NASHVILLE, Tenn. -- NewsChannel 5 has obtained radio traffic between paramedics and Vanderbilt doctors in a case that changed the way paramedics respond to emergency calls.
Earlier this year, Vanderbilt doctors told paramedics to declare a gunshot victim dead and not transport him to the hospital even though he was still breathing.
Police on the scene were so disturbed they called paramedics back to the town home at 735 Tulip Grove Road in Hermitage an hour after they left.
Paramedics then transported the victim, Antonio Foster, to the hospital where he survived for several hours.
Foster's roommate, Jason Carter was shocked when paramedics left the first time.
Carter called 911 that night on August 13 after he discovered that his roommate had shot himself in the head.
"I did everything I could," Carter told NewsChannel 5 Investigates.
The 911 operator told Carter how to stop the bleeding. Carter said his roommate was still alive when paramedics arrived.
"He was still breathing. I did the best I could. The paramedics got there really quick," Carter said.
Radio traffic indicates paramedics discussed with Vanderbilt doctors whether to declare Foster dead or transport him to the hospital.
Paramedics told Vanderbilt that Foster had no pulse and a devastating head wound. They also said he was still breathing. They asked for a decision from Vanderbilt.
"This is going to have be your call completely on whether to terminate here or transport," a paramedic said.
A Vanderbilt doctor responded, "Sounds like you have a traumatic injury that is not compatible with life."
"Not compatible with life" meant that paramedics declared him dead about fifteen minutes after first assessing him.
"I kept asking the police how's he doing? Is he still alive," Carter remembered.
Carter was surprised paramedics weren't working on Foster -- and so apparently were police.
It prompted paramedics to call back to Vanderbilt for a second opinion.
"Let me run this by you again," a paramedic said.
Nearly 30 minutes after the first call, paramedics told a different doctor at Vanderbilt that Foster was still breathing and police were concerned about leaving him.
The doctor responded, "We understand this is a very difficult situation in that this is an injury that is obviously incompatible with life. We feel very comfortable with your decision to terminate resuscitation."
So, an hour after arriving, paramedics left.
"We are returning to service. This is going to be a DOA," paramedics said.
Carter was surprised they left his roommate. He still worries about whether his friend suffered.
"I don't know if he was conscious or what, but just lying there and seeing all that was going on and nobody was doing anything.
"Even if there is a weak chance, you would think they would have still tried," Carter said.
But it wasn't over yet.
Two hours after the initial 911 call, police demanded that the ambulance come back because Foster was still breathing.
This time, there was no debate.
They put Foster in the ambulance and rushed him to Vanderbilt hospital.
He survived until later that afternoon.
In the days that followed the fire department said Foster should have immediately been taken to the hospital.
"I'm very disturbed," Fire Chief Richard White said in August. "If someone has signs of life it's not up us to decide if they go or not."
The fire department changed its policy.
Now, if a patient is breathing or shows any signs of life he will be transported.
"Who knows what would have happened if they would have gotten him the first time," Carter questioned.
Carter is still haunted by that night.
He remembers how he fought to keep his friend alive and how the fighting stopped.
Vanderbilt said it has not disciplined the doctors involved in the decision.
A statement said in part doctors used their best judgement but privacy laws prevent further comment.
Here is the full statement:
“Due federal patient privacy laws we are still not able to discuss specifics regarding the challenging and complicated medical circumstances surrounding this event. VUMC’s physicians, who were in consultation with EMS colleagues at the scene, used their best judgment based on the physiologic information available to them at the time. Since this event there has been collaboration between VUMC and our colleagues with the Metro Nashville Fire Department to clarify protocols for making a field determination of death,” said John Howser, Assistant Vice Chancellor, Office of News & Communications, VUMC.