Several lawsuits in 2008 and 2009 criticized Beaufort County Emergency Medical Services. County leaders ultimately commissioned a review of EMS operations in 2011. Resulting changes have drastically reduced emergency response times for county residents.
Brian Lanese, a Bluffton landscape architect, was grilling steaks with a friend in his backyard on Oct. 30, 2008, when three masked assailants beat him and rammed the stock of a pellet rifle into his forehead.
The family's neighbor, Adam Hoffman, an off-duty Hilton Head Island paramedic, quickly arrived on the scene and assessed that Lanese likely had severe head trauma, as he was acting erratically.
Hoffman explained to a Beaufort County 911 dispatcher that Lanese's injuries were so severe that a LifeStar medical helicopter should be put on standby to transport him to Savannah Memorial Hospital's trauma center, as Hilton Head Hospital is not equipped to treat severe head trauma.
County EMS paramedics Shayna Orsen and Jeffery Knieling arrived on the scene but said they would not touch Lanese until he calmed down and stopped moving, according to a lawsuit later filed by Lanese and his wife. They also refused to call a helicopter to transport him to Savannah, the suit claimed. According to her own written account, Orsen said, "Beggars can't be choosers" as she walked out the front door.
Responding to the paramedics' questions, the injured man's wife, Tracy Lanese, said her husband had had no alcohol that evening -- just sweet tea. But a follow-up report written by Orsen and signed by both paramedics claimed that family members acknowledged Brian Lanese had been heavily drinking.
Hoffman and Tracy Lanese picked Brian Lanese up from the living room floor and carried him outside to the ambulance by themselves, according to accounts from the family and friends following the incident.
Hoffman called Hilton Head Hospital's emergency room and spoke to a doctor, who said to divert the ambulance to Savannah. The paramedics initially started to drive to Hilton Head before they were rerouted to Savannah, where emergency room doctors quickly moved Brian Lanese to the trauma operating room and neurosurgeons performed the first of several life-saving surgeries, hospital reports said.
After spending nearly a month in the hospital, including several weeks in neuro-intensive care, Lanese went back home to his family in Bluffton and he was able to return to work.
The Laneses filed suit against Beaufort County EMS in October 2009, alleging the paramedics botched the ambulance call, resulting in Lanese's brain injuries. The county denied all allegations of wrongdoing in the suit and still do today.
Lanese's lawyer in the proceedings discovered that both responding paramedics had histories of past offenses the county failed to disclose to state investigators or upon public information requests from The Island Packet.
Brian and Tracy Lanese received a $150,000 settlement from the county in March 2012, and both parties agreed to a verbal non-disclosure agreement.
The two paramedics involved in the case are still employed by the county and no policy or training changes resulted from the case, although it was a factor in the county commissioning a complete review of EMS service. That review led to many changes that have shortened EMS response times.
James Smith, a 65-year-old Bluffton man, suffered a heart attack in his Baynard Park home in April 2009. His wife Sarah Smith immediately called 911, but the ambulance was delayed at an unmanned security gate in her neighborhood.
Paramedics entered a code that did not work in an attempt to open the gate. Without any emergency override system, EMS was unable to get past the gate until nine minutes after the call, the suit stated.
Sarah Smith filed a negligence and wrongful death lawsuit Dec. 17 on behalf of her late husband, who died 11 days after the heart attack.
The suit alleged negligence from the Bluffton Township Fire District caused James Smith to experience "conscious pain and suffering, and ultimately an untimely, premature and painful death" -- an allegation both the EMS and fire departments denied.
County EMS "used reasonable and proper skill and care in responding to, assessing and caring for the decedent in accordance with the applicable standard of care," the county wrote in answer to the suit.
Smith and the county reached an undisclosed settlement in the case in June 2011.
The Beaufort County Council passed a measure after the suit requiring all new gated communities to have codeless and keyless systems on each gate to prevent similar incidents. Existing communities were required to retrofit their systems with radio-controlled gate openers that allow first responders to control the gate to avoid the same delay experienced by the Smiths.
Bluffton high school student Josh George died in May 2008 while driving home from his prom. A driver ran a stoplight at the intersection of Buck Island Road and the Bluffton Parkway and struck George's vehicle. The 17-year-old, who was not wearing a seat belt, was thrown 30 feet and suffered serious head trauma.
County paramedics took George directly to Hilton Head Hospital, reporting that it was the "closest facility," although it was ill-equipped to treat trauma.
They said LifeStar, the medical helicopter, was unable to fly that night. George was loaded back into an ambulance after county paramedics dropped him off and was taken to Savannah Memorial.
In all, about 1 hour and 45 minutes elapsed from the time George was picked up to his arrival at the hospital.
George's mom, Cheryl George, frustrated by the decision to take her son to Hilton Head Hospital, filed a wrongful death suit in April 2009. She reached a settlement with the county in 2011 for an undisclosed amount.
Follow reporter Erin Heffernan at twitter.com/erinh.