Consultants Recommend Portland Police to Revise its Emergency Medical Care Policy

Dec. 04--Portland police should strengthen its policy on providing emergency medical care to suspects in response to a 2011 case in which a man died after complaining of trouble breathing, but officers decided not to call an ambulance, outside consultants say.

Consultants from the Los Angeles-based Office of Independent Review Group recommended in a recent report that the bureau make it very clear that officers should not only call an ambulance for someone who is "displaying" respiratory difficulty or breathing problems, but also for any person who claims to be having difficulty breathing or to be in some sort of medical distress.

OIR consultant Judy Ruhlin told City Council members on Wednesday that the policy should not leave the decision up to the officer's discretion.

"The ultimate outcome here makes it clear that officers should have called EMS," the consultants wrote in a recent report evaluating officer-involved shootings and the death-in-custody case. "Officers should be instructed -- by policy and in training -- to err on the side of calling EMS rather than being dismissive of subjects' complaints prior to transporting them.'"

In 2011, Darris Johnson, 26, died of cardiac arrest in Portland Adventist Hospital's emergency room after he had run from police at a traffic stop. Police caught him after he led them on a two- to three-block chase, scaling three fences. Once arrested, Johnson complained of shortness of breath. The police thought he was exhausted from the chase or trying to delay his trip to jail, the consultants' report said.

Two officers who drove Johnson to East Precinct thought he was pretending to sleep, but soon found him unresponsive and not breathing. They stopped the car once and an officer opened the back door of the patrol car and shook Johnson's chin, causing him to rouse and mumble something. The officers said his breathing seemed normal. They stopped the car a second time when they couldn't hear him breathing. This time, he didn't have a pulse. The officers called for paramedics and a sergeant, pulled Johnson from the car and put him on his side to ease his breathing.

"When a sergeant arrived, he instructed them to begin CPR," the report said. Two officers began CPR while a third tried to locate a breathing mask.

City Council member Amanda Fritz, a former psychiatric nurse, said she was perplexed why the officers didn't start CPR right away.

"I assume officers have some measure of emergency medical training," she said. "He has no pulse. ... The officers didn't know to do CPR when there's no pulse?"

Ruhlin, who reviewed the case, said the police record "was not entirely clear on how events transpired."

At the time, Portland Copwatch's Dan Handelman questioned why police didn't call an ambulance right away. "I thought they made a point, especially after James Chasse Jr. about getting medical attention more immediately to people. If they had dealt with it, who knows, maybe he'd be alive now," Handelman said then.

Chasse's death in 2006 revealed gaps in police and county procedures because no one recognized the significant injuries he had suffered until it was too late.

Chasse, 42, who suffered from schizophrenia, sustained multiple rib fractures, some of which punctured his left lung, early in an encounter with police on Sept. 17, 2006. Ambulance paramedics who responded to the scene said his vital signs were normal and had a Portland police officer sign for him, declining emergency transport to a hospital.

Police drove Chasse to the downtown Portland jail. He appeared to suffer a seizure in a holding cell and went unconscious. A jail nurse looked through the cell door window and told police the jail would not book Chasse. There was no discussion as to whether Chasse should be taken to a hospital by ambulance or by the police. Portland officers placed him in a patrol car. He died on the way to a hospital. The cause of death was broad-based blunt force trauma to his chest, the medical examiner ruled.

Though the Police Bureau tightened its emergency medical care policy after Chasse's death, the consultants said the Police Bureau should add their recommended language to strengthen it further and make sure there's no ambiguities.

In response to the consultants' recent report, the Police Bureau has said it agrees with the suggestion to tighten their medical care policy and will "consider" adding the language.

In other related developments: Fritz further questioned the commander of the Police Bureau's detective division on why the bureau disagreed with another of the consultants' recommendations -- that the state medical examiner be asked if a suspect killed by police could have survived if he or she had received emergency medical care earlier.

"What is difficult for us is to get the answer...we certainly can ask," Detective Division Cmdr. George Burke said.

In a written response to the consultants' report, the bureau wrote that it disagreed with the recommendation, noting that "such information from the medical examiner (if they chose to provide it) would at times be speculative."

"I'd like this question to be asked," Fritz pressed Wednesday. She said it would be helpful for the family of the deceased to know.

Fritz asked the mayor how the city should make sure police pose the question to the medical examiner.

"That's my job," said Mayor Charlie Hales, who serves as police commissioner. "It's information we should get."

--Maxine Bernstein

Copyright 2014 - The Oregonian, Portland, Ore.