By Erica C. Barnett

The death of pedestrian Jaahnavi Kandula, killed by a police officer driving to respond to a suspected overdose, has revived a longstanding dispute between Seattle’s fire and police departments about who should respond to medical emergencies, particularly overdoses.

Last month, after SPD announced that officer Kevin Dave was rushing to respond to an overdose in his capacity as an emergency medical technician (EMT), SFD union leader Kenny Stuart wrote a letter to Mayor Bruce Harrell objecting to the “troubling trend” of SPD officers “being trained and certified as Emergency Medical Technicians (EMTs) and … deployed to medical emergencies in our city.”

The issue with this, Stuart continued, is that the fire department—not SPD—is responsible for emergency medical response as part of the county’s Medic One system; “randomly allowing additional EMTs from other city departments to self-dispatch or to perform EMS functions” has “led to delayed scene security, delayed medical care, decreased continuity and coordination of care, and general confusion in life-threatening emergencies.”

Mayor Bruce Harrell’s office did not immediately respond to an email seeking his response to Stuart’s letter, if any, on Friday.

SPD’s EMS trainings are not funded by the city; instead, the Seattle Police Foundation solicits donations to pay for trainings and equipment. The police foundation website says the police need trained EMTs to respond to life-threatening situations at active crime scenes before it’s safe for fire department medics to enter. The head of the EMS program, SPD officer Tyler Verhaar, did not immediately respond to a request for an interview; we’ll update this post with his comments if we hear back.

Stuart, from the firefighters’ union, declined to talk on the record about the union’s opposition to SPD officers responding to medical emergencies. But former SFD assistant chief A.D. Vickery, who started at the department in 1968 and retired in 2020, said he’s heard alarming reports about police officers “racing to the scene, putting everybody at risk, so they can be the first one to the patient.”

“The Fire Department responds to hundreds of thousands of alarms. We are very cautious. There’s lots of people on the rig all working to make sure we get to the scene in a  appropriate period of time without creating a hazard,” Vickery said. “If police continue to respond to [medical calls] unchecked, you will end up with officers who are EMTs jumping calls so they can get some good publicity, and that’s not what it’s about.”

SPD has declined to comment on the circumstances that led to Dave striking and killing Kandula in a crosswalk the night of January 23. Initially, an SPD blog post said the then-unidentified officer was responding to a nearby emergency call “at the request of” the fire department; later, a department spokeswoman updated the post to say SPD was responding “with” Fire. Subsequently, police chief Adrian Diaz said Dave was “responding as an EMT” to the initial 911 call itself.

Many police department officers are equipped with Narcan (naloxone) nasal spray, which can restore breathing by rapidly reversing the effects of opioids like fentanyl, sending a person who is overdosing into abrupt withdrawal. Although fire department EMTs have carried nasal naloxone since July 2022, the department prefers to deliver oxygen first to restore an overdose victim’s breathing.

“With the increase in people using both methamphetamine and fentanyl at the same time, our teams then work to stabilize the patient’s breathing with small doses of naloxone ([which]also avoids a painful opiate withdrawal from excessive naloxone) and reverse the overdose,” SFD medical director Dr. Michael Sayre said.

According to one theory, bringing people back slowly also makes it more likely they’ll agree—in their groggy state—to go to the hospital, where they can access opiate withdrawal meds and learn about treatment options. “Some patients, once recovered from the drug’s effects, may refuse transport. That is a concern because it is a lost opportunity to connect patients with support services… that could be offered through the emergency department,” Sayre said.

Although the fire department doesn’t want SPD responding to medical emergencies themselves, they do want police on site when they respond to overdoses. One reason, which Fire Chief Harold Scoggins cited in a recent letter to the city’s Community Police Commission, is that overdose patients can purportedly “become violent” after they’re revived. A spokeswoman for the fire department said patients who overdose on fentanyl while also using meth, in particular, can “become quite agitated… risking harm to themselves and others around them,” because “when both substances are present, the sedative effects of fentanyl are reversed by naloxone, and the stimulant effects of methamphetamine then predominate.”

But the main reason fire EMS wants police at the scene of overdoses, according to Vickery, is to “control the scene to allow the EMTs or the medical personnel to do their jobs” without having to worry about bystanders or opportunistic thieves. “The environment that the overdoses take place in now is a much more hostile environment,” Vickery said. “In 1968, you might have an overdose in a particular area and it really was isolated to the room and the people that knew them, but there was not this the hostility that exists today.” Overdoses often occur on streets or in encampments, including many that first responders won’t enter without SPD backup.

Curious how often first responders actually encounter hostile situations from bystanders, I requested the fire department’s database of assault reports from EMS calls, which only includes incidents that involved formal reports (in other words, it isn’t comprehensive). In 2022, first responders logged 135 such incidents, which ranged from verbal abuse and threats (“Stated that he was going to kill us and that we were ‘motherf***ers””) to punches, “donkey kicks,” and a “wrestling match”; one person threw a hamburger at a fire truck.

Only a few of the reported incidents involved people brought back from an overdose with naloxone who were “combative” afterward and had to be restrained.

Overall, the reports unsurprisingly include many people in obvious crisis—like the person who was “slamming his head against the sidewalk several times before being restrained by SFD crews for his own safety as well as ours,” or the “well-known [patient]” who threw water on fire fighters before “barricading himself” inside a bathroom.

The tension between police and fire about their roles as first responders isn’t going away, as the police foundation continues to solicit donations for “training, certification, and medical supplies” for cops to respond to emergency calls. Vickery says he has no problem with police officers getting EMT certification on their own time, but says “there needs to be clear delineation” between the role of police providing backup at medical emergencies and fire personnel responding to those emergencies as EMTs. “The fire department doesn’t arrest people—stay within the realm of what your responsibilities are and support each other,” he said.