisco that they are in poor health today because of the experiments. They are demanding health care and a court ruling that the program was illegal.
The organization Vietnam Veterans of America is also part of the lawsuit, which seeks class action status on behalf of all participants who were allegedly exposed to unhealthful experiments without their knowledge.
Copyright 2009 The Associated Press.