Part 1: Many stories of the system's failure
It was a quiet and frigid winter morning, and nothing seemed out of the ordinary at first. Andy Anderson and her husband Don woke up early in their southwest home, well before the sun would rise on that January day.
But Don suddenly wasn't feeling well. The 57-year-old had surgery just over a week before and contracted a major staph infection. Andy believed he was discharged from the hospital too early.
"He just felt dizzy and then he fell back," said Andy.
Panicked, Andy dialed 911. She says what happened during the call was unexpected and horrifying.
In a phone recording obtained by CTV News, the operator took down their information and address and assessed Don’s condition. Two minutes and 38 seconds into the call, Andy was told an ambulance is on the way.
The operator can be heard saying, "I'm sending the paramedics to help you now. Stay on the line and I'll tell you what to do next. Reassure him (Don) that help is on the way."
Once it's confirmed Don was conscious again, the operator told the couple to wait for help and then hung up. But during this time, Don's condition gets worse.
"He had hemorrhaged through his bowels, so most of his blood was on my floor," said Andy.
"You know he laid there for a very long time, and you know it's hard to watch somebody you love slowly die and there's not a thing you can do to help."
Twenty-five minutes passed and still no ambulance. Andy called 911 again and a different operator answered the phone. She repeated her address and updated Don's conditions again and finally the operator said, "we don't have an ambulance dispatched at the moment. As soon as we have one available, we'll send one right away."
Andy was frantic at this point and asked for an estimated time of arrival, but the operator didn’t have one and eventually told them to "take care" and hung up the phone. It wasn't until after a third 911 call to a different operator an ambulance was finally dispatched. By then, 50 minutes had gone by since the first 911 call.
The fire department arrived within minutes of the third call and eventually two ambulances were dispatched, but records show the first one that arrived at the Anderson's home was off duty. The ambulance that could transport Don to the hospital finally arrived at 6:48 a.m. – one hour and 20 minutes after Andy made the first 911 call.
Andy said she's still upset about the 911 process and never knew how fractured it was.
"My expectation when I call 911 is to have an ambulance and not to have somebody ask me how many times for my address. It should not take three calls to get an ambulance, that’s horrific."
By the time the ambulance left their home it was almost 7 a.m. They arrived at the South Health Campus 20 minutes later.
By 10 a.m. Don died, two weeks before the couple's 13th anniversary.
"He was an amazing man and the love of my life," said Andy.
"When he died, I died. My life was turned upside down."
In Alberta, 911 calls for medical emergencies are triaged and coded into levels of increasing urgency. Alpha calls are considered minor and then there are Bravo, Charlie, Delta, and Echo calls which warrant lights and sirens.
Firefighters automatically assist EMS with Delta and Echo calls, which are reserved for high-priority patients having issues like a heart attack, serious bleeding, or they're unconscious and aren't breathing.
Freedom of information records show the operator coded Andy's first 911 call as Alpha.
It wasn't until 50 minutes later it was upgraded to Delta and an ambulance was dispatched.
Don Sharpe is a retired paramedic of more than 40 years and worked as a dispatcher in the early days of his career and trained new recruits.
"The initial call taker sounded like he was asking all the right questions and getting the right information, but then I see it was sent non lights and sirens as a cold response. And based on what I heard, in my opinion, I think it's reasonable to assume, that call should've at least gone lights and sirens."
Andy doesn't know for sure if a shorter ambulance response time would've saved Don's life, but she said he wasn't even given a choice. She also wondered why she was told an ambulance was dispatched when it wasn't.
"And that is one I can't forgive. If you're not going to send an ambulance, don't say one is on the way. Like you can't do that to people. These are lives you're playing with."
An emergency communications officer (ECO) in dispatch agreed to an interview but we're protecting their identity as they fear discipline speaking to the media.
This individual said ECOs are not allowed to tell the public an ambulance has not been assigned to the call.
"That's the hard part. When you are literally lying to somebody and telling them we've got somebody on the way, or our closest available unit is on route and they're at the bottom of the queue. We could get reprimanded for saying like, you know, do you have a neighbour, or can you take a taxi or an Uber and sometimes those are way better options."
The ECO said some call takers have suggested an alternate method of transportation when there aren't any ambulances to send.
"There have been a few call takers who have done it, yes, and then we ended up getting an email saying that like you guys have to continue to follow our protocols and you can't tell the public that one's not on the way."
Alberta Health Services (AHS) wouldn't comment specifically on the protocol but in a statement said:
"An ECO follows a stringent set of internationally accepted guidelines to evaluate an emergency efficiently and that estimations about ambulance response times or status are not provided unless requested by the caller."
The ECO CTV News spoke to says ambulances not assigned to a call is the norm these days because the province is in a constant state of red alert, when no ambulances are available to respond to a call.
That means they can't keep up with the 911 emergencies flooding in and ambulances can't be dispatched.
Records CTV News obtained show some of the longest dispatch responses in Calgary this year, ranging from one hour and 21 minutes to seven and a half hours for Delta and Echo calls, but there were also long dispatch responses of more than six hours for emergencies prior to 2018.
"You'll have around 20 calls just sitting in pending and sometimes they've been waiting for hours. And they try to have people like our ECOs call them back to check in on them, but we're not medical professionals. We should not be making a choice on who gets an ambulance and who doesn't but that's become part of the job," said the ECO.
When calls are in pending, or in the queue, a deep red alert has been reached.
The province only started formally tracking calls in pending in August 2021. Comparing numbers from last year to this year, in Calgary, there was roughly a 1,400 per cent increase in calls in pending while in Edmonton the increase was more than 900 per cent.
More calls in pending plus long dispatch times means longer response times.
AHS records show the average response times for all types of calls with an advanced life support (ALS) ambulance in Calgary jumped from just under 13 minutes in 2021 to about 24 minutes in 2022.
And some of the longest response times this year for all types of calls ranged from an hour and a half to almost 11 and a half hours. But there were also long response times ranging from four to close to seven hours prior to 2020.
Response times in Calgary that are more than 30 minutes long are still rare, but over the last eight years it's become more common.
In 2014, less than one per cent of responses to Calgary with an ALS ambulance were more than 30 minutes long and this year that figure is almost 18 per cent.
As for where the ambulance is responding from, it may not even be in Calgary.
Most are, but records show completed calls to Calgary came from as far as Edmonton, Sherwood Park, and Medicine Hat.
A long ambulance response time might have sealed the fate for Candace Speck's aunt, Betty Ann Williams, called "Rusty" by friends and family.
The 86-year-old loved her garden and was eager to spend more time outside especially after recovering from cancer.
"She was a fun just an all-in it girl," said Speck,
"She loved her sports, and she was in the service, and she just loved life."
On June 5, Rusty was in her back-alley pruning weeds when she was mauled by her next-door neighbour's three pit bulls.
Nicola Opsal, another neighbour heard the commotion.
"I hear this 'help' and I'm startled, and I was almost like did I actually hear that right?" she said.
"At that point, my husband happened to just come out and go 'what's going on?' So, I was telling him it looks like some dogs. I think they attacked somebody in the back alley. So, we got out there and he's like 'call 911!'"
Opsal made the 911 call at 2:01 p.m. saying a woman in her 80s was attacked or mauled by dogs. She says a bylaw officer arrived shortly, as did an ambulance, but it wasn't for Rusty and drove by.
"I'm going, 'what the hell is going on?' As time is going by and no one is showing up I'm getting more and more upset. The bylaw officer was literally on his radio, continually trying to get somebody here."
AHS said it took paramedics 30 minutes to get to Rusty and she died on the way to the hospital.
When Speck learned of her aunt's passing, she could not believe it.
"I felt dread. It was just like every emotion in the book. Anxiety, panic and I was angry," said Speck.
She said she couldn't even say a proper goodbye at the hospital.
"I couldn't touch her. They wouldn't let me kiss her. The damage was so extensive they didn't want more trauma to me. Basically, she was shredded from head to toe."
AHS said the call was coded as non-life-threatening and it wasn't until a second call was placed to EMS about the seriousness of the injuries that an ambulance was dispatched.
AHS documents revealed the ambulance responded in nine minutes and 53 seconds, but it wasn't dispatched for at least 20 minutes.
From the time Opsal made the 911 call to when the paramedics showed up, nearly 40 minutes had passed.
"If somebody would've called me, I could've got there faster from my work and taken her to the hospital in a shorter amount of time than it took for them to get here," said Speck.
As for Opsal, she felt AHS blamed her for not relaying correct information about the emergency and she is guilt ridden over it.
"Had they showed up sooner would she have lived? I mean, we don't know, but I worry did I say enough? Was I urgent enough on the phone? I want to know what I did wrong."
After Speck's experience, she said the EMS system is terribly run.
"It's sad because they don't have enough ambulances or people. Like how did we even get here? I'm just so heartbroken and I don't know if I'm ever going to recover from this."
As for Andy, recovery is a long road, but the memory of Don gives her strength.
"He was into Harleys, and we would go riding. We were supposed to do a big trip this summer. I went riding with a friend two weeks ago on his bike and as much as I loved it, it was bittersweet. All I can think of is I'm supposed to be doing this with my husband."
Until that day comes, telling her husband's story, is her way of honouring him.
"I have no faith in 911 anymore and that's a shame," she said.
"People need to know that it's bad. It's really bad and it's not just my story. There's many, many more stories."