The city of Aurora is contracting with an outside firm to evaluate the responses of its police, fire and communication systems to last July's theater shooting, and one longtime area fire chief expects procedures to change as a result of the investigation.
"I think you're going to see some folks who did it right, and they are going to share, and I'm sure they found some areas where they want to see improvement, I think they'll share that too," said Jerry Rhodes, chief of the Cunningham Fire Protection District and a former chair of the State Emergency Medical and Trauma Advisory Council.
Rhodes said that just as the 1999 shootings at Columbine High School led to changes in how first responders handle mass-casualty shootings, it's likely that reviews of what happened in Aurora will also lead to procedural changes.
"Are we going to learn additional things out of the tragic events at the Century theater? Yes," Rhodes said.
Testimony at this week's preliminary hearing for James Holmes, the man accused of killing 12 people and wounding 58 others at an Aurora theater, has once again raised questions about how ambulances and emergency medical personnel were deployed to the scene.
Monday, Aurora police officers choked up as they described driving bleeding victims to hospitals in their patrol cars.
One, Officer Justin Grizzle, testified that he made four separate trips from the theater to a hospital and back, carrying so many wounded that, by the end of the night, blood pooled on the floor of his patrol car, and stained its headrests and dashboard. There was so much blood, he said, that he heard it "sloshing in the back of my car."
Emergency medical workers from the Aurora Fire Department arrived at Theater 9 almost 24 minutes after the shooting, even though police began asking for help there eight minutes into the crisis, The Denver Post reported in July. Meanwhile, many ambulances were directed by the fire commander to a nearby staging area to await further instructions, dispatch tapes showed.
And at least six nearby medical responders weren't called to the scene for 20 to 35 minutes — or were never called at all.
What resulted was a medical response that operated from the outside in — allowing the less seriously injured to get to help first while critically injured patients who couldn't be moved waited as minutes ticked by to be assessed, treated and transported. When medical help finally did reach them, according to the dispatch recordings, ambulances weren't available.
At the time, Aurora Fire Chief Mike Garcia said the shooting scene was "severely congested" with cars and police, making it impossible to route ambulances to all the wounded.
The city will not answer specific questions about how its fire and police departments responded to the shooting until June, spokeswoman Kim Stuart said in an e-mail.
The city expects to finalize a contract at the end of the month with TriData, an independent firm that researches and analyzes fire protection, emergency medical services, prevention and preparedness.
Together, Aurora and the contractor will review radio and dispatch transmissions and together write a report that will be made public, Stuart said in an e-mail.
TriData reviewed mass shootings at Virginia Tech and Columbine High School. A final report is not expected for at least six months, Stuart said. She declined to answer any other questions, citing the court's gag order.
In addition to medical personnel on its municipal fire vehicles, the city of Aurora contracts with Rural Metro Corp., a national, for-profit company, to provide ambulance services.
Medical experts say that whether a patient is better off being treated by a medical responder or getting to the hospital as fast as possible can be analyzed only on a case-by-case basis. Dr. Comilla Sasson, an ER doctor on duty at University of Colorado Hospital the morning of the shooting, said in July that quickly transporting patients in police cars helped save numerous lives.
Colorado is one of only two states — California is the other — where oversight of paramedics and EMTs is separate from ambulance companies and municipal agencies that provide emergency transportation, said Randy Kuykendall, chief of the state health department's Emergency Medical and Trauma Services section.
"My sense is that goes with the local-control manner in which Colorado government operates," he said.
The state licenses individual EMTs and paramedics but has little authority over ambulance companies or municipal agencies that respond to medical emergencies.
While there are guidelines for things such as response times, there are no enforced statewide standards, Kuykendall said.
Any oversight of the agencies — both municipal fire departments and for-profit companies — that operate ambulances comes from cities and counties, Rhodes said. Generally, performance standards and sanctions are handled through the contractual agreements between the service providers and the municipalities, he said.