EMS in Scotland Co. faces state probe after family’s loss

Sharon Cripe is angry. Her uncle, Stacy T. Britt, died on Jan. 25, and she has questions about the care he received that night from the county’s EMS, she said.

For more than 40 years, Britt was a resident of Wagram, a small town in rural Scotland County, where he was surrounded by family.

On Jan. 25, one of those family members called 911 to report that Britt was experiencing chest pains. EMS reached him in roughly 19 minutes, about 3 minutes shy of the average response time for Wagram residents, which currently sits at 22 minutes and 39 seconds, according to a county report.

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Paramedics provided him care that included oxygen, CPR and certain medications, according to Britt’s patient care report. 

But Cripe has concerns about “the timeliness, accuracy and adequacy of care provided,” which she described in a letter to Scotland County administration and the North Carolina Office of Emergency Medical Services in March, despite assurance from the county’s EMS director that everything was done “by the book” in Britt’s case. 

The OEMS — which is housed within the North Carolina Department of Health and Human Services — decided to open an investigation.

As the family waits on the results of that investigation, the county’s current struggles with its emergency response services have come to light.

Calling EMS

At first, Britt’s family thought he might be experiencing indigestion or acid reflux.

About three days before that fateful January night, Britt called his doctor with complaints of acid reflux, for which he was prescribed Nexium, Cripe said.

Complaints of acid reflux gave way to cold-like symptoms, causing him to stay in bed or on his couch for the entire day that Sunday. His family wondered if he had pneumonia.

That night of Jan. 25, he started complaining that he was “feeling funny in his chest,” Cripe said. His wife called Cripe’s mom — her sister-in-law — in a panic, who then called 911 for her just after 8 p.m. so she could focus on tending to her husband.

While telling dispatchers about her brother’s condition, Cripe’s mom started walking, then running across her yard to his house next door. She suggested to dispatchers that he could be having a heart attack, and at 8:05 p.m., EMS was on the way to Britt’s house in Wagram. 

Around 8:19 or 8:20 p.m., she made a second call to 911 to report that his symptoms were worsening and that he was having trouble breathing.

At 8:24 p.m., EMS reached Britt’s house. They took his vitals a few minutes later, at which point he was alert and sitting up. The first oxygen was recorded being given to him at 8:40 p.m., according to his patient care report.

A couple minutes after that, at 8:42 p.m., he coded. The ECG from his report showed he was in asystole at that time, Cripe said.

By 9:31 p.m., after paramedics had been working on him for more than 30 minutes administering CPR and other medications with no change, they agreed to stop resuscitation efforts, his patient care report said.

He was gone.

The aftermath

A private autopsy the family had done a little over a week after Britt’s passing confirmed that he did indeed have a heart attack, causing his death, Cripe said.

The day after he passed, Cripe said she talked to Robert Sampson, EMS director for Scotland County. She said he told her that he reviewed Britt’s patient care report himself and assured her that “everything was done by the book.” He also told her her aunt could come get Britt’s patient care report — which details all medical care that paramedics provided, as well as a timeline of events — the next morning, since she was his next of kin.

When Cripe’s aunt arrived at the EMS facility in Laurinburg the following morning to pick up the report, she was told she needed to get a power of attorney document first.

Cripe’s aunt obtained this and brought it back to the office along with some other documents, handing them over to a woman there, possibly a secretary, Cripe said.

“She told my aunt that she would call her once the report was ready, which was confusing because Robert had just told us that the report was ready to be picked up,” she said.

When they did call Cripe’s aunt, it was to inform her that they couldn’t give her the report and that she would need to speak with the county attorney, Cripe said.

What followed was several weeks of back-and-forth between the family and the county before the patient care report was finally released to them in March, Cripe said.

After seeing the report for herself, Cripe said she had some concerns about what paramedics did and when.

“When they entered the residence, they did not take in an oxygen machine, and they also didn’t go in with the cardiac monitor,” she told Carolina Public Press.

“Based on everything that I took the time to research and look into, when a call is dispatched as a chest-pain-related call, the standard in North Carolina is they treat it as worst-case scenario, which would be heart-related or potential cardiac arrest, and if they would have taken in the monitor, then they would have been able to hook my uncle up and start performing a ECG, EKG.” 

When CPP reached out to OEMS to ask if it was standard for paramedics to bring this equipment into a residence for these types of complaints, a spokesperson from NC DHHS said: “Local EMS systems each have their own protocols and policies regarding emergency medical dispatch, equipment, and patient care.”

Another point of concern for Cripe was the timing of care. For example, she said, even though Britt was shown to be in asystole at 8:42 p.m., CPR wasn’t started for another 5 minutes, around 8:47 p.m. Oxygen and IV therapy were recorded as being given in the minutes prior, according to his patient care report.

“Why did it take 5 minutes to begin CPR if he had coded at 8:42?” she asked.

Cripe took these and other questions to the county and NC OEMS. On March 23, Cripe sent letters to each of them — along with her uncle’s patient care report, a timeline of events she put together and other documents attached — requesting they review the emergency response for her uncle. 

“Taken together, the reported symptoms prior to arrival, the patient’s condition upon EMS arrival, and the documented timing of monitoring, intervention, and escalation — particularly as reflected in (the timeline) — raise concerns regarding whether appropriate and timely care was provided during a critical window,” she wrote in her letters.

“I am not attempting to draw conclusions; however, I believe these circumstances warrant a thorough and objective review.”

The county never responded to Cripe’s inquiry, she said. CPP previously reached out to the county in April to ask about EMS-related complaints it had received since January 2025, but Scotland County Manager April Snead responded the following month saying there were none in her email inbox, nor did the county have any formal data for this.

OEMS had a different response. On May 13, it sent Cripe a letter saying it would be opening an investigation into her uncle’s case.

“Based on the information provided, it has been determined further review regarding the circumstances surrounding this allegation is warranted,” the letter said.

She said an official with OEMS told her “there’s usually a gray area and most of the time they do not launch an investigation and he just wanted to be transparent with me that they typically do not investigate.” 

The OEMS decision to look into the case further made her feel “relieved and hopeful,” Cripe said.

A spokesperson from DHHS confirmed that the investigation remains ongoing as of Oct. 2. Once the case is closed, more information can be released, they said.

OEMS has opened 56 investigations so far this year related to emergency responses, which is consistent with previous years, DHHS said.

“When OEMS is notified of a concern, staff look into every situation to determine the circumstances surrounding each event, what (if any) action was taken locally, and if there is a potential violation of administrative code or general statute,” a spokesperson from the agency said.

Since then, Sampson has informed county leaders that he will be resigning from his position as the county’s EMS director effective Oct. 21.

“After careful consideration, I have made the decision to pursue a new professional opportunity and take the next step in my career,” his Sept. 21 resignation letter said.

“This was not a decision I made lightly, as my time serving the citizens and employees of Scotland County has been an extremely meaningful part of my professional life.”

Struggling EMS in Scotland Co.

Scotland County includes roughly 320 square miles and is home to more than 33,000 residents. Like other EMS agencies across the state, Scotland’s has had its fair share of challenges. 

The county’s emergency call volume has increased 11.7% on average per year since 2019, and it’s trying to keep up with the increased demand, according to a continuous improvement and strategic plan analysis for fiscal year 2025-2026.

This is seen in its response times, which the report said have worsened through the years. Total response time increased from 16 minutes and 17 seconds for fiscal year 2019-2020 to 17 minutes and 48 seconds for fiscal year 2024-2025. 

Turnout times — the time between when emergency personnel are notified of an emergency and the time they leave to respond — ranged from 2 minutes and 41 seconds to 3 minutes and 31 seconds. This is more than the national standard of one minute, the analysis report said.

But some locations have it worse than others once EMS actually gets underway. 

For example, Wagram — where Britt lived — had one of the longest total response times in the county at 22 minutes and 39 seconds, the analysis report said.

Another challenge has been staffing shortages, which have become more problematic in recent years as the county has switched from a 24/48 to a 24/72 schedule to try and improve recruitment and retention, but the change has required an increase in minimum staffing needs, the analysis report said.

The central EMS base in the county is located in Laurinburg, the county seat and most densely populated town. The county had two operational ambulances until 2012, when it attempted adding a third one to better serve the people of Wagram, the analysis report said.

Operating out of a community center in Wagram, staff were expected to work 24-hour shifts, but certain state building codes prohibited staff from staying in the building overnight unless certain requirements were met. Correcting these issues would’ve cost the county roughly $80,000, so after about six months in Wagram, staff were moved back to the main facility in Laurinburg, the analysis report said.

However, discussions between the county and the Wagram Fire Department could lead to a partnership that would allow the county to put an EMS unit back in Wagram, the analysis report said. 

Even if there was an EMS unit stationed in Wagram, allowing for a faster response time, Cripe said she’s not sure if that would’ve even made a difference in her uncle’s case.

“That’s possible, but I think it comes down to overall a leadership, training and an accountability issue, not directly tied to a unit needing to be in Wagram 24/7,” she said.

As of May, the county has been exploring the possibility of privatizing its EMS, which Snead said costs roughly $4 million per year to run, as reported by ABC 15 News.

The county commissioners voted to take bids on contracts to run the services, yet some residents pushed back on the idea, saying “if it’s not broke, don’t fix it.” However, commissioners could ultimately decide not to do anything.

CPP reached out to the county to ask where it currently stands with its efforts to privatize and bring an EMS unit back to Wagram, and if it would like to respond to any of the claims made by Cripe, but county officials declined to comment.

“Given the nature of the story, I don’t think it would be appropriate to answer these questions at this time,” Snead told CPP.

What’s next?

Because they’re still waiting on the results of the investigation, Cripe said she isn’t certain yet what the next steps will be.

“I feel like no matter what happens, I’ll continue doing everything I can to bring awareness to the situation until I feel that there’s a heavy focus on accountability and training,” she said.

“I want this to be for other families and individuals out there because people call 911 every day and they’re home alone. And the difference in my uncle’s situation is he has family there with him, and he also has family that cares enough about him to make sure that his memory lives on, because that’s the type of person that he was.”

According to his obituary, Britt’s memory and presence will live on. For his family, “guiding us, grounding us, and reminding us that love endures beyond all things.”

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