Paralyzed EMT calls for better ambulance safety

By Kathleen Foody
Gannett Wisconsin Media Investigative Team
Feb. 18, 2013

Video report by Sharon Cekada/Post Crescent available on YouTube

MOSINEE — He went golfing that summer morning, humidity already rising. He prepared grilled steaks for dinner, stopping when an emergency call crackled through the radio. He walked quickly from the house to his truck and drove to the Mosinee Fire Station.

Matt Deicher doesn’t remember the rest of July 31, 2003. But he was told that he and another part-time EMT jumped into the back of an ambulance, unaware that a state inspector had ordered its failing tires replaced two days before.

He was told that his family was eating dinner when they heard the crash report over the radio still sitting on the kitchen counter. Two people, both male, were unconscious and badly hurt after an ambulance rolled over just after 6:30 p.m. en route to a Wausau hospital.

He was told that his wife, Melissa, spent much of the next six months by his side, while he recovered at hospitals in Wausau and in Denver, Colo.

He was told that a two-month investigation found the worn tires, in addition to a rain storm, the newly paved highway, and the ambulance’s speed, all contributed to the crash.

What he didn’t have to be told was that he was paralyzed, from the neck down.

‘I will never point a finger’

Nearly 10 years later, Deicher can re-tell the story without anger. He’s hoping the crash that paralyzed him and killed 52-year-old patient David Nicewander will remind emergency medical workers why maintenance is important.

“I’m not going to blame anybody; I will never point a finger,” Deicher said. “(But) could it have been prevented? Very, very easily.”

More than 1,200 ambulances respond to emergency calls in Wisconsin, and individual crews are responsible for daily maintenance. But only one person is responsible for biennial inspections statewide, and that inspector still finds problems — though the visits typically are scheduled and announced a week in advance, a Gannett Wisconsin Media Investigative Team report published Sunday found.

Deicher’s been a member of a crew responsible for keeping up with ambulance care. But after that system failed him, he has questions that make his quiet and gravelly voice louder and clearer.

Why did it take a state inspector to point out the problems with his department’s tires? He worked in an auto body shop as a teenager and remembers easily spotting when tires needed to be replaced.

Why did the inspector allow the department to keep using that ambulance? Deicher said the department had a back-up, older ambulance.

Asking those questions isn’t about assigning blame, Deicher said. He can’t do that, knowing that he had some responsibility for checking ambulance equipment and that he, too, would have sped up to get an unconscious patient to a hospital.

In the driver’s seat

The rain began on July 31 just as Jason Toboyek pulled the ambulance onto the highway. The three-member crew and their patient, Nicewander, were headed north to get treatment for his hip pain without activating the sirens or lights.

Toboyek heard “let’s go hot” from the back of the ambulance, a cue that Nicewander had lost consciousness. He turned on the ambulance’s siren and accelerated. As the highway pavement shifted from concrete to blacktop, he felt the back of the ambulance tilting toward the passenger side.

The end of July always was a rotten time of year for Toboyek. His oldest brother, Patrick, was killed during a car crash on July 30, 1996.

As he lost control of the ambulance, Toboyek remembers thinking: “Now my parents have got me.”

Mary Beth Lingl, the third EMT on the crew, was preparing to stand up when she felt the ambulance jerk sharply followed by a crash as the vehicle rolled. Then everything went black.

The ambulance slid into the grassy median of Interstate 39 near Rothschild, rolled over and came down on four wheels, siren still wailing. Toboyek scrambled for the radio.

Lingl could hear him reporting an accident, “10-50” in radio code. Dispatchers were confused, she said, asking if the ambulance driver had witnessed a crash.

“No, we are the accident,” she remembers Toboyek shouting back.

Toboyek ran to the back of the ambulance and opened one of the swinging doors. From her position toward the front of the ambulance cab, one leg pinned underneath the patient stretcher, Lingl shouted for him to be careful.

Deicher, buried in a pile of medical equipment and gasping for breath, could fall out of the other door.

Toboyek checked Nicewander’s pulse using the man’s foot, unable to reach his wrist, but found nothing. Nicewander was pronounced dead at the scene, and a coroner later found he died from massive head injuries.

It took Toboyek seven months to return to his full-time job, and many conversations with family, friends and a professional therapist before he could return to the side EMT career he started as a high-schooler. Lingl didn’t return to the Mosinee Department for almost three years.

All three have have stayed in touch in the decade since the crash. Toboyek, now 37, accompanied Deicher on a deer hunt in 2011, and Toboyek named Deicher the godfather to his 8-year-old daughter, Jenna.

Lingl, now 39, said she constantly questions why Deicher was injured so terribly but she’s been able to have three children since the crash. If the ambulance spun in another direction, would she be the one paralyzed?

“That’s my biggest question,” she said. “Why him? Why not me?”

Moving on

Winter is the most difficult time of year for Deicher, especially this year. He’s been on bed rest since November for pressure sores that have to be dressed regularly.

“Just another hurdle,” Deicher, 42, said and smiled.

It’s taken him years to clear others: building stamina to use a motorized wheelchair, overcoming the feeling that everyone was staring at him in public, and learning to hunt deer with a gun mounted to his chair that fires when he blows through a tube.

His house in Mosinee is engineered for his new life, with a large bedroom connected to a bathroom and a room for the rotating staff of registered nurses and nursing assistants who spend every day with Deicher.

He’s rarely alone now, between the nurses who seem to anticipate every need and his dogs, boxers named T.J. and Bhrett.

He brings up a question of his own. “Has the quality of life changed? No.”

His pre-accident relationships have, especially with members of the Mosinee Fire Department.

He tried to comfort his former colleagues after returning from Denver, visiting the station in his motorized wheelchair and ensuring them that he “was still the same,” just unable to move.

“That really didn’t help much,” he said.

Deicher suspects it’s difficult for them to see him as anything but a reminder of the bad things that can happen in a crash.

He and Melissa divorced in 2005, after 18 years of marriage, but have remained friendly. Their kids, 21-year-old Whitney and 18-year-old Austin, and 3-year-old grandson, Caden, keep them linked.

Beyond family, Deicher’s closest friends are the people who work to keep him healthy and his home maintained.

A rare but complicated crash

Looking back, and not for the first time, former state inspector Dee Evans wouldn’t have made a different decision in July 2003. He’d been traveling the state for two years, inspecting Wisconsin’s ambulances for problems and hoping to educate rather than punish departments.

He marked the Mosinee EMS Department’s ambulance “Not OK” for tires on July 29 and gave the crew 10 days to get new ones.

“Normally, when I talked with full-timers, they’re very good at taking care of their issues,” said Evans, who now directs the city of Berlin EMS in Waushara County. “I didn’t expect anything differently from this service.”

Ambulance crashes in Wisconsin remain rare. Ambulances were involved in 18 crashes of 179,816 total in 2010, the latest year available in DOT records.

An investigation into the Mosinee crash that killed Nicewander and injured Deicher took two months. Investigators concluded the worn tires, wet road conditions and speed of about 75 mph all contributed.

Jim Nicewander, David Nicewander’s brother, said he didn’t specifically blame anyone or anything for the crash that killed his brother. The state inspector caught a problem with the tires and gave the Mosinee department an appropriate time frame to fix it, he said.

“Even when the vehicles themselves are in excellent working condition, accidents can still happen,” Nicewander said. “And those accidents can still sometimes be fatal.”

What should change

Deicher said he’s not advocating sweeping changes in state ambulance inspections. He believes minor steps can prevent crashes like the one that paralyzed him.

Inspectors could strictly enforce certain violations, he said. Worn tires are an obvious example for Deicher.

“I think they could prioritize some things,” Deicher said. “Tires, driver training, steering. If there’s a problem with something like that, you’ve got a day or two (until) it’s red-flagged.”

Toboyek, who still works for the Mosinee Fire Department as an EMT, agreed. He and other veterans of the department constantly emphasize the importance of maintaining ambulances, and they have a no-tolerance policy for a vehicle that falls short.

One problem, and it’s taken off the road for repair.

“We have a lot of new people on our department now, and a lot of them weren’t around,” Toboyek said. “I think it’s more the veterans who understand it and did see what we all went through — and definitely don’t want to ever go through that again.”

Almost 10 years after the crash, Lingl said she still doesn’t know much about the state process. She was surprised to learn a state inspector visits once every two years.

“I know there are personnel and monetary issues, but wow,” she said. “We’re not just transporting health care workers, we’re transporting people.”

Jim Nicewander worked for 30 years as the safety director for the Stevens Point Area Public School District where his responsibilities included maintaining a fleet of school buses. He’s familiar with the state’s inspection process for the buses, annual checks plus random visits, and hopes ambulances are subjected to the same scrutiny.

He would favor adding more random checks of ambulances to the biennial inspection system already in place.

Nicewander also hopes ambulance departments will pass the results of vehicle inspections on to anyone who might be driving them.

“I’m not finding fault, but anytime something happens with bad consequences, you want to look at that situation and see if you can learn from it,” he said.

Deicher misses being an EMT every day. He worked in hospital maintenance and spent hours observing the emergency room action before pursuing a career in emergency medicine.

He and Melissa took classes at Northcentral Technical College in Wausau, organizing their study time around taking care of two kids and their full-time jobs. Toboyek was in their class, too.

“Helping people, it was a joy,” Deicher said about his time as an EMT. “It felt good … helping people, to save their life, to continue on their life journey.”

His son, Austin, has expressed some interest in emergency medicine. Deicher told his son “go for it.”

“I would never tell anybody to shy away from EMS, fire (department) or anything (like) racing a car or driving a motorcycle,” he said. “If you live life being afraid of everything, your life’s going to suck.”