U.S. doctor says at inquest that B.C.'s 911 call-taking algorithm is ‘flawed'

Global News

07-05-2025

The inquest into the death of Sidney McIntyre-Starko continued on Wednesday, when a doctor from the U.S. took the stand.
Dr. Michael Kurz is a physician who has written academic papers on best practices around emergency medical dispatch in the United States.
He testified that in order to save lives, dispatchers need to be quicker with key questions, which Sidney McIntyre-Starko's family says could have saved her life.
McIntyre-Starko died of fentanyl poisoning in January 2024 after she and a friend collapsed in a university dorm room after consuming drugs found in a box of coolers a friend found on a street corner.
She was attending the University of Victoria at the time and it was her first year away from home.
On Jan. 23 2024, the 18-year-old and two friends took what they thought was cocaine. However, according to toxicology the substance in the vial was fentanyl.
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When the two girls passed out, the third teen called 911.
It took the 911 call taker more than three minutes to establish the young women were in a dormitory on the UVIC campus, but critically it takes another minute to ask key questions.
'911: Are they awake?
Student 2: No
911: Are they breathing?
Student 2: Um…I'm not 100 per cent sure. I think so. Are they breathing? Yes, they are.'
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Kurz said on the stand on Wednesday that those questions should come from 911 call takers immediately after securing a location.
'If they need emergency medical care, it's very simple,' he said.
'You secure an address, and then you ask two questions. One, is the patient conscious? Yes, no. Two, is the patient breathing normally? Yes, no.
'If the answer to either of those questions is no, you're at the point where you have enough information to dispatch the appropriate response.'
Kurz said that response is dispatching resources and beginning CPR on the patient.
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Instead, the inquest has heard that BC Emergency Health Services uses technology provided by a private company called Medical Priority Dispatch, which is software that uses a much a more complicated algorithm to assess patients.
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The 911 call taker was told the students were having seizures, which meant they spent nearly eight minutes trying to get people on scene to perform a breathing diagnostic prescribed by the dispatch system.
Finally it was discovered the students had overdosed and Narcan was administered.
CPR finally started 15 minutes into the 911 call as McIntyre-Starko's condition worsened.
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Kurz said the algorithm is flawed.
'This is a perfect example of what happens when we don't over-triage,' he said.
'When the system is built to be as precise as possible, it will be, you know, maximally efficient. That's not the goal of emergency medical response. The goal of emergency medical response is to eliminate the public harm and save lives.'
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Medical priority dispatch manages 911 call procedures in every Canadian province and much of the rest of the world.
Changes have already been made in the system in the wake of McIntyre-Starko's death.