This January, a mom dialed 911 when her daughter stopped breathing, but there was no ambulance available to help.
"I just kept asking, 'What's going on? Is she breathing? Is the ambulance coming?'" Andrea Feeley recalls of the moments after her 2-year-old daughter, Yuna, slumped over on the couch and stopped breathing.
Fire crews from the town of Winthrop, Massachusetts, responded within minutes, but the two ambulances in town, contracted through Action Ambulance, were tied up on other calls, sitting at emergency rooms waiting with patients miles away. The situation became more urgent as time ticked away.
The fire chief put Yuna in the back of his SUV and rushed to Massachusetts General Hospital in Boston with firefighter EMTs performing CPR along the way. They arrived at the hospital 23 minutes after the initial call for help. Yuna didn't survive.
The girl deserved "an ambulance and paramedics who could have possibly done more," Feeley says.
It's an example of what's playing out in EMS services across Massachusetts because the system is stressed. Some in the industry call the moment when there's a critical need for an ambulance but no crew is available to respond "Level Zero," and it's happening more often across Massachusetts.
"Our largest worry is that those truly life-threatening cases, we might not have a resource available," said Michael Woronka, the president and CEO of Action Ambulance.
The NBC10 Investigators embedded with Action Ambulance and witnessed the challenges to fill the critical need firsthand. On a weekday afternoon, emergency crews were scrambling, responding to call after call.
They again hit Level Zero, which Woronka explained meant that, if someone called 911 within minutes, it would "be a waiting game in terms of who has a resource to potentially send" for help.
At the same time as Winthrop is at Level Zero, there are also no ambulances available in Revere, the city next door. Revere in fact had a 911 call and called Winthrop for help with mutual aid. Two municipalities had no ambulances at the same time.
But the EMS system is taxed across the state. On this day, on the South Shore, ambulances are stacked up at Good Samaritan Hospital waiting for patients to be seen. In Boston, data we obtained shows response times are slowly creeping up, and the number of calls have increased 20% in three years, with fewer EMTs on the road.
A call goes out for an elderly man in Hampden, but there's no ambulance available. In Pittsfield, a Level Zero was declared.
Staffing issues and overcrowded emergency rooms are part of the problem, according to Dr. Robbie Goldstein, the commissioner of the Department of Public Health, which oversees the Emergency Medical System in the Massachusetts. Wait times at emergency rooms cause ambulances to wait, which keeps the ambulances off the road.
"It's tragic and it's horrible and we have to fix the system because we can't not answer the call," he said.
In fact, the Office of Emergency Medical Services found this May that the "taxed" system left no ambulances available to respond in Yuna's death on Jan. 26. Action Ambulance followed policies and procedures correctly, and members of the Winthrop Fire Department tried to meet up with another ambulance that answered the mutual aid call, but it was too late.
Woronka, of Action Ambulance and a first responder for 38 years, said low pay — impacted by a pay structure that only reimburses ambulances for patients being transported and not the care they receive — and an increase in the number of calls are also having an impact.
"The entire system," he said, "it's not just at a breaking point. It is breaking as we are watching this unfold in front of us right now."
Yuna's mother is calling for to change that system, saying it "shouldn't have happened" that no one was there to help when she dialed 911.
"It could have been the difference of saving her life," Feeley said.
