A 911 dispatcher was charged with manslaughter after refusing to send an ambulance for a woman who later died. Experts say there's 'never a time not to send an ambulance.'

• A Pennsylvania 911 dispatcher was charged with involuntary manslaughter after declining to send an ambulance.
• The dispatcher was reportedly uncertain whether the patient was "willing to go" to the hospital.

The criminal charges against a 911 dispatcher for refusing to send an ambulance to a patient is "one of the rarest cases" some emergency services experts have ever seen.

The dispatcher, 50-year-old Leon Price, was charged with involuntary manslaughter in Greene County, Pennsylvania, Insider previously reported. Price refused to send an ambulance in July 2020 when Kelly Titchenell called 911 on behalf of her mother, 56-year-old Diania Kronk, who Titchenell said was "jaundiced, incoherent and bleeding from the rectum," a civil complaint filed by Titchenell said. Both criminal charges and a civil suit have been filed.

Price repeatedly asked Titchenell whether Kronk was "willing to go" to the hospital for treatment, The Associated Press reported. But experts told Insider that an ambulance should have been sent to Kronk's home regardless.

"This is probably one of the rarest cases I've ever seen," said Bill McDonald, an emergency medical services expert and executive director of McDonald Public Safety Consulting. "There's never a time not to send an ambulance because you don't know what's going on."

A caller may be told there will be a wait if there are more urgent cases, McDonald said, but dispatchers are trained to "get the quick questions, get the ambulance moving or the fire engine moving, and then continue asking questions and give treatment over the phone."

"We always send a resource one way or the other, and then it's up to that resource whether it be triaged at the basic level, which is the EMTs, or the advanced level, which is the paramedics," McDonald added. "It's up for them to triage the patient, determine what additional resources they need, if any."

In some cases, McDonald said, first responders will even call a patient's physician or drive them to their preferred hospital, "pretty much giving them any option to get them to definitive care."

Callers may refuse treatment, but that doesn't happen until they have been assessed by first responders, McDonald said. In this case, he added, Kronk didn't have the chance to refuse care.

Based off of reports on the dispatcher in Kronk's case, McDonald told Insider it "seemed he was just hell-bent on, 'Hey, if you're not going to go, I'm not sending anybody.'"

"But there's no way to know if she was going to go because he was talking through her daughter," he added. "The daughter could say, 'Yeah, she doesn't want to go.' That doesn't mean that the paramedics can't show up, do some assessment and say, 'Ma'am listen, this is what's going on. You really need to go to the hospital,' and change her mind. A lot of our job is communication with the patient."

In addition to involuntary manslaughter, Price was charged with reckless endangerment, official oppression, and obstructing the administration of law, Green County District Attorney David Russo told Insider, adding that the investigation is ongoing.

Paul Werfel, director of Stony Brook University's EMT and paramedic program, said the case seemed "rare" but that "we are only hearing one side of this" case.

"Criminal liability is rare to begin with on this," Werfel told Insider. "I wouldn't be surprised if this goes forward, as far as it can go, but I also wouldn't be surprised if there's a huge amount more of the story that we're not hearing."

Werfel said civil suits are far more common than criminal charges in the realm of emergency services. Whether the involuntary manslaughter charges stick may depend on what was said during the 911 phone call, he added.

"Criminally, I'd be very surprised that this continues. A lot of it depends on what was said and what the tapes actually reveal. Like I said, I know what the plaintiff's attorney is alleging and the family is alleging, but that sometimes does not fare out necessarily with what really happens," Werfel said.

Diania Kronk's outcome "more likely than not" would have been different if an ambulance had been sent, McDonald said.

"Nobody can say that it would've been different, but I could say my opinion is more likely than not if she would've had the care, it would've been different," McDonald said. "At the minimum it could have prolonged her life enough for definitive care, being a hospital where she can go to an operating room or whatever the doctors would call for, the physicians would call for, at the facility."