Paramedics fired after Downtown Eastside patient forced to crawl

Two Vancouver paramedics have been fired for encouraging a vulnerable patient who complained of agonizing pain to crawl toward the exit of his Downtown Eastside building instead of carrying him on a stretcher after a call for help last October.

In a ruling last month described as "most probably career-ending," a labour arbitrator upheld B.C. Emergency Health Service's decision to fire paramedics Alyson Banner and John Crawford, who were accused of failing to bring proper equipment to a call and then being dishonest during the ensuing investigation.

"I have struggled with the question of whether discharge was excessive in the circumstances of this case," arbitrator Paul Love wrote.

"This is a tragic case in terms of the careers of the [paramedics], their treatment of the patient and their demonstrated lapse of service which reflects poorly on the employer."

'In a real crisis'

The Ambulance Paramedics of B.C. — CUPE 873 — says the decision is under appeal to B.C.'s Labour Relations Board.

Union president Troy Clifford says the union acknowledges that certain mistakes were made and has worked with the employer to address shortcomings, but they dispute the findings of the arbitrator and the characterization of events.

"It's a really unfortunate situation for everyone involved, including the patient," Clifford said. "Our goal is to care for people." 

The incident unfolded on the 10th floor of the Woodward's Building in the early hours of Oct. 15, 2019.

The patient, a 56-year-old man with a history of drug addiction, lived in the building. He asked two mental health workers for help.

One of the workers said the man was "screaming, moaning and in a considerable amount of pain." Another, who said he knew the patient as a "generally easy going, polite man" said the man wasn't aggressive and came out of his room "to get help, as he was in a real crisis."

Banner and Crawford responded to the 911 call but did not bring a stretcher. According to the ruling, Banner later said the stretcher wouldn't fit in the elevator and Crawford said the patient didn't want to be touched and was "aggressive, belligerent and foul mouthed."

But the arbitrator found those statements to be untruthful, and an investigator proved that a stretcher would have fit in the building's elevators.

'Afraid to call 911'

Love's decision leans heavily on four video clips taken inside the building.

"The video evidence shockingly reveals the patient crawling along the floor, in the presence of a police officer and the two [paramedics] who do not have a stretcher. Ms. Banner follows behind the patient and at one point keeps the patient's head from hitting the side of the wall near the elevator," Love wrote.

"The second video depicts the patient lying on the floor of an elevator, at the feet of the police officer and the [paramedics], with the [paramedics] apparently ignoring the patient and talking amongst themselves."

According to the decision, the patient described his pain level as "10 out of 10" and didn't recall telling the paramedics not to touch him. Once he got to hospital, he was diagnosed with sepsis and spent three days in intensive care.

He claimed he used to have "a deep respect for paramedics and would often thank them for the good work and help that they were doing in his neighbourhood."

"He is now afraid to call 911 or seek assistance from paramedics," Love wrote.

B.C. Emergency Health Services investigated after receiving a pair of complaints: one from Woodward's Building mental health worker James Kent and the other from the patient's mother.

Kent said he was "surprised and angered by the lack of assistance provided and the lack of compassion of the paramedics as the patient was in pain and appeared to need assistance."

Unblemished work records

Both Banner and Crawford testified at the arbitration hearing, but Love found their testimony "riddled" with "I don't know, I don't recall" and "I don't remembers," whereas both were able to remember exculpatory things like the patient not wanting to be touched and choosing to crawl to the elevator.

The union accused the investigator of being biased, because she was "horrified" by the video and apologized to the patient at the outset of his interview. But Love said the investigation was neither biased nor inadequate.

Both Banner and Crawford have unblemished work records. Banner has 10 years seniority and Crawford has seven years. They were both fired on March 5, 2020.

In assessing the discipline, Love said it was "difficult to imagine that this type of substandard patient care by a paramedic would be afforded to anyone outside of the Downtown Eastside."

"What is unclear is whether the [paramedics] deliberately treated the patient differently because they perceived him to be yet another overdosing drug addict from the DTES … or whether as a result of an unconscious bias they treated him differently," Love concluded.

"The patient abuse in this case was serious. It has a demeaning effect on the patient — a marginalized person who was deserving of more dignity and respect than he was accorded by the paramedics."

In a statement, Neil Lilley, the senior provincial executive director for B.C. Emergency Health Services, said the organization expects a high degree of professionalism from staff.

"While it is relatively rare that we need to take this measure, termination of employment only occurs after a thorough investigation indicates serious misconduct," Lilley said.