Family Blames Gateway For Lonnie Harrawood's Death

UNIVERSITY CITY, MO — Lonnie Harrawood couldn't breathe, so his girlfriend Laura McDermott called 911. Across town, her call was answered by University City's police dispatcher, who relayed the call to Gateway, the private ambulance service the city has employed for almost three years. Behind the scenes, it's a process — almost like clockwork — meant to get lifesaving aid to where it's needed as fast as possible.

A Gateway ambulance arrived a few minutes later — within five minutes, McDermott said, or it may have been a little longer. But at that point the mainspring seems to have broken, or something got caught in the gears, because that's where the clockwork stopped.

"They were totally unprepared for [Lonnie's] situation," McDermott said.

Harrawood was awake and talking when the paramedics arrived. But, as it became harder to breathe, he started to have a panic attack, and, according to McDermott, the ambulance didn't have the right medication to treat it. What's more, while many ambulances are required to have two paramedics on board, Gateway ambulances make do with a paramedic and an emergency medical technician. The paramedic, McDermott said, was physically unable to carry an oxygen tank upstairs to Harrawood's bedroom, and the pair together were unable to bring him downstairs on a stretcher.

"Lonnie was a larger person," McDermott said. "There was no way they were going to get him down the stairs. He was 330 pounds."

So, the Gateway team called for assistance from the University City Fire Department. It took another five minutes or so for a firetruck and two additional firefighter paramedics to arrive, and ten more to get Harrawood down the stairs, McDermott said.

By the time they got him downstairs, Harrawood had fallen silent.

"It was when they started putting him into the ambulance that I noticed something that was very odd," McDermott said. "Lonnie had a lazy eye. His eye would wander on one side. And at that moment, both of his eyes were fixed on a point in the distance."

As the ambulance door closed, the medical tech called for help from the paramedic in the driver's seat. "Get back here, he doesn't have a heart beat," he said, according to McDermott.

By that time, the fire truck had left the scene. They called it back so that someone could drive the ambulance while two people worked on Harrawood.

By the time the ambulance arrived at the hospital, about 45 minutes had passed since McDermott's initial 911 call.

"By the time [Lonnie] got to the hospital, doctors told me he had probably been without oxygen for 20 minutes, and the chance of survival was less than 10 percent," McDermott said. "They almost called code on the table."

Harrawood never woke up again. He went into a coma and died five days later. McDermott blames Gateway.

Working in a doctor's office, McDermott says she deals with urgent situations on a regular basis and knows how important minutes can be in life or death situations. "Had they been able to calm the panic attack. Had they been able to get him down the stairs faster. Had they not sent the fire truck off and were able to get the extra assistance on restarting his heart sooner, it may have changed the outcome," she said.

That's far from the only complaint against Gateway since the city decided to outsource its ambulance service in 2015. Many citizens have raised concerns about the company's billing and response times. One of them is U. City resident Aren Ginsberg, a retired librarian, who took it upon herself to compare raw data from University City’s computer-aided dispatch records to data sent to an outside auditor.

An official analysis by the last administration found that Gateway's response times were, on average, about a minute faster than the old in-house ambulance service. That was one of the city's stated intentions back in 2015, to speed up ambulance service by stationing crews in their ambulances at hot spots around the city, rather than at the firehouse.

But Ginsberg doesn’t think the numbers don't add up.

"This is not a battle I wanted to fight, but I think we as a community deserve to have a good ambulance response," she said.

She filed a Sunshine Law request in 2016 for the same data submitted to an independent auditor — Emergency Services Consulting International — for the city's official analysis. That material showed dozens of discrepancies between the city’s raw data and the data provided for independent review. Some incidents included in the city's data were not sent to ESCI for analysis, while others were duplicated. Some calls were cancelled, yet still showed on-scene times; and these short calls were still included in Gateway's average response time. Others, impossibly, showed ambulances arriving before they had even been dispatched.

Ginsberg provided much of this data to Patch.

"When I started, I had no idea what I was looking at," she explained. Eventually, while recovering from cancer, she taught herself what the numbers meant. What she found, she said, raised serious questions.

"More than half of the time-stamped [computer-aided dispatch] reports I received were inaccurately reported to ESCI. I'm not saying anybody is lying, I'm just asking why our computer-aided dispatch doesn't match the data that was sent to [ESCI]. We paid a lot of money to this company to verify Gateway is doing the job they claim they are. Could these have been transcription errors? Yes. But, why are all the transcription errors in Gateway's favor?"

Greg Pace, a retired engineer who helped write the Gateway contract, admitted errors can happen, but said in the end they tend to cancel out. The data examined by ESCI, he explained, came from the University City Police dispatch and show a consistent error rate across EMS and Fire calls.

"The calls come in through the same radio system," he said. "They're dispatched by the same people."

Pace said the push back against Gateway has been largely political, and that members of council haven't taken any steps to improve the EMS service, such as implementing new emergency medical dispatch (EMD) software, which guides dispatchers through EMS calls to reduce errors and improve response times.

"If they see all these problems, why don't they try to correct them?" he asked. "This isn't about public safety. It's just about bashing Gateway."

Pace said Harrawood's death was tragic, but he ultimately doesn't believe it was Gateway's fault. He blamed the police dispatcher for not asking the right questions regarding Harrawood's size, and firefighters for not sending a paramedic with the ambulance from the start. The Gateway contract, he said, stipulates that the fire department is in charge when they are on the scene, and the firefighters themselves would have been responsible for sending the truck back to the station the night McDermott called 911.

While some blame former City Manager Lehman Walker for outsourcing the EMS service as retribution for a political spat with the firefighters union — something he doesn't deny, saying "You'd have to ask Lehman" — Pace said ultimately it came down to the money. University City was losing more than $700,000 annually from its in-house ambulance service, he said, which was unsustainable. According to Pace, the city saved a significant portion of that when it outsourced that service to Gateway — roughly $500,000, not including pension savings.

On top of that, he maintains, Gateway really is faster.

"If it takes our people 90 seconds to get out the door, and Gateway is already in the ambulance, are they going to say that U. City paramedics are faster drivers? It's just simple time in motion. Physics. A posted ambulance is going to beat a house-based ambulance, on average, always."

But, with the numbers in question, it's impossible to know for sure, and there have been at least a few occasions when Gateway ambulances have taken more than a quarter hour to arrive on scene.

Before being chosen as U. City's new ambulance provider, Gateway had never had a 911 contract, and surrounding municipalities have since cancelled their mutual aid agreements with the city. When both U. City's two dedicated Advanced Life Saving (ALS) ambulances are out on calls, another ambulance is dispatched from elsewhere in St. Louis County to pick up the slack, but multiple calls can overwhelm the system. When that happens, less capable Basic Life Saving (BLS) ambulances are sometimes dispatched to fill in.

Pace said that’s only happened once that he knows of, and it was with the approval of the fire department for a non-life threatening call. And since no records were kept of mutual aid response times, it’s impossible to know whether they were faster than Gateway’s response times for third or fourth calls.

The old in-house ambulance service also showed some very long response times, including ones over 15 minutes. Pace said there were as many or more ambulance calls that took that long before Gateway as after.

Nonetheless, the current council majority is in favor of bringing the city's EMS service back in-house. For now, only money and lawyers are standing in the way.

On the money side of the equation, the city has applied for a $1.9 million grant from the Federal Emergency Management Agency to hire 12 firefighter paramedics. If approved, the grant will cover most of the cost of bringing the ambulance service back in-house, while the city will need to foot about $250,000 of the bill.

Whatever it costs, Ginsberg thinks it's worth it. "How much are our lives worth?" she asked.

Getting out of the Gateway contract, which doesn't expire until 2020, may be harder. To break the agreement legally, the city would need to show Gateway in material breach of the contract. At that point, Gateway would have 60 days to make the issue right. The city has previously tried to pass legislation stipulating that all U. City ambulances must have two paramedics on board (as opposed to a paramedic and an EMT), but another such attempt would almost certainly be challenged in court.

Whatever the city’s plan actually is, it’s clear that one exists.

"One of the issues that is on the horizon is resolving the issue of EMS transport. I think we have a strategy for that," said University City Manager Gregory Rose at a recent study session. "We're still looking into some of the legalese, but that project will be wrapped up around the August time frame, or whenever we get information back on our grant application."

What’s clear, though, is that none of that will bring Lonnie Harrawood back. His daughter, Jacqueline Harrawood Burgio, said they had just begun to repair their father-daughter relationship when she lost him. She remembers him as an avid table-top gamer, superhero connoisseur, a prolific actor and roleplayer, and an outgoing man who loved being active, despite his health issues.

“My dad might have had his health issues, but he never let his health issues stop him from being who he was,” she said. “He had more friends that I could keep track of. He was the light in everybody’s day. Everybody loved him.”

Photo: Lonnie Harrawood, center, with his children several years ago; from left, Johnathan Harrawood, Reanna Dupre and Jacqueline Harrawood Burgio (used with permission).