This is a very hard story to read, with graphic descriptions of injuries suffered by the shooting victims at Robb Elementary School in Uvalde. Click over very carefully, but whether you read or not know that the failures at the site of this shooting were not limited to law enforcement’s response.
The chaotic scene exemplified the flawed medical response — captured in video footage, investigative documents, interviews and radio traffic — that experts said undermined the chances of survival for some victims of the May 24 massacre. Two teachers and 19 students died.
Law enforcement’s well-documented failure to confront the shooter who terrorized the school for 77 minutes was the most serious problem in getting victims timely care, experts said. But previously unreleased records obtained by ProPublica, The Texas Tribune and The Washington Post for the first time show that communication lapses and muddled lines of authority among medical responders further hampered treatment.
Three victims who emerged from the school with a pulse later died. In the case of two of those victims, critical resources were not available when medics expected they would be, delaying hospital treatment for [teacher Eva] Mireles, 44, and student Xavier Lopez, 10, records show.
Another student, Jacklyn “Jackie” Cazares, 9, likely survived for more than an hour after being shot and was promptly placed in an ambulance after medics finally gained access to her classroom. She died in transport.
The disjointed medical response frustrated medics while delaying efforts to get ambulances, air transport and other emergency services to victims. Medical helicopters with critical supplies of blood tried to land at the school, but an unidentified fire department official told them to wait at an airport 3 miles away. Dozens of parked police vehicles blocked the paths of ambulances trying to reach victims.
Multiple cameras worn by officers and one on the dashboard of a police car showed just two ambulances positioned outside the school when the shooter was killed. That was not nearly enough for the 10 or more gunshot victims then still alive, though additional ambulances began arriving 10 minutes later. Six students, including one who was seriously wounded, were taken to a hospital in a school bus with no trained medics on board, according to Texas EMS records.
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Although helicopters were available, none were used to carry victims directly from the school. At least four patients who survived were flown by helicopter to a more fully equipped trauma center in San Antonio after first being driven by ambulance to a nearby hospital or airport.
In public statements made since May, law enforcement officials have defended their officers’ actions as reasonable under difficult circumstances. Federal, state and local agencies that responded to the shooting have not directly addressed the medical response, nor did they answer detailed questions from the news organizations that worked jointly on this investigation.
Eric Epley, executive director of the Southwest Texas Regional Advisory Council, a nonprofit that helps coordinate trauma care in Southwest Texas during mass-casualty events, said medics encountered challenges, including a faulty radio system.
“These scenes are inherently confusing, challenging, and chaotic,” Epley said in an email. He later added, “We remain steadfast that the decisions by the on-scene medical leadership were sound and appropriate.”
The Texas Rangers, an arm of the state Department of Public Safety, are investigating what went wrong in Uvalde, including whether any victims might have survived if they had received prompt medical care. The local district attorney has said she will use that investigation to determine whether to charge anyone with a crime, including law enforcement officers.
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It’s difficult to know whether Mireles or anyone else who died that day might have survived their wounds, in part because local officials have refused to release autopsy reports. But footage shows that Mireles was conscious and responsive when she was pulled from the classroom, an indicator that she probably had survivable wounds, according to medical experts.
“Had medics gotten to her quickly, there’s a good chance she would’ve survived,” said Babak Sarani, director of critical care at George Washington University Hospital.
The flawed coordination among police and medical crews echoes missteps during other mass shootings, despite the development of recommended practices after the 1999 massacre at Columbine High School. In several of those cases, the communication problems resulted in delays in getting medical care for victims.
Medics on helicopters and in ambulances who responded to the Uvalde shooting told investigators they were confused about who was in charge, where they should be stationed and how many victims to expect. Some of them pleaded to be allowed closer to the scene. In the absence of clear guidance, experts said medics did the best they could while trying to save lives.
“They were told, essentially, to go to the airport and wait,” according to an interview the Texas Rangers conducted with Julie Lewis, the regional manager for AirLIFE, an air medical transport service that sent three helicopters from the greater San Antonio area. “They couldn’t figure out who was in command.”
There’s a lot more. The bottom line is, as we have learned before, that there was no clear command structure, so those who were trying to help didn’t know who to talk or listen to and didn’t know what they needed to know to proceed. It remains the case that a lot of official information about what happened is still closely guarded and not available to reporters or the public. More infuriating is that we have learned what the best practices are to respond to one of these tragedies, as there have been so many to learn from, and yet the same type of failures keep happening. Given the regularity with which they occur in Texas and the certainty that the next one is a matter of when and not if, that failure is owned not just by local officials but also by our state “leaders”. We know that failure will continue, because they have no interest in doing anything about it. Go read the rest of the story if you can stand it.