Heart Disease Killed Woman Whose Death Led to Milwaukee 911 Policy Change
Jolene Waldref died in January after calling 911 from bus stop in sub-zero weather.
A Milwaukee Fire Department truck. Alana Watson/WPR
A Milwaukee woman whose death at a bus stop on a freezing cold day inspired a change in the city’s 911 response policy died of heart disease.
The Milwaukee County Medical Examiner released the “final cause of death” report for Jolene Waldref on Tuesday. The report states Waldref, 49, died of “hypertensive and atherosclerotic cardiovascular disease.”
An email from the medical examiner’s office said they would have no further comment. In their initial report shortly after Waldref’s death, the office said it was investigating the possibility her death was caused by hypothermia.
Waldref died Jan. 15 after calling 911 from a bus stop. In the call, she sounded confused and distressed. The call was dispatched as a low-priority response, and a private ambulance service was sent to her aid.
The temperature at the time of the call was below zero, with wind chills of 20-below.
When the Curtis Ambulance Service crew arrived at the scene, paramedics never left their vehicle. Their view of Waldref, who was lying on the ground, was blocked by snowbanks. They drove through the intersection and attempted to contact Waldref by phone but left when they were unable to reach her.
A passerby later called 911 again after finding Waldref unconscious. Milwaukee Fire Department paramedics who then arrived were unable to revive her.
An initial report from police by the medical examiner’s office in January said it appeared on security video that Waldref had fallen and hit her head. That report appears to have been mistaken. Video from the scene released to media does not show a fall.
News that the first responders left the scene without looking for the woman after she called for help outraged city residents and many local officials. That prompted a change in policy that requires paramedics in the city to exit their vehicles and look for patients when there is extreme weather or visibility obstructions at a scene.
In February, the Milwaukee Common Council approved new contracts for the two private ambulance companies that serve the city only after they agreed to the change. The city’s 911 medical response is split between fire department paramedics, who are dispatched to the most urgent cases, and the two private services, who typically handle less critical medical emergencies.
Under the new policy, when patients are “not immediately present,” first responders must ask 911 dispatchers to attempt to call the person back, interact with bystanders who may know more about the patient’s location and use their lights and sirens when they arrive at a scene to make themselves more visible.
Heart disease caused death of woman in case that led to Milwaukee 911 policy change was originally published by Wisconsin Public Radio.
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The private ambulance companies may or may not staff their rigs with paramedics; they are usually Basic level. The Milwaukee Fire Department has no Basic Life Support ambulances but 12 Advanced Life Support (paramedic) units.
Each fire department in Milwaukee county has their own dispatch system, but all medical operates under County authority. Any 911 call within Milwaukee County is answered by the County Sheriff who transfers the call to the relevant municipality.
That dispatch then triages the call and based on a flow chart assigns the appropriate response. This can range from a private BLS ambulance, a fire department BLS unit (in Milwaukee that may be a fire engine which will assess the patient at which time they may then either call for a private ambulance for transport, or escalate the call level to ALS and request a paramedic unit). In many cases, fire companies have a paramedic on the crew who can initiate ALS procedures.
Upon arrival it is quite common to find a situation that does not match what dispatch was told. This could be the chest pain is the result of a gun shot, the dead guy is just a passed-out drunk or a diabetic with low blood sugar, a seizure is an overdose, dispatch is given the wrong address or poor directions, etc. And sometimes the patient got a ride, or caught their bus before first responders arrived.
I still don’t understand why the 911 dispatcher classified the call as a low priority. The victim’s confusion should have clued the dispatcher to that the women was experiencing cardiac or neuro distress. I believe the dispatcher’s decision to classify the caller as a “low priority” was the ultimate cause of her death.