City releases EMS investigation report

The city of Iola has released the final report by the Kansas Board of Emergency Medical Services regarding an investigation of Ron Conaway in 2008 – the report made no findings of malfeasance. Conaway is director of Iola’s ambulance service.
The matter, regarding the death of a 17-year-old diabetic patient in 2008, has been brought into the spotlight multiple times during public meetings, specifically those regarding a merger between Allen County EMS and the city’s service, operated by Iola Fire Department.
The original complaint alleged that Conaway failed to provide advanced cardiac care life support during 10 minutes of patient contact — including an unsecured airway, no IV started and no administration of cardiac drugs.
The report outlines the Sept. 10, 2008 incident and investigation carried out by KBEMS investigator Jerry Cunningham:

TWO IOLA EMS responders arrived at a scene in which a 17-year-old diabetic patient was experiencing what seemed to be non-life-threatening medical conditions. Upon arriving, the EMS workers advised the patient to seek attention at the nearest possible hospital after he refused services from the EMTs on the scene. The patient’s aunt agreed to take the patient to the Chanute hospital by private vehicle. As the responders were preparing refusal paperwork for the patient, he suddenly went into cardiac arrest.
From that point, the service of Ron Conaway, a registered nurse and emergency medical technician, was requested to the scene. He arrived approximately two minutes following the request.
The patient was moved to a “spine board” to facilitate his placement into the ambulance. Conaway is quoted in the report:
“I again contacted Allen County Hospital ED (emergency dispatch) and spoke with T. West PA (Travis West, physicians assistant). I updated him on patient condition and he asked about our location for transport time. I advised him we were less than two minutes away and he ordered rapid transport.”
Conaway reported that he was on the scene for 10 minutes or less, and had a very active role in patient care. As for the airway device, Conaway said:
“This probably should have been done as a precaution and I feel it probably wasn’t due to the shock of the initial crew having a young man who was up and talking, getting ready to sign a refusal form suddenly crashed on them.”
Three formal complaints were made, cases 2008-078, 2008-079 and 2008-080. The KBEMS declined to open investigations upon the third complaint. Investigator Cunningham’s final correspondence with Conaway stated, “after reviewing the information, the committee moved to close this case without further action. I appreciate your efforts and cooperation in resolving this issue.”

CONAWAY met with the Register to discuss the matter, and provide his own insight on the incident. He said his motivation is to move forward from the past, and recognize that the case has been closed.
“I could easily tell stories and sling mud,” Conaway said.
Comments made by County Commissioner Dick Works during a joint meeting between the city and the county on Feb. 4 alleged that Conaway “did not know what he was doing” during the 2008 incident.
“That is grossly inaccurate,” Conaway said.
Conaway said he believes the complaints were politically motivated.
City council member Steve French publicly apologized to Conaway during Monday night’s city council meeting, saying that he “should have stood up for Ron” after the comments were made in a public meeting. He also commended him for “keeping his composure” under the circumstances.

WORKS SAID while he “shouldn’t have gone into specifics” during the meeting at the Bowlus, he believes the situation in the report shows some key differences between a type-I ambulance service and a type-IIA service.
According to information gathered from the KBEMS website, a type-I ambulance service has a paramedic in the vehicle on a call. Works said the county currently has one ambulance with a paramedic at all times, and they are looking to expand their fleet to three by April.
A type-IIA service has a paramedic on-call when ambulances are dispatched to an emergency. Whether or not a paramedic is on the scene is determined by the severity of the situation.
“For me, the difference is life and death,” Works said.
He said the delay in time for the paramedic to respond to the scene can leave the patient unattended to for a critical amount of time.

DR. TIM SPEARS, the medical director for both the county and Iola ambulance services, said he believes both provide excellent quality of care for the citizens of Allen County. When asked directly if the city of Iola provides substandard care, he responded: “No, they (the city and county) provide excellent care. Whether it is a type-I or type-II service, quality of care is quality of care.”
As for the report, he said the KBEMS takes investigations, such as situation involving Conaway, very seriously.
He said that if there is “even a hint” of something that needs to be corrected, the KBEMS generally recommends education or re-evaluation of the parties involved. The board recommended no such action in the case of Conaway.
However, he said it is important for people to be held accountable in any situation where there are questions.
“Any time there is a question of quality of care, and people review the case, it is good,” Spears said. “There can never be too much quality review.”

ALL SOURCES who responded to the release of the report urged a need to move forward from any sort of complications in the past — especially those in which investigations have been closed and filed.
“My goal is not to point fingers or blame,” Works said. “My agenda is to get this resolved.”
He said he believes the city of Iola is “on the right track” with a type-IIA service. But, he still emphasized his thought that a service should have type-I ambulances ready at all times.
Discussions are currently underway between the city and the county regarding which direction to take the EMS services for Allen County.
County commissioners and city council members have met twice in moderated meetings. Citizens of Allen County will be able to see the active discussion firsthand during the next meeting, which has a tentative date of March 4.