Alberta Health Services (AHS) said Thursday an independent review will take place on the response to a fatal dog attack in Calgary last Sunday.
CEO Mauro Chies told reporters Thursday that the agency in charge of the province's ambulance services has conducted an internal review of the response, but another pair of objective eyes is needed.
"We are aware of the concerns expressed about the time it took for an ambulance to arrive at the scene and we take those concerns very seriously," Chies said.
Later Thursday, Calgary Mayor Jyoti Gondek said the city would be conducting its own investigation of the incident — and levelled criticism at the province's consolidation of EMS dispatch services.
"The system is broken," Gondek said.
"The bottom line is, longer response times and additional unnecessary steps in the process of reporting a complex emergency drastically impacts patient outcomes."
It took an ambulance 30 minutes to get to 86-year-old Betty Ann Williams, who had been attacked by three dogs in the city's Capitol Hill neighbourhood and died from her injuries.
Chies said the person who will conduct the provincial review will be from outside Alberta and external to the province's system, but familiar with EMS dispatch and 911 protocols.
"The independent review will look into the events surrounding the calls to EMS dispatch, call-handling protocols inside EMS and with other agencies, ambulance response time, and availability of ambulances at the time," Chies said.
A final report is expected to be delivered by the end of September, Chies said.
Calgary in red alert when dog attack occurred: AHS
The incident came after reported increases in ambulance red alerts and 911 urgent disconnects.
A red alert is when no ambulance is available to respond to calls and an urgent disconnect is when a 911 call taker must hang up to respond to incoming calls.
While Chies said he did not know whether the system was in a state of red alert and that would be something the external reviewer would take a look at, AHS spokesperson Kerry Williamson confirmed later Thursday that it was.
"Eighteen ambulances were waiting to offload patients at various medical facilities; this includes paramedics waiting inside the facility to transfer care, ambulance crews readying to return to duty following transfer of care, or those just arriving with patients," Williamson said in an emailed statement.
"All other ambulances in Calgary Zone were already assigned to events."
Gondek said Thursday that city council is steadfast in its call for a return to the previous dispatch model, which she said demonstrated an ability to respond to complex emergencies.
It had firefighters often first on scene in cities like Calgary and Red Deer as calls came in, and were coordinated between EMS, fire and police.
"The decision to move away from … [the] model was, in effect, changing a system that reflected industry best practices which agencies around the world were actually trying to replicate," Gondek said.
Dog bite initially classified as non-life threatening
However, AHS conducted an internal EMS review of the response early this week, which found response times were appropriate based on the information provided by the initial 911 call.
According to Chies, EMS dispatchers initially deemed the dog bite as non-life threatening based on communication they received from the City of Calgary 911 call centre.
"We then subsequently received a second call from the 911 dispatch centre informing us that the patient's injuries were very serious and that EMS was required immediately," Chies said.
An ambulance arrived approximately nine to 10 minutes after the second call, he added.
The AHS CEO said there is also an ongoing "quality assurance review" meant to find areas where the overall system response could be improved.
Chies offered condolences to the family of the 86-year-old woman and those who responded at the scene. He also thanked the first responders and AHS staff.
A neighbour, Nicola, whose full name CBC is withholding to protect her identity, called 911 that day.
"I said, 'There's an 80-year-old woman that's been mauled by three dogs,'" she said, adding that the whole thing was traumatic as the senior had significant injuries.
The city said Thursday it would not be releasing the recording or transcript of the call, as the incident is still an active police investigation.
Response inappropriate, Kenney says
Premier Jason Kenney said Thursday that it was inadequate that it took so long for an ambulance to arrive.
Alberta Health Services must get to the bottom of what went wrong to make sure it never happens again, he said.
In this year's provincial budget, the province committed an additional $64 million to the EMS system, which saw a 30 per cent increase in call volumes in the past year.