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Ambulance Software Glitch Blamed For Woman's Death

Pierce Herald via YellowBrix

June 04, 2010

PIERCE COUNTY, WI – A software glitch is the likely culprit behind a malfunction onboard a Red Wing ambulance that led to a woman’s death in April, according to ongoing investigations.

Janice Hall, Red Wing, died April 22 while being transported to Minneapolis when the ambulance’s onboard oxygen system unexpectedly quit. The malfunction led to her death, according to a Dakota County Medical Examiner’s report.

“It spontaneously shut itself off,” Red Wing Fire Chief Tom Schneider said, referring to the oxygen system’s failure.

He said investigations – conducted by the ambulance’s manufacturer and an electrical engineer hired by the Red Wing’s legal insurance trust with the Minnesota League of Cities — indicate a problem with the oxygen system’s software probably caused the unexpected shutdown. The parties are continuing to look into the matter.

A call placed to Steve Duane, project engineer of Spartan Chassis, the parent company of the oxygen system manufacturer, was not immediately returned.

After the incident the ambulance was taken out of service. It received an equipment overhaul – a new oxygen supply system and electrical controls — and was returned to service in early May.

However, the oxygen system unexpectedly quit again on May 25, Schneider said. He added the department is now using portable oxygen systems onboard the ambulance, which is being used only as a last resort.

“I’m not going to use this truck in its full capacity until it’s fixed,” Schneider said. The department has four ambulances.

Schneider has been in contact with the family, he said.