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HomeMy WebLinkAboutXfinit Center Sub Comm 10/01/2013Minutes of Meeting of October 1, 2013 Comcast Center Post -Season 2013 a r C C -(C� Attended by: Nick Riccio, Building Inspector, Town Mansfield Bruce Montgomery, General Manger, Live Nation Dr. Brian Kelly, Sturdy Hospital Ronald Sellon, Chief of Police, Mansfield Police Department Lt. Samuel Thompson, Mansfield Police Department Justin Desrosiers, Mansfield Fire Department Neal Boldrighini, Fire Chief, Mansfield Fire Department Deputy Chief James Puleo, Mansfield Fire Department im i`[4 S r � ry� Jess Aptowitz, Selectmen; Town of Mansfield William Ross, Town 'Nlanag'er,:T6wn of Mansfield David Faunce, Exec. Dir., Southeastern Massachusetts Emergency Medical Services Council Bill Shinkwin, Aegis Protection Group Mike Holston. Aegis Protection Group Mr. Ross began the meeting at 9:03 a.m. He informed the group that he had recently met with his staff to discuss the 2013 Comcast Center Season. Mr. Montgomery indicated that it was he and Dr. Kelly who had called the meeting and that he was disappointed to see that only one selectmen was in attendance. It was his hope that the presence of a more selectmen would help to facilitate the distribution of information to the Board. Mr. Aptowitz expressed his desire to keep the meeting civil and professional. Mr. Montgomery stated that the request for this meeting was triggered by two incidents: 1. The Wiz Khalifa event at which 5 local ambulances were taken out of service to cover at the venue. He presented a document evidencing the ambulance transport statistics in 2012 and 2013 for this event and believes that the statistics indicate that the extra ambulances were not warranted. He expressed his concern that doing so was not in the best interest of the Town. 2. He has been receiving feedback from patrons about people being encouraged to be transported to Sturdy or being told that refusing transport could result in legal action. He stated that a woman called his office complaining that she had tried to refuse transport and that she was told legal actions could be taken if she didn't transport. He stated that when she arrived at the hospital she was not found to have any urgent medical need and left without being treated. Mr. Ross asked Mr. Montgomery if he had thoroughly investigated the claim and Mr. Montgomery stated that he had not spoken directly with the woman. He believed that the determination to transport her was made by the Fire Department. Chief Boldrighini stated that he was aware of the allegation and had investigated it. He stated that the woman had passed out and struck the back of her head during the Kid Rock Concert. MFD personnel responded to lawn area and transported the patient to the triage via wheelchair. 1 He indicated that, while at the medical tent, her blood pressure was below 100, and protocol dictates that she should be transported. He stated that he was personally concerned about the allegation and wanted to hold his staff accountable if it had, indeed, happened. He stated that he had spent 45 minutes on the phone with the patient and had her describe the staff who had transported her. She described the staff as wearing the same color shirt as the staff who had transported her to the hospital, and that staff was from Events EMS, not from the Mansfield Fire Department. He said that her recollection was clear and detailed. Upon further discussion with the patient, he discovered that there were family dynamics which prompted the patient to complain about the bill and the fact that she had been transported. Chief Boldrighini stated that none of the Events staff or his staff recall anyone being adamant about not wanting to be transported, and that refusals to transport have, in the past, been dealt with according to an established protocol. He summed up his discussion with the patient by saying that he believes that she did not make it known to anyone in the triage area that she did not want to be transported and panicked when she realized that her spouse would find out. The Chief indicated that he had spoken with Dave at Events EMS and that he was going to follow up on this allegation. Mr. Montgomery again expressed his concern about the absence of another member of the Board of Selectmen, and asked that Mr. Aptowitz to pass along to the Board the information that he is presenting. He thought that it would be beneficial to have all of the selectmen visit the site and meet with his staff. He believes that his staff has input on what they have observed over the course of the season. Mr. Aptowitz asked Mr. Montgomery if the Kid Rock issue, for purposes of this meeting, had been fully discussed and is being worked on, and that this issue has nothing to do with Town staff. Mr. Montgomery agreed. Dr. Kelly agreed that the patient initially required treatment based on protocol in that her blood pressure was low. He stated, however, that she can refuse care. Mr. Montgomery indicated that this was only one example and that there is still an issue with who should be making the decision to transport. He believes that Events EMS and the Town of Mansfield Fire Department are working under a different set of protocol. Dr. Kelly believes that the venue is a complicated place and that more people are going to refuse treatment than usual. It becomes difficult for the staff to make a decision about whether or not a patient has the capacity to make a medical decision to seek treatment or deny treatment. Chief Boldrighini stated that there were a total of 738 medicals and 172 transports. Mr. Ross stated that he believes the number of transports relative to the number of medicals is low. He asked if the protocol should be standardized based on state regulations. Mr. Faunce indicated that both Events EMS and the Town Fire Department are subject to the same set of protocols. 2 Dr. Kelly stated that the treatment is subject to protocols, but the decision to transport is not and can be subjective in this environment Mr. Faunce stated that the big issue is that alcohol is involved and when an intoxicated individual is unable to make a decision about treatment, the liability burden then shifts to the medical personnel evaluating the patient. Mr. Montgomery again reiterated that there has been a significantly higher number of ambulances assigned to the facility. He is also concerned by Dr. Kelly's report of the assessment of cases coming from the compound. He stated that he is very concerned about the management of resources. He believes that the Town has gradually been throwing more people at the venue rather than managing the process through the medical tent. Chief Boldrighini stated that there were 5 ambulances, 3 ALS and 2 BLS initially assigned. Mr. Ross and Mr. Aptowitz both indicated that they were in attendance at this show and found it to be worthy of the assigned ambulances. Mr. Ross believes that there are logistical issues of moving patients from the compound to triage tent. Chief Boldrighini explained that it was necessary to bring in additional ambulances when it became clear that there were patients in the compound who would need transport. He could see that there were multiple needs for multiple pieces of equipment at the same time. He stated that the doctor in the medical tent could not leave the tent to assist at the compound and that conditions at the compound were poor for attending to those in medical need. The group then discussed the movement of patients from the compound to the medical tent. Chief Sellon believes that it is a safety issue moving people through the crowd from the compound to triage. Dr. Kelly asked for the protocol in making a decision about whether a patron is brought to the compound or to the aid station. Chief Boldrighini stated that it is a difficult job; security goes into the crowd if there is a disturbance, and unless the patron is in obvious distress, they are taken to the compound. He stated that the group has to avoid asking non-medical professionals to make medical decisions. Dr. Kelly suggested that security bring individuals to the medical tent first and then make the decision to move them to the compound if there are no medical issues. Mr. Montgomery indicated that he has no problem with the way patrons are being moved from the compound to the first aid station, and Mr. Ross indicated that it would continue to happen except under extraordinary circumstances. Mr. Aptowitz described the scene during Wiz Khalifa and indicated that certain decisions had to be made to reduce the chaos. Mr. Montgomery stated that his staff believed that this show was easier than the year before. Chief Sellon, however, disagreed. Mr. Montgomery acknowledged that both 2012 and 2013 were difficult but again stated that the number of ambulances and a call to Norton was unwarranted. Mr. Aptowitz again stated that several ambulances were needed at the same time, and it was unavoidable. Chief Sellon stated that, in accordance with Graham v. Connor, the level of liability lies in whether or not they acted in a reasonable manner. He stated that nothing that was done was unreasonable that night, given the circumstances. Mr. Montgomery indicated 3 that Live Nation is willing to take on the liability for first responders, but Mr. Ross stated that this is not an option. Chief Boldrighini stated that 5 ambulances were not enough that night. He believes that it is possible that 2 ALS patients were put into an ambulance, which should not have been done. While two patients can be transported in one ambulance they should only be BLS. Dave Faunce supported this. Dr. Kelly asked if the Chief has taken turn -around time into account. Chief Boldrighini stated that the initial issue involved a need for multiple transports at the same time. All of the events vehicles as well as three municipal ambulances were committed, including two coming back from the hospital due to these simultaneous calls for service that included patients from the compound, the triage and the lots. This left no ambulances on site during this very busy period. However, utilizing the command center, it was determined that two Events EMS ambulances were in fact heading back to the Comcast. This prevented the need to call in more municipal ambulances. Dr. Kelly indicated that he had heard that after Norton was called during Wiz Khalifa, ambulances were returning from a run. Dr. Kelly stated that perhaps another medical staff person in the compound would be beneficial. Mr. Aptowitz stated that things happened all at once within a short period of time that night and that the Fire Department made the right decisions. Mr. Faunce stated that this is "making a mountain out of a mole hill". He stated that doubling up patients is not possible if you have a patient who is vomiting, as it becomes an airway issue. He stated that he had spoken with people who were there that night and acknowledged that it became chaotic, but that the Town adjusted. He stated that he does not see an issue. Chief Boldrighini stated that he has seen an overall 1/3 reduction of the use of municipal services from the prior year, indicating that the system is working. He also stated that Town resources often have to be used prior to the start of events when the gates open early and Events has not arrived on the scene. Mr. Ross stated that Events needs to be there when the gates open. Chief Boldrighini also stated that he has seen a reduction in Town responses to the Police Department as the use of the compound has cut back on the need to do so. Chief Sellon stated that the busiest time during concerts is between 7 and 9 and that persons being brought to the compound are coming from all areas of the venue. Lieutenant Thompson reviewed the criteria for placing an individual in protective custody, which includes a demonstrated incapacity and that the decision to place an individual into protective custody is based on the level of that incapacity. He stated that once an individual is placed in protective custody, he/she becomes the Town's responsibility. Lt. Thompson reviewed the new law expanding the definition of "minor" to include anyone under the age of 18, rather than 17, and expressed the concern that a majority of the individuals placed in protective custody are in the 17 year old range. They can no longer bring those individuals back to the police department. Chief 0 Sellon stated that the compound will be somewhat more complicated next season because of this change. Selectmen Aptowitz suggested relocating the compound to an area nearer to the first aid tent and asked if this would help with the transport of patients. Mr. Montgomery stated that he would consider it. Dr. Kelly suggested that this arrangement would have been helpful at the Wiz Khalifa event. Mr. Shinkwin stated that there is some confusion over who should take responsibility for patrons once he removes them from the crowd. He uses his best judgment and has brought individuals directly to triage when necessary — specifically, when they are unable to stand. He also suggested segregating the underage patrons waiting for parents in a separate area. Chief Sellon stated that the juvenile detentions have pushed the compound to capacity. Chief Sellon also suggested that he would like to separate the males from the females in the holding area. Everyone agreed that moving the compound closer to the medical tent would be beneficial. Chief Boldrighini expressed a slight concern that the area will be very busy, but thought that it could be worked out. Selectmen Aptowitz indicated that everyone should keep in mind that the statistics presented by both Mr. Montgomery and the Chiefs do not include the patrons known as "fence hangers." These are individuals who are not necessarily taken into custody, but who utilize valuable resources in the process of making the decision whether or not to detain them. Mr. Ross indicated that the suggested reorganization could result in a cutback of staff. Mr. Shinkwin stated that Aegis could certainly take on the added responsibility of monitoring the minors in custody. Mr. Ross asked that the group meet, evaluate the venue and discuss where to place the compound and medical tent. He would also like to see Dr. Kelly or one of his staff at the venue during challenging events. He stated that the responsibility for the well-being of all of the residents of Mansfield, as well as visitors, rests with the Town. Mr. Faunce stated that, if there is a doctor present, the burden shifts to the doctor. Mr. Montgomery suggested that the Town has the authority to delegate that responsibility under the Service Zone Plan, to Events EMS, and that is the way it has been done in the past. Mr. Ross said that this is not an option that the Town will consider. Selectmen Aptowitz assured Mr. Montgomery that the Town wants to see the venue succeed, and that the safety of patrons goes hand-in-hand with that success. I -Ie complimented all involved for putting forth their best effort. 5 Chief Sellon asked Mr. Montgomery to let Mansfield staff know his thoughts on where best to locate the compound and medical tent for next season. Mr. Riccio stated that everything will go smoothly with the proper permitting, cooperation, and compliance with codes. Meeting concluded at 10:07 am. Minutes taken by Deb Herbert