On Saturday, July 6, Congress Heights resident Shaquana Bates went into labor with her son, Daymarion Sams. Bates, who is 26 years old, was 32 weeks pregnant at the time.
Her mother, Tamara, called 911 for an ambulance at 9:22 p.m., but one did not arrive at her home until 9:53 p.m. Bates arrived at Medstar Washington Hospital Center at 10:23 p.m. and gave birth shortly thereafter, at 10:53 p.m. Daymarion was stillborn.
“I blame the city,” says Bates. “They just got to understand that there’s more than just one person out here who’s been through something like this.”
It’s difficult if not dangerous to give birth in the District. The city has one of the highest maternal mortality rates in the country: 36.1 deaths per 100,000 live births in 2018. The infant mortality rate isn’t much better: 5.6 deaths per 1,000 live births in 2018. Black residents are disproportionately impacted. Between 2014 and 2016, 75 percent of District mothers who died of pregnancy or childbirth complications were black.
These statistics represent structural and systemic failings. D.C. is working to address this crisis with a new review committee that is investigating pregnancy-related deaths and near misses. But Bates, who flinches every time a fire truck or ambulance drives by, wants the city to be held accountable for her traumatic childbirth experience. She’s contacted two different law firms to determine if she has standing to file a lawsuit. She’s also looking into filing a direct complaint with the DC Fire and EMS Department.
Bates, a black resident who works as a family engagement specialist in the Office of Neighborhood Safety and Engagement, still finds herself thinking a lot about that day—how long it took for an ambulance to get to her home and how the first responders seemed to lack a sense of urgency when they arrived.
“I wish I recorded that night,” Bates says.
Bates didn’t expect to have an emergency delivery. Not only was she giving birth to her second child, but she says no medical professionals told her she had a high-risk pregnancy. She worked full-time into her eighth month of pregnancy and scheduled a Caesarean section for Aug. 23 at Washington Hospital Center. On July 2, Bates was told her baby was healthy after having a 3D ultrasound. She voiced concern to the ultrasound technician and the doctor that delivered the results about pelvic and uterus pain she’d experienced on and off since April. They assured her everything was fine.
Then on July 6, sometime between 8:30 p.m. and 9 p.m., Bates started to experience a similar pain. When the pain became too much to bear, she called her grandmother, who advised her to call an ambulance. Instead, Bates decided to take a nap, remembering the assurances she received during her exam days earlier. When she got up from her nap to use the bathroom, her water broke.
“Blood started running down my legs. It was a little bit of water at first, but then it was all blood,” Bates says. “That’s when I started to panic.”
First responders officially arrived at 9:27 p.m. But the fire truck that came, Engine 32, wasn’t able to transport Bates to the hospital, so they waited for an ambulance. During that time, first responders, which included three emergency medical technicians and one paramedic, checked her vital signs and had her lay on her left side. Bates remembers one of the first responders being visibly irritated that the ambulance was taking a while to come.
“That’s when I knew something was wrong,” says Bates. “It sounded like a circus,” her mother recalls.
When two ambulances arrived, 31 minutes after Bates’ mother first called for help, the first responders debated which vehicle would transport her, she says, making every second feel like lost time. Bates recounts other instances that felt this way: The ambulance stopped twice because the driver said the back door was open, first responders sounded like they didn’t know where to go when they arrived to the hospital. The ambulance departed for the hospital at 10:02 p.m. and arrived at 10:23 p.m.
Bates delivered a stillborn baby. The obstetrician who delivered Daymarion said Bates too was at risk—she could have died due to blood loss. She received two blood transfusions, and stayed in the hospital for seven days after the birth. The hospital let Bates keep her baby in a refrigerated crib in her room.
“If the ambulance came on time, I don’t think I would be going through this,” says Bates. “The only support I really had was the caseworker from Washington Hospital.”
The obstetrician told Bates she had a severe placental abruption, which is why she delivered a stillborn baby. It rarely happens, the obstetrician told her, and they couldn’t explain why it did.
The caseworker helped her navigate what became a complicated, expensive process. Bates had 10 days after she left the hospital to collect Daymarion or he’d be cremated. It cost $30,043.72 to deliver her baby, per the hospital bills Bates shared with City Paper, $473.85 for the ambulatory care, per the Fire and EMS Department bill, and roughly $4,000 to bury him. Health insurance will pay for some portion of the associated costs.
“I’m young, I’m 31. For me to bury my son, it’s devastating. It’s heartbreaking. I always wanted a son,” says Damon Sams, who’s been in a relationship with Bates since they were teenagers.
Sams was with Bates on July 6 and confirmed her recollection of that night. He too faults the ambulance.
“It just so happened that we had a bad ambulance,” says Sams. “I’m not saying all ambulances are not good or don’t respond quickly.”
The DC Fire and EMS Department confirmed the timestamps and reached out to Bates after City Paper requested comment. The medical director, Dr. Robert Holman, spoke with Bates Friday morning by phone. Bates says he apologized at various times during the 19-minute call and told her the department is investigating the incident. Bates did not receive a timeline, but Holman assured her she’d hear from him again.
“The DC Fire and EMS Department shares its sincere condolences about this loss,” Doug Buchanan, its chief communications officer, wrote in an email on Thursday. “The Department’s medical director is currently reviewing all records and reports associated with this call for service to ensure that high quality medical care was provided in the field by our firefighter/EMTs and firefighter/paramedics.”
The department says it quickly responded to the call: An engine company—whose first responders were all trained to deliver babies—arrived within the target goal, which is between four and six minutes. The Office of Unified Communications, which receives and processes emergency calls, got the 911 call at 9:22 p.m. and dispatched a truck 42 seconds later. The call was classified as serious but not life threatening, or for a “Basic Life Support” patient. The fire truck arrived in just under five minutes. The ambulance was dispatched at 9:31 p.m. and arrived 22 minutes later.
But the department also confirmed that there were issues getting transport vehicles on the scene. What appeared to be the closest ambulance to Bates was roughly 20 minutes away, so OUC dispatched another ambulance. However, that ambulance had “mechanical issues,” so the initial ambulance was back on call. And at some point, a second medical transport was also sent.
Ward 8 Advisory Neighborhood Commissioner Christopher Hawthorne has been sharing Bates’ story during community meetings as a way to draw attention to the lack of medical services east of the Anacostia River, where residents are predominantly black. These neighborhoods are also home to larger shares of D.C.-born residents.
“We both see the same thing happening over and over again,” says Hawthrone. “She was one of the numbers that decided to say ‘Hey I’m going to speak to this issue. This is happening to me. The city is wrong and I’m going to sue them.’”
There have been no maternity wards east of the Anacostia since 2017, when United Medical Center shuttered its obstetrics unit, citing dangerous medical errors. Residents also lack a trauma center, so gunshot and stabbing victims need to be transported to hospitals in different quadrants.
Now residents are waiting for the promise of a new hospital. UMC is slated to close by 2022, and another community hospital is expected to open on the St. Elizabeths East site; negotiations are still ongoing.
“I’m hoping for a sense of urgency that kicks into the mindset of our city leaders,” says Hawthorne. “A full-service hospital is needed here east of the river.”
Dr. Jamila Perritt, a D.C.-area OB-GYN and fellow with Physicians for Reproductive Health, agrees with Hawthorne. But Perritt, who’s lived in District all her life and made her home, at one point, in Ward 8, says that a new hospital shouldn’t be viewed as the panacea to this public health crisis. Culturally responsive care is also critical.
“The presence or absence of a physical building doesn’t constitute quality care—that’s not an indictment on UMC but a statement of fact,” says Perritt. She cited the legacy of racism in clinical settings. “Both are true,” she says. “This has been going on for a really long time and it’s unacceptable that we don’t’ have a maternity ward in Wards 7 and 8.”