In his first call to 911, Curtis Mitchell sounded calm, explaining to dispatchers that his "entire stomach [was] in pain."
By the time his longtime girlfriend made a 10th call nearly 30 hours later, she was frantic. He wasn't breathing. He was cold to the touch.
"Oh God, oh God," Sharon Edge sobbed to dispatchers. "I've been trying to get an ambulance over here for three days."
Paramedics arrived at their Hazelwood home as Ms. Edge tried to resuscitate the 50-year-old, but it was too late.
"I sat up here with him, watching him die," Ms. Edge said Tuesday, after city officials apologized to her and pledged immediate changes in emergency response after Mr. Mitchell's death on Feb. 7. "They didn't do their jobs like they were supposed to."
Snow-covered roads, poor communication and a 911 center deluged with more than double the average number of calls during last week's crippling snowstorms combined to cause Mr. Mitchell's long wait, city officials said.
Ambulances were dispatched three times on Saturday, Feb. 6, to the couple's home in the 5100 block of narrow Chaplain Way, but couldn't get there because of the snow. Paramedics twice asked whether Mr. Mitchell could walk to an intersection, even after he told them that he could not because he was in too much pain.
Emergency vehicles were within blocks of his home three times -- once so close Ms. Edge could see the ambulance lights from her porch -- but did not make contact with him. They finally reached the home on Sunday morning, Feb. 7, but Mr. Mitchell was already dead.
"We should have gotten there," Public Safety Director Michael Huss said. "It's that simple."
Complicating matters, communication problems meant that each call was seen as an individual request for help. Information gained on previous calls was not passed down during the next request, said Ron Roth, medical director for the city's public safety department and Allegheny County's emergency operations center.
"As a result, we made the same request over and over," he said.
Dispatchers sent the first ambulance to Mr. Mitchell's home just after 2 a.m. on Feb. 6, after he called complaining of abdominal pain, according to dispatch records. The call was graded E-2, or less pressing, as his symptoms were deemed not life-threatening. He called 911 again two hours later, asking what the hold-up was.
The call-taker told him medics were on their way, but the ambulance got stuck in the snow near the Elizabeth Street Bridge. The call was canceled after paramedics learned that Mr. Mitchell was in too much pain to walk out to them. Mr. Mitchell said he would try again later.
A second request for help was made about an hour after the first was canceled, though medics were not aware that an ambulance had gotten stuck while en route the house earlier. They, too, became stuck, according to Dr. Roth's report.
"If he wants a ride to the hospital, he is just going to have to come down to the truck," a medic told the dispatcher. Mr. Mitchell said he would try to walk to the truck, but later told them he couldn't make it across the bridge. The second call was canceled.
The third call for an ambulance came nearly five hours later, at 11:17 a.m. Saturday. Mr. Mitchell reported similar abdominal pain, and officials identified "no priority symptoms," and the call was held because of limited availability, Dr. Roth wrote in his report.
"At this point in time, higher priority calls are being held, there are over 30 calls in the pending queue," he wrote.
At about 8:15 p.m. Saturday, nine hours later, the call was upgraded to E-1, or higher priority, because Ms. Edge, who had begun making the calls on Mr. Mitchell's behalf, told call-takers he was short of breath and that they'd been waiting all day.
Less than an hour later, Ms. Edge called again to tell dispatchers that her boyfriend took sleeping and pain pills and she "could not get him up."
A doctor who called Ms. Edge back was "convinced he took his prescribed medications and went to sleep," Dr. Roth said, and the call was canceled.
In the final call, about 8 a.m. Sunday, she screamed for help. The call was graded E-0 -- a top priority. But when paramedics arrived, Mr. Mitchell had already died.
The cause of death is pending toxicology test results, the medical examiner's office said. Dr. Roth wrote that Mr. Mitchell had a history of pancreatitis, though his reported symptoms were not exclusive to that disease.
"It's unacceptable what happened," Mayor Luke Ravenstahl said. "It needs to change. We're talking about somebody who lost their life, and it's no small matter."
The city planned today to start dispatching firefighters as first responders on medical calls of the two highest grades of severity, and on calls of the third highest level that remained unanswered for more than 30 minutes. Firefighters are currently only called as first responders to the most severe incidents.
Sadie Gurman: firstname.lastname@example.org or 412-263-1878.