Lebanon
Part of the problem might be that college employees aren’t hooked into the same communications systems used by medical center staff. But the college employees who were critical of communication during the crisis also faulted the timeliness of the notifications they received, a general lack of preparedness and poor coordination between the medical center and the college.
Code Silver
One college employee, Samir Soneji, an assistant professor at the Dartmouth Institute for Health Policy and Clinical Practice, was in a fifth-floor library on Tuesday when he heard the “code silver” alert come over the intercom.
“It was odd,” Soneji recalled in a Wednesday phone interview. “We get P.A. announcements often. It’s an actual person speaking. (This time), it sounded like a real person, but you could hear panic in his voice. He only said it once.”
One problem for Soneji was that he wasn’t sure what code silver signified. He and the other dozen or so people in the library looked up, but there wasn’t a subsequent announcement informing them about the code silver alert or canceling the code, Soneji said.
He tried a Google search for “code silver DHMC,” but said the link that came up was broken. Another hospital’s website indicated a code silver was a violent situation.
Two people sprinted out of the library.
“It was the sound of their sprinting that was very concerning,” he said.
The librarian then informed Soneji and the others in the library that there was an active shooter in the building and they should evacuate.
That instruction triggered a “confluence of lots of mistakes because nobody had any sense of what to do,” he said.
Instead of using an emergency exit behind him, he and everyone else headed for the main exit. On his way out of the building, he stopped in his office to find his wife, who also is a Dartmouth College faculty member. He informed her of the situation and said, “Don’t get your wallet. Don’t get your phone. I have our car keys,” he said.
From there, the pair went outside, where they congregated with other members of their department “like there’s a picnic.”
“Nobody knew what to do,” he said.
Eventually, they decided to head for their cars and they pulled out onto Loop Road with everyone else, he said.
“We weren’t going anywhere,” he said.
They watched police cars come into the hospital with their lights flashing. Soneji, his wife and two other college employees first called DHMC’s main telephone line and spoke with an operator who instructed them to watch their email. Then, they called the Lebanon Police Department, which directed them to stay in their car.
Delayed Communication
Soneji said about 40 minutes passed between the time of the initial intercom announcement and the first email from the college.
At 1:24 p.m., the Lebanon Police Department received the first 911 call about a shooting in the hospital’s intensive care unit, according to the affidavit filed in Grafton County Superior Court. It alleges Travis Frink, 48, shot and killed his mother, Pamela Ferriere, a 70-year-old from Groton, N.H., while she was being treated at DHMC.
The hospital issued the code silver alert at 1:27 p.m., said Josh McElveen, D-H’s vice president of communications and marketing.
Dartmouth College’s first all-campus email went out at 2 p.m., after administrators learned of the incident through the police scanner monitored by the school’s safety and security department, college spokeswoman Diana Lawrence said in an email. College officials confirmed the incident with the Hanover Police Department before sending out an email to everyone with an active Dartmouth College email account, including staff, students and faculty — including those of the graduate schools, Lawrence said.
“Our first Facebook post went up at 2:08 p.m.,” she said. “We posted an emergency alert notification on the Dartmouth website homepage at approximately 2:15 p.m.”
Redirected Questions
A Dartmouth College employee who works on the DHMC campus but asked not to be named because she is up for a promotion and feared her prospects would be threatened if she spoke publicly said she did receive email updates from the college, but they did not provide instructions for employees who were at DHMC at the time.
There are 868 Dartmouth College undergraduates, graduate students, Geisel School of Medicine employees, Thayer School of Engineering employees, and third- and fourth-year medical students who spend time at DHMC, Lawrence said.
Though “inquiries from media about the affairs of the college are frequently referred to the Office of Communications,” Lawrence said, “no one at the college is prohibited from talking to reporters about their personal experiences. We do not have an employment policy related to media inquiries. I personally have not instructed anyone not to share their experiences with reporters.”
For its part, D-H officials have asked employees to alert them when they receive media requests, McElveen said. But McElveen, a former television journalist, emphasized that D-H is “not muting anyone.”
Attempts to reach students and faculty members of Colby-Sawyer College who were at DHMC at the time of the shooting also were unsuccessful because D-H officials asked the school to direct questions to them.
A member of the New London-based school’s nursing faculty initially was willing to speak with a reporter, but later said in an email, “I learned that the request I received to speak with you was sent to me quickly and several steps for how college communications are managed were missed.” The faculty member referred the reporter back to the college’s communication staff.
“I don’t think we’re going to be able to help you with getting that perspective,” said Kate Seamans, Colby-Sawyer’s senior director of communications.
At the time of the shooting, 31 students and six faculty members were at DHMC for clinical rotations, according to the college’s Facebook page.
“There are always Colby-Sawyer students doing clinical rotations at (DHMC),” Seamans said.
A similar request made to the press office at Geisel seeking to speak with medical students also was directed back to D-H officials on Wednesday.
At least two other individuals who were at DHMC on Tuesday declined to comment on their experiences, and instead directed a reporter to hospital officials.
Emergency Planning, Drills Differ
Like Soneji, the employee who asked not to be named ended up in a car with some colleagues and sat in traffic after evacuating from the hospital complex. She and the others in the car debated whether to escape into the nearby woods, but decided they didn’t want to get between the police and the shooter if they were to come upon them there.
“We were terrified,” she said.
They followed developments on Facebook, she said.
In retrospect, the college employee estimated the suspected shooter was in a vehicle just 20 cars ahead of her.
“Maybe we shouldn’t have been sitting in our car,” she said.
In the two years Soneji’s department has been located in the Williamson Translational Research Building there’s never been a drill for such a situation, he said.
But Dartmouth’s Lawrence said college employees receive emergency training during their orientation and graduate students receive training on lab and fire safety and evacuation.
“Individual departments are responsible for emergency plans and training around those plans,” she said.
Emergency planning resources, including active shooter scenario training that includes a visit from the campus emergency manager, an instructional video on how to survive an active shooter event and active shooter drills, are available to departments that request them, the spokeswoman said.
Future Improvements
Dartmouth has an emergency planning group that meets monthly, Lawrence said. The group, which includes approximately 50 representatives from across the institution, is scheduled to meet next week “to review the DHMC incident and identify safety and communication improvements that could be made,” she said.
Soneji said he recognizes that “there’s a lot of uncertainty” in a situation like the one that occurred on Tuesday, but he was upset to realize that the suspect was later apprehended on the same road he used while attempting to leave the campus.
“He was in that long line of cars that we were all in,” Soneji said. “We unintentionally made the police’s job harder.”
Dartmouth-Hitchcock officials on Wednesday said they were aware of the communication gaps and planned to address them in the future.
“Part of what we’ll take from this, too, is how we have a more unified alert system,” D-H’s chief clinical officer Ed Merrens said in an interview.
Even among D-H employees, Merrens said, only about 20 percent are linked to a cellphone alert system. Information about emergencies also is disseminated through computers and the hospital’s loudspeakers, he said, but more communication would be better.
“We’ll work on it,” he said.
He said that Dr. Joanne Conroy, D-H’s chief executive, was in communication with Dartmouth President Phil Hanlon and Duane Compton, dean of the Geisel School of Medicine, during Tuesday’s emergency, and noted that most college employees’ offices are “far away from the clinical environment.”
Medical students who were on rotations at the hospital at the time of the incident were notified promptly, said Merrens, a hospitalist who had a medical student on his team at the time. In addition, Merrens said, the medical students checked in on one another.
“They are so connected,” he said.
Both hospital and college officials have acknowledged that communication systems could be improved, but the college employee who asked not to be identified said she wasn’t sure her concerns were being addressed.
Rather than accepting the hospital’s offer of counseling in the aftermath of Tuesday’s events, she said, she would like to have protocols in place so she would know what to do in case of a future incident.
“I don’t know that people have the best feeling,” she said.
Not all college employees were critical of the way information was disseminated on Tuesday.
Heather Carlos, a researcher who works on the top floor of the Norris Cotton Cancer Center on Medical Center Drive, said that she and others holding similar jobs tend to be the last people on hospital officials’ minds because they have nothing to do with patient care.
Despite not being a top priority, Carlos said, she felt safe “because people can’t even find our offices when they try,” she said.
Carlos said she heard one message about the code silver come over the loudspeaker at about 1:30 p.m. and then heard through word of mouth that she should shelter in place in her office.
In terms of training, Carlos said, she had participated in a computer-based training about what to do in an active shooter situation, but it didn’t provide specifics about where she should go or what she should do, which she said is where communication should come in.
Even so, “overall, it went well,” said Carlos, who was stuck in her office until about 4:30 p.m., when an armed law enforcement officer came by to clear the area. “There were enough level heads that … people still figured out what to do.”
She said she feels confident that the missing link in communication will be fixed.
“They’re well aware of it and I think it will get fixed,” she said of hospital and college officials. “We were never in any danger. We were just bored. … We had Twitter to keep it lively.”
Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.
