911 Tapes Reveal Richardson Timeline From Accident to Treatment

March 31, 2009 — -- New 911 tapes from the day actress Natasha Richardson suffered a fatal brain injury have raised questions about whether she could have been saved if treated sooner.

Though emergency officials say they followed protocol, some say that a series of different decisions regarding Richardson's care could have helped save her life.

The 911 calls, released by Canada's Globe and Mail newspaper, reveal what happened during the five crucial hours between Richardson's accident and when she was finally examined by a team of neurosurgeons at a Montreal hospital.

On March 16 at approximately 12:45 p.m., the ski patrol at the Mont Tremblant ski resort in Quebec called 911 to report a possibly dangerous fall on the hill.

Paramedics responded, but were turned away after Richardson, 45, who had taken a tumble on a beginner's slope, said she was fine. Then, at 3 p.m., the resort called another ambulance. It said Richardson was vomiting and had a severe headache.

The call was designated a "priority 1" and ambulances rushed to the scene.

Richardson was loaded onto a stretcher and taken to Sainte-Agathe, the nearest hospital, about 45 minutes away.

During the trip to the hospital, medics reported her Glasgow score -- a coma scale that measures a patient's degree of consciousness. They gave her a Glasgow score of 12 out of 15, with a score of 15 meaning a patient is totally alert. A score of 12 is considered a treatable condition.

Medics said Richardson responded when spoken to but did not know what day it was or what had happened to her.

Richardson stayed in the Sainte-Agathe emergency room for nearly two hours. A hospital representative said that doctors were "stabilizing her" but would not say exactly what happened during that time period.

The hospital has a CT scan but does not have a neurosurgeon on staff who, doctors say, would have been able to drain the blood pooling in her brain and possibly save her life.

"In this specific case, this is a blood clot that is expanding very rapidly so time is of the essence so an early operation would have made a big difference," said Jamshid Ghajar, chief of neurosurgery for the Jamaica Hospital -- Cornell Trauma Center in New York and also the president of the Brain Trauma Foundation.

Richardson's family did not have any comment on the release of the tapes.

Why Not Go to Trauma Center First?

Doctors decided at 6 p.m. that Richardson should be rushed to Montreal's Sacre-Coeur Hospital, a Level 1 trauma center with a team of neurosurgeons on staff. That trip by ambulance took a little less than 45 minutes.

By the time Richardson had arrived, her condition had deteriorated significantly. According to the Globe and Mail, a neurologist was overheard saying that Richardson's pupils were unresponsive.

"That is an early sign you are losing your brain stem reflexes, and early sign of brain death," Ghajar told "Good Morning America."

Doctors say time is crucial when it comes to treating brain injuries.

So why didn't paramedics skip the local hospital and drive her straight to the Montreal hospital? A spokesman for Sainte-Agathe said that it was "protocol."

But, Ghajar said, "it's better to stay in the ambulance and go to the proper trauma center than stop off at a small hospital."

An ambulance ride from the resort straight to Montreal would have taken about an hour and a half. Neurosurgeons could have been working on Richardson a full hour earlier.

There is no emergency helicopter system in Quebec. But ABC News spoke to a local chopper pilot who offers tours of the area. He says his choppers are not large enough to carry a stretcher, but he could have "definitely" taken someone to Montreal if that person could sit. The flight from the ski resort to the Montreal Hospital would have taken 30 minutes.