Looking for a quality used fire truck? Selling one? Visit our sponsor Command Fire Apparatus
The caller to WAMU’s “Kojo Nnamdi Show” said her name was Christina (video above). Christina had a story to tell about a 911 failure. One of the guests on the September 3, 2020, radio program was Karima Holmes, director of DC’s Office of Unified Communications. Holmes had run 911 in the nation’s capital since January 2016. Here’s what Christina told Holmes and Nnamdi:
“My daughter has a very good friend. She’s a teenager. And she watched her mother die from a heart attack in her home because D.C. 911 sent EMS to the wrong address. So, people who deny that this is not happening are incorrect. And now this poor child, who is 14 years old, and about to start high school, no longer has a mother. And her grandmother, who’s now in her 80s, has to raise this child on her own. So, the woman who’s talking about D.C. 911 not having a problem is dramatically incorrect. And this affects people’s lives on a daily basis.”
Despite Christina’s detailed information relaying an unusual and extremely tragic story involving a young teen doing CPR on her own mother, Holmes said she “didn’t know the specific incident.” But that wasn’t true. Holmes and her staff began investigating the call within hours of it occurring. It happened on June 5, 2020. And it happened exactly as Christina said it did.
How could a 911 director — who had previously admitted publicly that it’s her job to know about 911 calls that are mishandled — not recall a case where a young teenager was doing CPR on her own mother as a 911 call-taker sent fire and EMS to the wrong address?
The answer is pretty straightforward. OUC, Holmes and other top city officials didn’t want this information to become public. And despite Christina’s very public phone call, the death of 59-year-old Sheila Shepperd did not make news for another two months.
STATter911 didn’t know key details
I was a guest on the same radio show with Holmes. When I heard Christina’s call it was news to me even though I’d actually reported on some details of the same incident in June of 2020 just four days after the death occurred. But I didn’t know what Karima Holmes should have known about a child calling DC 911 and doing CPR on her mother. All I knew was a woman in cardiac arrest died after DC Fire & EMS was mistakenly sent to a house at 414 Oglethorpe Street Northwest. The correct address was 414 Oglethorpe Street Northeast. Even after hearing Christina’s call to the “Kojo Nnamdi Show” I didn’t immediately connect the incidents. Another reason I didn’t have the information to make that connection is OUC under Holmes refused to answer my questions about the call. It was their practice at the time to not even acknowledge STATter911 requests for information about any incident.
As STATter911 has previously reported, on June 9, 2020, the day my story with limited information about the Oglethorpe Street call was published, Holmes was at a DC Council hearing. Council member Charles Allen asked Holmes about my story (video above), which not only cited the Oglethorpe Street call but told of a May 17 childbirth where fire and EMS were also sent to the wrong address. The newborn died. At the hearing, Holmes said she couldn’t recall either of the very recent calls. Yet, under questioning from Allen, Holmes confirmed it’s the director’s job to know about these tragic 911 mistakes.
Multiple people working at OUC and elsewhere in DC government in 2020 tell STATterr911 the Oglethorpe Street mistake and its details were well known inside the agency and in the upper levels of the Bowser administration. All these insiders talking with STATter911 requested anonymity due to not being authorized to talk publicly about 911 mistakes. According to these sources, OUC leadership followed its usual practice of immediately investigating the incident internally and ordered retraining for the call-taker who entered the wrong address. This was also verified by a summary of investigations OUC eventually released through a FOIA request (above). In addition, on multiple occasions, Karima Holmes has talked publicly about the agency’s process for handling mistakes. Most recently on Friday.
The OUC insiders also say Karima Holmes kept then Deputy Mayor for Public Safety and Justice Kevin Donahue (currently DC’s City Administrator), the fire chief, police chief and the Executive Office of the Mayor informed of all complaints involving mishandled calls where deaths occurred. In the childbirth case three weeks before the Oglethorpe Street call, STATter911 has reviewed an email from Holmes to Donahue that copied those same officials. It showed in detail exactly what went wrong during the call. Holmes sent the email about 40 hours after the baby died.
911 call makes news
On November 19, 2020, the tragic details of the Oglethorpe Street call made news for the first time. On that day, “Communications Daily” published the 911 call from Maria Shepperd. The industry publication had filed Freedom of Information Act requests for 911 calls and documents connected to a number of STATter911 OUC stories. Under Holmes, the agency generally refused to release 911 calls to news agencies. That policy continues today. All the DC government sources familiar with these incidents tell STATter911 they believe that somehow the Oglethorpe Street call and childbirth calls were released without Holmes’s knowledge. The sources tell STATter911 Holmes was unhappy when she learned OUC’s FOIA officer released the recordings.
Anyone who has heard the call form Maria Shepperd (audio above) — including 911 veterans — will tell you it’s not an incident you can soon forget. In fact, reporter Mark Segraves asked Mayor Muriel Bowser (video below)) on November 23, 2020, if she heard the call. Bowser answered, “I’m not sure.” Segraves responded, “You’d remember it. It’s pretty heart-wrenching.” Yet somehow, during two public appearances, Karima Holmes, the woman whose job is to listen to that awful call or, at the very least, read the transcript, didn’t find it memorable.
Not long after the mayor’s press conference, Karima Holmes finally issued a statement admitting the call-taker’s mistake and apologizing for the error. Within three weeks Holmes announced she was leaving the agency.
Since March of this year Holmes has been back as acting director of OUC. Tomorrow, Bowser’s nomination of Holmes to be director is scheduled for a vote by the DC Council. Last week, Council member Charles Allen recommended disapproval of the nomination. Allen and Council chairman Phil Mendelson have suggested Bowser withdraw Holmes’s name. Both claim the votes aren’t there to approve her nomination.
The death of Sheila Shepperd was the fourth one STATter911 uncovered where there were 911 mistakes since August of 2019. This year, Holmes has been in charge during six more deaths involving significant 911 errors. Despite that, Mayor Bowser on Friday came out in support of Holmes. The mayor said she was not withdrawing the nomination. Bowser called Holmes a nationally known 911 leader and featured Holmes at a press conference. Holmes also spoke, defending her own record.
One of the reporters at Friday’s event was Stephanie Ramirez. On November 23, 2020, Ramirez asked Bowser why the city didn’t come clean about the 911 call for five months. Ramirez pointed out that no one from the city, including Holmes, contacted the Shepperd family. On Friday, Ramirez finally got to ask that same question directly to Karima Holmes. She attempted to find out why — even to this day — city officials have not reached out to the family. Remember, Karima Holmes issued a public statement two years ago apologizing about Sheila Shepperd’s death but has never shared that same apology with the Shepperds. The questions from Ramirez — two years apart — are included in the video above.
A mother grieves
STATter911’s reporting in recent years has shown many reasons why Karima Holmes shouldn’t be running DC 911. These include blown addresses, questionable statistics, chronic failure to answer emergency radios, wasting of limited fire and EMS paramedic resources, a critical audit of the agency, and, of course, serious 911 mistakes surrounding 10 deaths in a little more than three years. (Note: There was another death in that time period that occurred while Cleo Subido was interim director.)
Making all of this worse has been the agency’s general lack of transparency. It has delayed the public and families from learning details about the mistakes surrounding the series of deaths. No one knows this better than 82-year-old Billie Shepperd. Ms. Shepperd not only lost her daughter, but her granddaughter is now far away. Maria lives with Shepperd’s other daughter in Canada. Billie Shepperd says the withholding of information has caused insult upon enormous injury. She testified during a September DC Council Oversight Roundtable on OUC and talked with STATter911 last week (below).
Mayor Bowser’s decision to bring back Karima Holmes is extremely upsetting to Billie Shepperd. The 911 director not having the decency to admit what occurred when asked by both a council member during a hearing and a family friend in the middle of a radio program is shameful. Ms. Shepperd says there has been no accountability for how the Shepperd family had been treated.
Karima Holmes has at least twice publicly claimed she can’t remember what Billie Shepperd and her family will never forget. Tomorrow’s vote will show whether Holmes is finally held accountable for those memory lapses.