Failures of Response to Carbon Monoxide Dangers

Carbon Monoxide Dangers Require Training and Detection

Countless tragedies related to carbon monoxide dangers occur because of delayed recognition of CO, which puts both victims and first responders at risk.  

By Rebecca Martin

Carbon monoxide dangers exist anywhere there are fuel-burning devices such as furnaces, boilers, hot water heaters, pool heaters and appliances. Yet uniform protocols for response to potential carbon monoxide poisonings don’t exist. Carbon Monoxide is defined as “a colorless, odorless, and toxic gas, which is predominantly produced by incomplete combustion of carbon-containing materials. [1]It is described as the “silent killer”, and less commonly as an “invisible killer”. However fitting these labels are, there are other words that might apply to carbon monoxide such as underestimated, underacknowledged, and sometimes outright ignored.

Poor recognition limits response to carbon monoxide dangers, resulting in loss of life and permanent brain damage in the survivors.

Due to lack of clear and concise policies, paired with the lack of adequate functioning carbon monoxide detectors, people have perished unnecessarily due to carbon monoxide poisoning. Even more significant in terms of impact is the 20 to 30 people left with brain damage from the poisoning effects of the blood stream transmitting CO instead of oxygen to the brain. The unnecessary death and injury from this poisoning happens far more than be catalogued, because it is hard to quantify the unknown. Yet, our review of those incidents that made the news provides telling examples.

The Honeymoon Poisoning

In 2021, newlyweds Catharine Hudgens and her husband, Lewis Hudgens, were honeymooning at a vacation lodge in Montana. They had been married in Alabama January 9, 2021 and their stay at Rainbow Ranch began on January 11, 2021. That evening they opted for a quiet night in with room service and an Alabama vs. Ohio State game.

Around January 13-14, family members became concerned about not being able to reach the couple and Hudgens’ sister subsequently called the lodge to ask hotel staff to check on the couple. According to the allegations of a lawsuit filed related to this poisoning, hotel staff failed to respond to the request.

On January 15, the hotel manager decided to check the room. Lewis Hudgens was found deceased in bed and his wife, “severely disoriented” on the floor next to the bed.

The lawsuit states that there were holes drilled in the couple’s room that allowed carbon monoxide to pass freely into their room from the adjacent boiler room and that the boiler had not been inspected during lodge maintenance some 42 days prior to their stay.

            “Had Rainbow Ranch staff checked on the Hudgens as requested, it is likely Lew would be alive and Catharine would not have been injured,” the suit states. See https://www.foxnews.com/us/alabama-widow-blasts-luxe-montana-lodge-husbands-carbon-monoxide-death-honeymoon

The Sandals Poisoning

The failure of Rainbow Ranch employees to respond to the family’s concerns is hauntingly similar to the 2022 Sandals Resort incident in the Bahamas that took the life of three American tourists.  In the Sandals carbon monoxide poisoning, two couples had complained of feeling ill one evening and had gone to the emergency room as a result. After receiving nominal treatment for what was thought to be food poisoning, they returned to their respective rooms at the resort. The following day, three of the four were dead and the one survivor was in critical condition. Reportedly, guests at the resort had previously complained of nausea and other symptoms. Those symptoms had been written off as non-specific and carbon monoxide was not considered.

An Invisible Killer Requires Specialized Warning Systems

Those responsible would have had much different responses dangers had been visible. If it had been a fire, it could have been seen or smelled. If it had been a fire, there might have been a sprinkler system to have put it out. Smoke detectors would have mechanically smelled th smoke. How do you see the invisible toxin that can’t be smelled? With special goggles? It isn’t magic. You need an electronic device that can identify this toxin.

The truth is that the possibility of carbon monoxide poisoning is often ignored in the absence of adequate and functioning carbon monoxide detectors. Not just the absence of these detectors in the physical space, but on the emergency responders and hospitality staff. In addition to detection, responders must be required to have a forced choice rule out of CO when faced with these symptoms that can be so easily confused with something else. The only way to prepare staff for carbon monoxide emergencies is through education and training; and establishing protocols for potential carbon monoxide emergencies.

Multiple Illness is Warning of Carbon Monoxide Dangers

Victims of carbon monoxide may have warning signs that are easily shrugged off by victims, such as nausea and headaches. By the time the levels of carbon monoxide rise to a deadly level, victims are disoriented and not able to seek help. When speaking of incidents in the hospitality sector, more severe symptoms often turn deadly while the guests are sleeping and incapable of recognizing the danger.

These protocols should include the knowledge that the danger of carbon monoxide poisoning is always a possibility when fuel-burning devices are present, what the most common symptoms are and what the response should be. This is true especially if multiple people have the same complaints.

Failure to Respond at the scene of Carbon Monoxide Dangers

In 2021, winter storms hit the Houston, Texas area. Massive power failures ensued and persisted for days at a time. Michael Negussie called 911 because he was concerned for his cousin’s family who he feared might have succumbed to carbon monoxide fumes. He was unable to drive to check on them because emergency services had asked that people stay off the icy roads so as not to impede emergency service vehicles.

When responders arrived at his cousin’s house, Negussie was assured by the captain that if there was no response at his cousin’s residence that a decision would be made by first responders on how to proceed to enter the house and check on its occupants. When asked by the dispatcher why he was concerned that they might have suffered from carbon monoxide exposure, Negussie explained that he had heard earlier in the day that the family had a car running in their attached garage to keep their phones charged.

Negussie was very concerned and asked if he would be updated as to their status and the phone call was abruptly ended before he received a response.

First responders remained at the residence for approximately five minutes and left because there was no response from the residents and did not seek to gain entrance.

The dispatcher had failed to inform first responders that the caller had fears that the family had succumbed to carbon monoxide.  The captain of the fire crew did not contact the police for assistance. As a result, the police did not arrive to attempt entry into the home to complete the wellness check.

Negussie called 911 again approximately three hours later, still concerned because there had been no response at the home. It was nearly midnight and he feared that something had happened to them.

This time, entry to the home was made and “they found Etenesh Mersha, 46, and her 7-year-old daughter, Rakaeb, dead. Her husband, Shalemu Bekele, and their 8-year-old son, Beimnet, were lying on the floor, still breathing. They were rushed to the hospital. Bekele spent days recovering. Beimnet was in the hospital for nearly a month.” https://www.texastribune.org/2021/08/19/texas-winter-storm-carbon-monoxide-poisoning/

Similar cases across the country in which first responders did not gain entry to a home to make actual contact with the residents have highlighted the need for policy changes.

“First responders have discretion to decide whether to force their way into a home based on what they see, the details they get from dispatchers and the perceived credibility of the information provided by the 911 caller.” https://www.texastribune.org/2021/08/19/texas-winter-storm-carbon-monoxide-poisoning/

Because the dispatcher failed to recount the caller’s concern over a possible carbon monoxide poisoning, first responders did not react to the potential severity of the situation, even though the severe winter weather should have raised concerns as well.

“The key consideration for first responders should be to ensure that the person is not in danger, said Thompson, a fire and medical expert with the International Academies of Emergency Dispatch. “You keep trying to make contact until you prove yourself wrong,” he said.” https://www.texastribune.org/2021/08/19/texas-winter-storm-carbon-monoxide-poisoning/

The 2021 Texas ice storm brought to light failures to improve the power grid and pass legislation mandating carbon monoxide detectors in homes, it also invoked a sharp look at emergency response in the event of carbon monoxide poisoning.

Ultimately, disciplinary action was taken against a fire fighter present during the first 911 response. Investigations found evidence of misconduct. But news agencies conducting an investigation of the incident found failures at every level of government to protect the citizens. Texas did not require carbon monoxide detectors in any residences until after legislative action was taken following this tragic storm. And even then, they limited requirements to new construction only, leaving 10 million residences without any mandated requirement. They also left it to cities and unincorporated areas to make the decision for themselves.

However, Texas is not the only state to resist sweeping mandates to install carbon monoxide detectors. Texas was one of six states that had no statewide requirements for carbon monoxide detectors in homes before legislative measures were taken as a result of the deaths and injuries which occurred during the ice storm.

The lack of carbon monoxide detector mandates was not the only culprit. The lack of standardized policies when responding to a suspected carbon monoxide incident was also a factor.

There were fuel burning devices present in all these incidents. More than one victim was overcome with the same symptoms at the same locations. Family members were concerned that something had happened. And alerted those in charge. Requests for wellness checks went unanswered and repeated efforts to gain contact with the families were not carried out by those at the scene until it was too late.

Whether the failure to respond occurs at the source of the co poisoning incident or there is a failure to act when first responders arrive on the scene, there is clearly a need for clear and concise policies for dealing with potential incidents of carbon monoxide poisoning.  We see over and over that it is always a possibility in any structure where there are fuel-burning devices, by its very definition. We know that it is odorless, colorless, in fact, invisible, but has the potential to injure or kill, nonetheless. It deserves the same attention as any other potential disaster that can occur, with the same attention to protocols for all involved.

While carbon monoxide is called the “silent killer”, there are many signals which should alert responders to its presence. In the case of failure to respond in Texas, first and foremost were the conditions at the time. A winter ice storm had enveloped the area, hospitals were inundated and overwhelmed with an unprecedented number of carbon monoxide victims, and these concerns were clearly present in the news media and public safety warnings. When a family member expressed concerns over the possibility of a carbon monoxide warning it should have been immediately plausible that these concerns were valid.

With no carbon monoxide detectors on site, the number of victims complaining of similar symptoms should have elicited a response at the Bahamas Sandals Resort. Those symptoms were directly applicable to possible carbon monoxide poisoning; headaches, dizziness, nausea. With a diagnosis of food poisoning at the ER, other guests should have been questioned to rule out a common source of the complaints.

The U.S. Consumer Product Safety Commission diagrams an appropriate response to all calls related to possible carbon monoxide exposure which asks the questions the following way.

• Is anyone unconscious, nauseous, lightheaded, having chest pains?
• Is a CO alarm sounding?

If the answer to the first question is yes, send a responder vehicle and an ambulance with trained personnel and a professional CO meter. https://www.cpsc.gov/s3fs-public/coguide.pdf

We also see that, in the case in Texas, a police officer should be dispatched to gain entry into the home if the residents are non-responsive.

None of these incidents would have become the tragic events that followed if carbon monoxide alarms had been present.

[1] Incomplete combustion occurs when insufficient oxygen is used in the fuel (hydrocarbon) burning process.” https://www.cdc.gov/niosh/topics/co-comp/default.html#:~:text=Carbon%20monoxide%20(CO)%20is%20a,fuel%20(hydrocarbon)%20burning%20process.