Northwood’s former fire and Emergency Medical Service (EMS) medical director had concerns for years about whether the Northwood Fire Department met the “standard of care.”

Dr. David Miramontes, who was Northwood’s EMS medical director for nearly 10 years before taking a job as the full-time EMS director in Washington, D.C., last month, told The Press he spoke to former Fire Chief Tim Romstadt in the past about problems he saw in the fire department.

“I expressed my concerns about the budget cuts to the fire chief,” said Miramontes. “I have been expressing concerns about the staffing beginning in 2008, 2009 and in 2010.”

In 2009 and 2010, Mayor Mark Stoner and city council made budget cuts in all city departments due to plummeting revenue in the General Fund. In the volunteer fire department, there was a 10.7-percent cut, including a hiring freeze, a pay reduction, and the elimination of two firefighter/EMTs who covered the day shift from 7 a.m. to 5 p.m.

On the morning of March 3 this year, Ellen Mix, of Parc Rue, called 9-1-1 three times because her husband, Tim, was having breathing problems. By the time help arrived 28 minutes later from a rescue squad from Northwood Fire Station No. 1, Tim, 67, had stopped breathing. He was revived and transported to Mercy St. Vincent Medical Center, where he was removed from life support two days later. He had suffered brain damage caused by a lack of oxygen, according to Ellen.

After Mix died, Miramontes wrote a letter to Stoner in which he made 14 recommendations for adequate staffing, supervision and deployment of resources in the fire department.

“I am a subject matter expert in EMS and I have been your EMS medical director for nearly 10 years,” states Miramontes in the April 16 letter, a copy of which was obtained by The Press. “I am intimately familiar with your department, its operations and the needs of the community. Your current deployment plan does not meet the community standard of care, in my opinion.”

Miramontes attended a Safety Committee meeting on March 24 in which he discussed the recommendations.

Losing firefighters
Miramontes told The Press he did not think the fire department’s staffing plan met the standard of care when compared to other communities with similar demographics.

“When the mayor and council cut the two firefighter/EMTs from the day shift, and when they imposed a hiring freeze, they directly affected the mission readiness and deployment of the department,” said Miramontes. “They were losing firefighters.”

City Administrator Dennis Recker, who was hired last October, said he meets every week with the city’s department heads, which had included Romstadt before he resigned in April. 

“He attended staff meetings on Mondays at 2 p.m.,” Recker said of Romstadt. “If there were fire issues, he was to report on those.”

Was Recker ever informed that the fire department was not meeting the standard of care? Not from Romstadt. And not from Miramontes.

“Don’t know anything about it,” said Recker last week.

Romstadt confirmed that Miramontes had told him there were problems in staffing and deployment. He did not inform Stoner, council, former Administrator Pat Bacon, or Recker of Miramontes’ concerns, he said.

The city was already cutting the budget, he said, making it unlikely there would be any improvements in the fire department.

“When you make those kinds of cuts, you do not have a chance to make the system better,” he said. “Once the budget is cut, it’s cut. We had no way of improving our care. We could not buy another ambulance, we could not buy monitors, and we could not hire people.”

No reports
Recker said Romstadt never submitted reports regarding any concerns he may have had about the fire department.

“I had not seen formal reports coming from the fire chief that I see coming from the police chief,” said Recker.

Would Recker have expected Romstadt, or anyone in the fire department who received such information from the city’s medical director, to relate those concerns to him as the city administrator?

“Oh yes. If our medical director had advised the fire chief that we were not providing the appropriate standard of care, it should have been brought to the administrator,” said Recker. “The administrator could have gathered that information and brought it to the mayor and council. That is what should have happened.”

Recker also questioned why Miramontes would not have followed up his concerns after speaking to Romstadt with a letter to the administrator, who is the city’s safety director.

“He is a compensated advisor and we rely on him for information,” Recker said of Miramontes. “There should have been a report to the next level in the chain of command. I would have passed that information to the mayor and I would have gone to the Safety Committee with it. That would have been the bare minimum.”

Miramontes validated and helped establish protocols for the fire department’s EMS, Basic Life Service (BLS) and Advanced Life Service (ALS) training, according to Recker. Miramontes also advised what kind of training was necessary.

“There is no file with previous correspondence from Miramontes,” said Recker. “He was the certified medical authority who assisted the chief in managing services for EMS. He is an expert in that line of work. If he had long term concerns, he should have written a letter a lot sooner.”

Stoner also said he was not informed by Romstadt or Miramontes that the fire department was not meeting the standard of care.

Romstadt, he said, had missed several Safety Committee meetings, which he was expected to attend along with Police Chief Tom Cairl. Romstadt could have brought up Miramontes’ concerns at any of the meetings.

Stoner added that he had met Miramontes only twice in the past several years - once when he was on council and last March.

“Why all of a sudden did he just come out and say, `Major problems here?’” asked Stoner, referring to Miramontes’ April 16 letter.

Council later approved some of Miramontes’ recommendations:

• hire a part-time deputy chief to be charged with EMS oversight; train city employees in CPR and the use of the AED;

• lift the hiring freeze for firefighter-EMTs, and allocate $20,000 for adequate training of new recruits and training of existing members to the paramedic level over the next 18 months;

• soft-bill homeowner insurance companies for structure fire responses, automobile insurance for motor vehicle response and responsible parties for hazardous material incident response.

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