Passengers and transit officials in Massachusetts are asking why a conductor failed to stop his train after a passenger suffered a heart attack, and they are wondering whether the stricken commuter could have been saved if the conductor had listened to passengers' pleas to get him immediate medical help.
James Allen, 61, of Wellesley, Mass., began having the heart attack when the Framingham-to-Boston train arrived at its Auburndale stop. The crew was told of the emergency, and a distress call went out at 8:53 a.m Tuesday. But the train conductor continued his regular stops, meaning Allen waited for medical help until 9:10 a.m, when the train reached Boston's Back Bay station.
Paramedics were waiting at Back Bay station, and Allen was taken to Boston Medical Center. He died that morning in the emergency room.
Passengers Told Train Had to Make Stops
Although the crew knew of the emergency, train made its regular stops at West Newton and Newtonville before arriving at Back Bay. Passengers reportedly were told there was no access for medical teams at the other stations.
An assistant conductor on the train, Susan Bergeron, said she performed mouth-to-mouth resuscitation on Allen, and that it would have been dangerous for the conductor to rush through stations without stopping.
"The No. 1 priority in everybody's mind is to save that man and help him," Bergeron said. "Everybody did their part, what they did best, to try to help that man."
Passenger Carolina Pearson said passengers on the train implored the crew to do whatever they could to get Allen help. The passengers were told that medical personnel couldn't get down the stairs at the two stops before the end of the line, she said.
"A guy two rows in front of him [Allen] said it was really disturbing," Pearson said. "They couldn't get anyone to stop the train."
Conductor on Administrative Leave
Amtrak, which provides crew to operate the train for the Massachusetts Bay Transit Authority, has placed the conductor on administrative leave. The conductor's name was not released.
MBTA spokesman Joe Pesaturo said transit police were reviewing Amtrak's response to see if there was any negligence.
"It doesn't seem right to the [MBTA] general manager that you have a man in major distress on your train and you continue to make stops," Pesaturo said.
Bergeron, the assistant conductor, said the train did not skip its scheduled stops because of the risk of a train accident. But Bob Sullivan, a spokesman for CSX Transportation, which owns the tracks, said if the conductor had asked to stop before Back Bay, or to proceed there without stopping, he would have been allowed to do so.
Immediate Medical Attention Is Crucial
Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital, said it's crucial that heart attack victims get immediate medical attention. He said that emergency personnel could get anywhere, and that steep stairs at train stations wouldn't be a serious obstacle.
"If you can get emergency medical technicians there and do defibrillation or shock patients back within the first five minutes, survival is reasonable," he said. "If it goes beyond 10 minutes, studies have shown survival to be basically zero."
Allen had to wait 17 minutes before receiving help.
The paramedics were dispatched immediately after the emergency call was placed, but they had to wait at Back Bay Station for about five to seven minutes for the train to arrive, according to Tom Lyons, a spokesman for Boston Emergency Medical Services.
The CPR provided by bystanders would have helped maintain a minimal level of oxygen supply to vital organs, especially the brain, notes Chief of Cardiology Jonathan Steinberg of St. Luke's-Roosevelt Hospital Center in New York.
But it is the lifesaving shock that is critical to survival. "When you suffer a heart attack, the greatest risk of sudden death is within the first few minutes," explains P.K. Shah, chief of cardiology at Cedars Sinai Medical Center in Los Angeles. "In fact nearly 40-50 percent of people suffering an out-of-hospital heart attack do not even make it to the hospital."
Adds Shah: "As we say in cardiology circles, 'Time is myocardium' … Every minute that goes by without appropriate treatment, heart muscle dies and risk of sudden fibrillation and death remains quite high."
Allen, a coastal erosion specialist for the U.S. Geological Survey, is survived by his wife of 30 years, Marlene, and their two children. The family issued a statement saying they were "in a state of shock and grief" and felt "it would be inappropriate to make any comment at this time."