American Medical Response

[September 8th, 2004] It's not always fair to sweat the small stuff. But there are places where picking nits seems appropriate. Ambulances, for example. That's why the results of a recent state inspection of American Medical Response, the company that contracts to provide Multnomah County's ambulance service, are troubling.

According to an Aug. 24 "letter of instruction" from the state to AMR, investigators found a litany of rule violations during a pre-arranged inspection of AMR's Portland operation on Aug. 10 and 11. The letter, which WW obtained through a public-records request, socks AMR for record-keeping quibbles. But it also says the company fails to stock enough medicine or replace outdated equipment and expired medications.

"[I]n several cases some of the supplies were critical and the units were prohibited from responding until fully stocked. In discussions with several of the employees they reported that it is not uncommon for on-duty crews to 'rob' off-duty cars of supplies not available in the supply room," according to the letter, which says inspectors found violations on all 16 ambulances they looked at.

The letter, which orders AMR to fix problems within 30 days, has the company crying foul. Spokesman Larry Harvey says the scathing assessment came "out of the blue" after AMR agreed to help the state, which hadn't inspected the company since 1997, test out a new inspection regime. Regional director Randy Lauer says the state flat didn't know what it was doing. He says many of the record-keeping violations were the product of misunderstandings and overhyped comments about minor problems with seldom-used medicines and equipment--nerve-gas antidote and spare flashlight batteries, for example.

"It was a very sloppy inspection," says Lauer, adding that all 16 ambulances were judged acceptable despite violations. "If they conduct this kind of inspection in other parts of the state, they're going to come under a lot of heat."

OK. That may be. But the fact is, AMR had 18 days advance warning of the inspection--if there was ever a chance to ace a pop quiz, this was it. And when it comes to emergency response, can't we be forgiven for being sticklers once in a while?