D.C. Fire Department Medical Director Resigns, Delivers Scathing Exit Letter

The D.C. fire department’s medical director, hired last year to help reform an agency beset by failures in response times and patient care, is resigning, saying that her proposals have been blocked and that “people are dying needlessly because we are moving too slow.”

Jullette M. Saussy, ending her eight-month tenure, delivered a scathing indictment of the District’s new fire chief and what she calls his refusal to end a culture of indifference that she contends endangers residents’ lives.

“The situation is grim,” Saussy wrote in her Jan. 29 resignation letter to D.C. Mayor Muriel E. Bowser (D), a copy of which was obtained by The Washington Post. Saussy said that without an immediate change in leadership of paramedics and other first responders, the department “will continue to be plagued by serious — but fixable — issues that result in the continuous, unnecessary loss of life.”

Chief Gregory M. Dean declined an interview request.

Bowser’s chief spokesman, Michael Czin, issued a statement saying that the administration “is committed to reforming” emergency medical services and that the fire chief, hired nearly a year ago, and his team have made progress. “We are committed to improving patient outcomes and delivering the change that residents expect and deserve,” the statement says.

Saussy, 51, was hired in June as a critical audit was released saying the fire department had failed to implement reforms recommended nearly a decade earlier. The doctor has vast experience with emergency medical services and served in a similar role in New Orleans during Hurricane Katrina in 2005.

Dean and others hailed Saussy as an answer to the department’s critics. Bowser hired Dean from Seattle earlier last year to confront a department that was criticized almost daily for failing to respond quickly to 911 calls, for its broken equipment, and, in one notable case, for failing to help a dying man who collapsed across the street from a fire station.

Saussy’s letter is the first direct broadside fired at Dean’s tenure, and it comes from a top aide he hired. She directly attacks the chief, saying he bowed to union pressure to scuttle the assessment tests of emergency medical technicians, allows his firefighters and others to run “undisciplined and unchecked,” and did not put in properly trained supervisors to oversee crucial medical care.

She also criticized Dean’s plan to privatize ambulance service for routine medical calls to free up advanced care for critically injured patients, writing that it “is as unlikely to fix the situation as placing a Band-Aid on a gushing artery.”

And despite a string of headlines about delayed response times that have resulted in deaths, Saussy noted one call in her letter that received no press attention.

She said it took more than 18 minutes for an ambulance to reach a 25-year-old man who was stabbed Jan. 27 in Southeast Washington and died. “We failed that young man,” Saussy wrote, noting that his injuries were “potentially survivable.”

Dean has confronted some serious episodes as head of the 1,800-member department, including that of a man who died of a heart attack when firefighters went to the wrong address. But the chief has largely escaped the criticism of his predecessors during what he has described as his long breaking-in process.

Dean also enjoys the support of the rank and file through the endorsement of the firefighters union.

Edward Smith, president of the firefighters union, said he disputed many of Saussy’s assertions and denied blocking her attempts to appraise EMTs. He said he objected to her timing and her implementation and said he offered alternatives that were ignored.

“I think we’re making changes in the short term,” Smith said, noting the biggest problem is a shortage of ambulances and paramedics while the number of 911 calls has spiked. He said privatization, which has not begun, needs to be given a chance.

Czin, the mayor’s spokesman, cited progress in the department that he said includes the first entry-level exam in eight years to hire new firefighters and emergency medical technicians, the privatizing of ambulances and an end to years of conflict with the firefighters union. And he said it is incorrect to say that Dean has “little to no experience” running an EMS system, as Saussy wrote in her letter.

Replying to Czin’s comment, Saussy said that Dean oversaw basic life support responders in Seattle but that the city’s renowned Medic One program was a separate entity.

Saussy also said that most of the changes that should still be put in place in the District are simple, such as disciplining EMTs and firefighters who she said “disappear” in hospitals after calls instead of quickly returning to the streets. She also said elaborate statistics showing improved response times are “not based in reality.”

In an interview Tuesday, Saussy said she is “disappointed that the residents and visitors to the nation’s capital will continue to not get the care they deserve, and will remain unaware of it. They deserve better.”

She said she could not remain in her job in good conscience, saying she had taken an oath “to do no harm” and that she could no longer be “complicit” in what she terms a failed agency. “I would have to compromise my ethics and my morals and what I know to be right.”

From The Washington Post

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