PHOENIX — A Phoenix man says the city’s fire department violated state law when firefighter-paramedics did not promptly take him to a hospital during a heart attack last September.
Robert Martino, 67, filed a complaint with the Arizona Department of Health Services which regulates ambulance services and licenses paramedics and emergency medical technicians.
Martino’s significant other called 911 twice on the same night in September 2023. The first time, a fire truck and ambulance were dispatched for a heart trouble call. Martino was only taken to a hospital after the second call, which happened five hours after the first one.
“My heart went without oxygen for five hours,” Martino told ABC15. “How many years is my life shortened?”
Medical records show Martino started having chest pains on the morning of September 2. His significant other, Carrie Gale, called 911 around 9:40 p.m. that night after she said Martino collapsed in the bathroom. Martino said he was unable to get up, convulsing, and barely speaking. He has a history of heart attacks and takes more than 20 medications.
Within minutes of the first call, six firefighters arrived at the house. All Phoenix firefighters are trained as either paramedics or emergency medical technicians.
“I knew that it was very serious,” Gale said. “My expectation was that they'll handle it accordingly.”
Martino said he doesn’t remember much about what happened next. Carrie fielded questions from the EMTs.
“They said, ‘Mr. Martino, you're not having a heart attack; you're having a panic attack. You need to put ice on your neck. You need to breathe from your stomach.’ And they left.”
Martino’s condition worsened. “Because they didn't transport me,” Martino said, “I was having a heart attack for five hours.”
Carrie called 911 again at 3 a.m. on September 3.
This time, the ambulance transported Martino to Mayo Clinic. Doctors determined he was having a heart attack and needed an emergency procedure to place a stent.
Martino said the damage to his heart is permanent, and his life has changed.
“I get up in the morning, get in the shower, I’m sweating because I'm doing too much,” Martino said.
When ABC15 visited his home in November, Martino was wearing a heart defibrillator under his shirt the entire time.
“If this ‘life vest’ goes off and I can’t press the two buttons at the same time, that tells the vest I'm in trouble,” Martino explained. “Then it will zap me.”
Martino is one of dozens of people who reached out to ABC15 investigators saying they called 911 for emergency medical help, but the city’s firefighters never brought an ambulance or convinced them to decline a ride to the emergency room.
One patient, Haydee Pate, even caught the firefighters on her ring doorbell camera in August 2021. One firefighter said the ambulance transport would cost $1,500.
“I mean we'll take her, but if you have 1,500 bucks, I know what I'd like to do with 1,500 bucks,” the firefighter told Pate’s son.
In another case, the City of Phoenix paid a $1.65 million lawsuit settlement to Bruce Sandberg. Sandberg’s wife, Francesca, died of a heart attack on December 31, 2021. He had called 911 asking for an ambulance, but when firefighters didn’t bring one, Sandberg tried to get Francesca to a hospital in time in his own truck.
“My wife would have had a 95% chance of survival if she had gone in an ambulance,” Sandberg said.
An Arizona law that went into effect in 2022 says emergency medical care technicians may not provide a presumptive diagnosis and may not counsel a patient to decline emergency medical services transportation. The law even requires EMTs to explain the risks and consequences if a patient is not transported.
Phoenix Fire Department leaders have told ABC15 that its staff has received several trainings on the new law.
In a mandatory training video, Garth Gemer, the medical director for the Phoenix Fire Department, advised first responders on what to say to patients when they wrap up an exam.
“We've reached an endpoint in our assessment,” Gemer instructed firefighters to say. “We don't have the tools to give you a formal diagnosis, therefore, we suggest that you receive immediate follow-up care, and then the best way to get that is probably in an emergency department.”
Phoenix Fire officials told ABC15 that after the law changed they are making more hospital runs. Their data shows about 35 more patients were transported each day in 2023, compared to the previous year. The department’s policy is anyone who wants an ambulance gets one.
However, Martino’s 911 calls came in after the changes in law and firefighter retraining.
“It's not fixed,” Martino said.
The fire department repeatedly declined to comment on Martino's case because it is under investigation.
The state health department, which received Martino’s complaint in December, also declined to comment because it is an active investigation. The health department can require ambulance service providers to take corrective action or discipline state-licensed paramedics and EMTs who don’t follow Arizona regulations.
Meantime, Martino is offering his own ideas for a solution. Like a form you sign saying you understand your HIPAA rights at a medical office, Martino suggests first responders give patients a paper explaining their ambulance transportation rights.
“So they have proof that they've given her the law, and then if she says don't transport him, it's my fault or her fault, not their fault,” Martino said.
Martino questions whether he will live to see the end of the investigation in his case, but he says that doesn’t matter if his story can change the system and save someone else’s life.
