SOS Causes Distress

I hope I never need an urgent emergency response in Sweden, because the system here is frighteningly flawed. I’d literally be scared for my life if I ever need immediate medical assistance.

Last night around 11, I heard what sounded like someone trying to open our kitchen door. I went to check it out and sure enough, the handle moved a few times while I stood there. I tried to open the door but couldn’t.

We had heard a big group of people leave a party on the floor above us a short time before, and we soon ascertained that someone had passed out in our stairwell.

Amanda went out our front door, walked around the building and back in through the rear entrance to find an unresponsive woman slumped against our door. She tried to talk to the woman but she was incoherent. Amanda went upstairs to see if anyone was still at the party, but evidently everyone had gone to the bars and left this woman on our doorstep. By the time Amanda got back downstairs the woman had lost consciousness, but was still breathing.

Our other upstairs neighbor Ida came down to help and we called multiple friends of the people who threw the party to see if anybody knew who the woman was or who she had come to the party with, but to no avail. The woman’s cell phone had a pin code and she couldn’t give it to us.

I’ve heard too many horror stories about people choking on their own vomit and dying because their friends left them to pass out, and I knew this woman could be in danger, so we decided we had no choice but to call for an ambulance.

The emergency number in Sweden — and the 26 other member countries of the European Union — is 112. Children are taught to memorize it by “1 mouth, 1 nose and 2 eyes,” which has always been somewhat confusing to me because people also have two ears, and sound can be a very useful sense in detecting certain emergency situations, too, right? But I digress.

For almost 40 years, a private for-profit company called SOS Alarm has been responsible for operating 112 in Sweden. When you dial the number, you reach an operator in one of 18 regional offices.



You explain your emergency situation and the operator makes a critical determination of which services — police, ambulance and/or fire — you need dispatched to your location. They then transfer you to who they feel is the most appropriate authority in your local area and you repeat your situation to them before coordinating the details of the response.

I might be missing something here, but it sure seems like one of those situations where the middleman can be cut from the equation.

In the 15 minutes between our call to 112 and the arrival of two policemen, the woman had regained some consciousness. Also during that time, one of the partygoers returned and tried to help the woman sit up. Another partygoer showed up shortly after the police and saved the woman from arrest by convincing the police that they should just let her and the first partygoer drive the woman home.

What upset me the most wasn’t that the police spent most of their short time in our building laughing as the woman tried to put words together. It wasn’t that they didn’t ask any questions or do any investigation, like trying to find out if she had combined drugs with alcohol and maybe really needed serious medical attention. It wasn’t even that they didn’t blink an eye as the second partygoer, who also appeared drunk, offered to drive the woman home in a country with a virtual zero-tolerance policy for driving while intoxicated.

It was the fact that contrary to the ambulance response that Ida, Amanda and I were recommending based on having observed the woman first-hand, the SOS Alarm operator concluded that only police should be sent. If the police had then found the woman in as serious trouble as she appeared to be when we called, I suppose it would have probably taken another 15 minutes for an ambulance.

The company’s money-saving measure worked out last night, but it often doesn’t. SOS Alarm and the 112 system have come under serious fire recently, and with good reason.

• Earlier this year, a 23-year-old man in Stockholm had difficulty breathing. The on-call nurse at SOS Alarm refused to send an ambulance despite the man’s repeated “help me” pleas (read the sickening transcript here). The man died of a ruptured spleen.
  

• Last year, a woman in Gothenburg was also denied an ambulance and died from renal failure and pneumonia.
  

• A few years ago in Eastern Sweden during a wild street party, a man was found unconscious. The SOS operator passed the information along to police, assuming it was just a drunk passed out, when in fact the man had choked on food. He was eventually taken to a hospital, where he died.

• In 2008, a 34-year-old man died despite his mom’s five calls to SOS while she thought he was having a heart attack. The ambulance took two hours to arrive, and when it finally did the man dropped dead. SOS blamed the huge delay on icy roads.

It doesn’t always end fatally.

• Just this month, friends of a Green Party politician who was stabbed outside a Stockholm subway station accused SOS Alarm of a negligent reaction and slow ambulance response. SOS contests that the 17 minutes between call and ambulance arrival is adequate, which shocks me.

• Earlier this year, the wife of a man who complained of chest pains was told by an SOS operator that they should just go to the pharmacy and buy cough medicine, since it was cold season. The wife persisted and when an ambulance was eventually dispatched, it was determined that the man had suffered a heart attack.

• Two years ago, a young boy who spilled a cup of hot tea on himself. An SOS operator told his mom she should drive him to the hospital herself. The drive took 40 minutes, and when they arrived the boy was taken by ambulance to another hospital based on his critical burns.

SOS Alarm’s defense is pathetic. The company usually claims these unfortunate situations occur during times of high demand for emergency services, but I think it has much more to do with money. In this article from just a week ago, the troubled company’s owners are demanding profit hikes.

I can practically count on both hands the number of times I’ve heard emergency sirens since I moved here last August. Service demand can’t be that high, and it’s so sad that lives have been lost because SOS is too profit-oriented to operate under a “better safe than sorry” mentality. If any company should take such precautions, they’re it.

Four Swedish counties already plan to ditch SOS Alarm in favor of another company this fall and others should follow suit. SOS has a track record of incompetence and that’s just unacceptable when human lives are at stake.

Sobriety Checkpoints

We were walking down a remote side street in Göteborg this afternoon, near the Avenyn, when we came across a small cluster of cops standing in the road.

Here’s an unsuspecting motorist turning down the street.



We watched for a while and it became clear they were waiting to stop the few cars that happened to travel down that isolated street.

It was a typical Swedish sobriety checkpoint. I’d heard about them many times but hadn’t encountered one in my first four months here.



Such DUI stops are astonishingly common here. So common that Swedish police executed more than 2.5 MILLION breath tests in 2009.

I just can’t wrap my head around that number, for a few reasons. Since I’m killing time in the hotel while we wait to hear if my parents’ flight is going to get off the ground from Brussels tonight, I decided to reference some tables and charts on the Statistics Sweden website to help me explain how mind-boggling that figure is.

As of last New Year’s Eve, Sweden’s population was 9,340,682. That’s 2.5 million breath tests in a country with fewer than 10 million people.

Then you’ve got to remember than the driving age is 18 and there are about 2 million kids too young to be on the roads. Very few people over age 80 are driving around either, so let’s also subtract that half-a-million.

The number is even more astounding when you consider that an estimated 85 percent of the population lives in urban areas, and the other 1.5 to 2 million people live in the large cities like Stockholm and Göteborg. Very few of those people even own cars due to the efficient public transportation systems.

If you accept those calculations, that probably means 1 in every 2 drivers were stopped and breathalyzed in 2009. Obviously some didn’t encounter a single checkpoint and others were tested multiple times last year but on average, that’s 1 in 2.

So how is that possible? How can Swedish police legally issue breath tests to that many people?

Swedes scoff at the constitutional protections California’s drivers are afforded. In the Golden State, landmark Supreme Court cases have created major burdens for police to conduct legal DUI checkpoints. These requirements include:

• The checkpoint should be located on a major thoroughfare (streets with a high concentration of DUI arrests or accidents)
• Checkpoints must be advertised in media outlets at least one week in advance
• Checkpoints must be identified by signs or lights so they are obvious to approaching vehicles
• There MUST be a marked route to circumvent a checkpoint, and drivers must commit a moving violation or show obvious signs of impairment to be pulled over for taking such a route around a checkpoint
• For drivers who are stopped at a checkpoint, police must establish probable cause that they are intoxicated in order to conduct breath or other field sobriety tests
  

Those are some high hurdles for California’s cops. Swedish law enforcement officers face none of those restrictions.

The thing that struck me most about the checkpoint in Göteborg today wasn’t that it was unadvertised, unmarked or that it was located on a side street with little traffic. It wasn’t even that every driver was tested. It was that police were conducting it at 2 p.m. On a Sunday. Not a Friday or Saturday night or a holiday weekend.



I asked my girlfriend why and was shocked to hear the police were likely targeting drivers who may have imbibed too much last night. They may have made the right decision not to get behind the wheel last night, but if they still had even minor traces of alcohol in their system some 12 hours later, the police were there to arrest them.

Sweden lowered the blood-alcohol limit from .05 to .02 in 1990 — four times lower than California and most other states. I read on a lawyer’s blog recently that his local police department approximates that a 180-pound man can drink six beers or five mixed drinks in two hours before reaching the .08 threshold.

Pretty incredible, then, to think that a BAL of .10 or higher in Sweden is deemed “aggravated drunk driving” and first-time offenders are usually sentenced to two years in prison. That’s only a drink or two more than what a driver can legally consume in California. No wonder the Golden State has more than twice as many alcohol-involved fatalities as Sweden.

Observing the checkpoint this afternoon really got me thinking. We’re so concerned with the government violating our constitutional rights in California, but is guaranteeing these extreme protections coming at the cost of avoidable DUI deaths?

I don’t completely agree with Sweden’s drunk driving prevention measures, but there’s got to be a middle ground between this and the way things are enforced in California that can still save lives, right?