Serial 911 caller may land in guardian’s care After thousands of 911 calls, D.C. woman may get a guardian

The Washington Post

WASHINGTON

Martha Rigsby collapsed to the ground for the first time in 1977. The spells continued, and she began calling 911 for help.

She hasn't stopped.

In the past year alone, she has accounted for 226 calls to 911 and been whisked by an ambulance to a hospital 117 times.

Among firefighters in the District of Columbia, she's a dreaded legend. They can recite her date of birth and Social Security number from memory.

Over 30 years, Rigsby has become the most frequent 911 user in Washington history, totaling thousands of emergency calls and trips to the hospital after falling down, court papers say.

Dubbed "super users" or "frequent fliers," repeat 911 callers have long been identified as burdens on the health system and a drain on public safety resources.

"There will come a time when one of these Some cities, including San Diego, track mileage and ambulance hours for each frequent caller to calculate the long-term costs and effects, Dunford said.

"All cities are going through a similar experience of how do we deal with this small subset of people," he said.

For years, there has been concern that if crews are tending to Rigsby, the next 911 caller with an emergency might get a paramedic from farther away, said David Miramontes, medical director of the D.C. Fire and Emergency Medical Services Department.

A group of D.C. officials met earlier this year to figure out how to solve their problem with Rigsby. Her situation has led to the first known attempt in the city to seek guardianship for a serial 911 caller.

The Department of Behavioral Health filed a court petition in April, alleging that Rigsby, 58, has bipolar and borderline personality disorders and does not have the mental capacity to handle her medical affairs.

These are "uncharted waters," Miramontes said.

It might be a unique attempt in the District of Columbia, but other cities have reported success with similar proceedings.

Niels Tangherlini, a paramedic captain for the San Francisco Fire Department, led a successful pilot program from 2004 through 2009 to stop 911 serial callers. During the height of the program, Tangherlini said, officials successfully filed conservator petitions, which are legally similar to guardianships, for about 12 serial 911 users a year.

Public documents and legal proceedings detail Rigsby's 911 habits and assessments of her mental state and medical problems. They also reveal continued concerns from D.C. officials about the impact of one woman's troubles on health and safety resources.

Although Rigsby has had various medical insurance plans throughout the years, she has an outstanding balance of $61,366.33 owed to the D.C. Fire and EMS for ambulance transports, according to Andrew Beaton, the department's management program analyst.

Over the past five years, each ambulance trip has averaged $478.

Rigsby opposes the city's attempt at guardianship. Over two weeks, she has quietly watched the proceedings in Judge Erik Christian's courtroom in the D.C. Superior Court's probate division. She has whispered instructions to her court-appointed attorney, Vickey Wright-Smith, at times.

Wright-Smith has argued that Rigsby is able to care for herself and has no malicious intent for calling 911.

If the District of Columbia's petition is successful, the medical guardian could take responsibilities for such things as hiring a home health aide, filling prescriptions and proposing a different living environment. But it would still be possible for Rigsby to dial 911 because the guardian would not be a live-in caregiver.

After a court session this week, Rigsby seemed taken aback by a question about her calls to 911. "Well, I don't do it on purpose," she responded.

According to testimony during the court hearings, Rigsby's calls follow a general pattern. She feels faint and collapses. About 40 percent of the time, she dials 911 on her own. Other times, she's out in the District of Columbia when passers-by see her fall and call for help, the testimony indicated.

About 55 percent of the time, she refuses to be transported in an ambulance and signs a waiver allowing emergency responders to leave.

Court proceedings won't resume until January, when Rigsby will have had a neuropsychological assessment, according to attorneys in the case.

Several mental health experts have been called to testify.

According to court records, Abayomi Jaji, a psychiatrist with the city's Department of Behavioral Health, said Rigsby continues "to place herself in real danger of bodily injuries from falls under the claim of 'seizures' or 'Narcolepsy,' which have never been correlated with medical findings."

Jaji also said Rigsby lacks the mental capacity to take care of herself as evidenced by "almost every other day calls to 911."

On Oct. 31, he testified in court that Rigsby's repeated calls may be driven by a feeling of "impending doom."

"She seems to be aware at some level that she shouldn't be calling," he said.

Rigsby first remembers passing out in 1977. She thinks the spells "could be stress," according to the examiner's report.

Although Rigsby has been known to paramedics for decades, city officials increased their focus on her in December after she called 911 and threatened to harm herself, according to court testimony.

The Department of Behavioral Health's mobile crisis team was sent, and Rigsby was involuntarily admitted to the hospital for a mental health evaluation, according to testimony by Jonathan Ward, the team's director.

After that, a group including representatives from several city agencies met to discuss a plan for Rigsby. Rigsby declined some suggestions, such as having a home health aide and using a wheelchair, Ward testified.

She has a lingering fear that the volume of calls might lead to criminal charges and said she has been handcuffed before.

"I've been through a lot," she said. "I'm surprised they haven't put me in jail by now."

But as discussions continued, the idea of guardianship emerged.

"It's a high bar to prove someone is not competent to make decisions," Miramontes said. "We didn't think we had enough data. The goal of the committee was to pool our data together."