'The longer you wait, the more people die': Lafayette theater shooting first responders relied on training, focused on task at hand _lowres

Advocate staff photo by LESLIE WESTBROOK -- Law enforcement and other emergency personnel respond to the scene of a shooting at the Grand 16 movie theater Thursday, July 23, 2015, in Lafayette, La. Multiple injuries are reported and the shooter is presumed dead.

It’s the kind of event emergency responders prepare for but never expect to happen.

Yet when a lone gunman opened fire on July 23 inside a darkened Lafayette movie theater, police officers and medical professionals — both on- and off-duty — rushed to the scene, forced to focus on the task at hand despite the horror of their surroundings.

“We didn’t think we’d come up against an active shooter scenario,” said Dr. Chuck Burnell, Acadian Ambulance’s chief medical officer. “This isn’t something that we really think about in Lafayette.”

From 2000 to 2013, the U.S. saw an average of 11.4 active shooter incidents each year — during which a person is actively killing or trying to kill people “in a confined and populated area” — with more than 45 percent of those happening in commercial settings, according to an FBI study on the topic.

And like the theater shooting in Aurora, Colorado — where a gunman in 2012 killed 12 and wounded 70 during a sold-out, midnight premiere of “The Dark Knight Rises” — Lafayette now joins a small number of communities forced to cope with the grim aftermath of a seemingly random shooter in a public place. In Lafayette, that gunman killed two people and injured nine others before turning the weapon on himself.

Although police and medics prepare for what are called “mass casualty incidents,” responding to The Grand 16 Theatre during a 7:10 p.m. showing of the comedy “Trainwreck” proved an unprecedented setting for medics most used to rescuing several people from a fire or a severe traffic accident.

Although workers at each of Lafayette’s three major hospitals can attest to treating gunshot victims, Lafayette Parish is among more than a dozen parishes with the lowest trauma rates in a state with one of the highest in the country, according to data from the Louisiana Emergency Response Network.

While reckless gun-bearers are more apt to wreak havoc in other Louisiana cities, treating multiple gunshot victims at once in Lafayette is unusual — and first responders at the theater that night encountered a number of other unexpected obstacles.

Wounded moviegoers were scattered throughout a dim auditorium with tiered seating. As frantic police officers yelled back and forth, a fire alarm blared. The smell of buttered popcorn lingered in the air along with gunpowder and blood.

“Nothing can prepare you for that,” Burnell said.

First call

The first Lafayette police officer arrived a few seconds after the 7:28 p.m. dispatch told of a man firing a gun at moviegoers. Within a minute, three to four more officers were outside the Johnston Street theater as frightened patrons rushed from the building.

“At that point, we had four or five guys that were ready to engage,” Lafayette Police Chief Jim Craft said in an interview July 30, one week after John “Rusty” Houser opened fire on the two dozen people inside the cineplex’s screen 14. Houser, a 59-year-old Georgia native and Alabama resident, had been living in a University Avenue hotel since early July in the weeks before the shooting.

Officers and medics entered an uncertain scene. Although the gunman already lay dead after turning his .40-caliber pistol on himself, responders didn’t know if additional threats remained inside the dark theater.

“We didn’t know if there was a second shooter. We didn’t know if there was a booby trap or bomb or something ready to detonate,” Burnell said.

John Witt, Acadian Ambulance’s quality improvement coordinator — who abandoned a cheeseburger dinner with his family that Thursday evening to co-command the emergency medical response at the theater — recently looked upon one of hundreds of published photographs from the scene that night.

Under daylight, the photo shows medics loading a patient into one of three ambulances parked outside the theater beside a powder blue 1995 Lincoln Continental.

Almost two hours would pass before police identified the car as the gunman’s, with a State Police bomb dog sniffing out two potential threats inside the vehicle. A robot later detonated the items, blowing the windows out of Houser’s car.

“I’m glad I didn’t know then what I know now,” Witt said, recalling medics leaning against the vehicle and congregating beside it.

Acadian Ambulance trains its employees to deal with mass casualty events, but what’s learned in those drills is used most frequently during traffic accidents and fires and explosions.

“Active shooters are not something we would handle on a consistent basis, obviously,” Witt said. “It’s a once-in-a-lifetime kind of deal.”

As they’re taught in training, medics that night had to maintain focus in the chaotic scene.

“The longer you wait, the more people die,” Burnell said. “The No. 1 cause of death during active shooter situations is examination.”

The dark auditorium

Two-and-a-half minutes after police arrived at The Grand 16 Theatre, they reached Houser, who lay dead on the auditorium floor. At least six people inside the theater needed help, according to police-radio traffic from that night.

Each Lafayette patrol officer is issued one first-aid kit to render aid to another officer who is wounded. But that night, civilians needed help.

Craft said at least 10 of the kits were used at the theater to aid the wounded. The officers wrapped tourniquets around the wounds and applied a clotting agent to stop bleeding.

“You definitely want that thinking,” said Dr. Foster Kordisch, Lafayette General Medical Center’s trauma coordinator and the attending emergency room doctor on July 23. The hospital that night treated five of the nine shooting victims who survived. “Actions like that are going to save someone.”

Medics from Acadian Ambulance’s three-state service area treat penetrating bullet wounds almost every day, said Burnell. But traditional emergency medical care — starting IVs, giving fluids — “they’re not really beneficial” in shooting situations, he said.

And time matters, Witt added.

“Those patients needed surgery. And our job is to find out which patients need surgery and get them there as fast as we can,” Witt said.

Medics who stayed on the scene until early the next morning also treated collateral patients — those at the theater who suffered anxiety or panic attacks or were injured trying to leave the theater — but only a few, Witt said.

Thirty-two minutes elapsed from when the first ambulance arrived on scene until the last one delivered the final patient to an area hospital, and all of the injured had been removed from the theater within 18 minutes after ambulances began arriving at 7:34 p.m., Witt said.

He made his first phone call to the Louisiana Emergency Response Network at 7:42 p.m., giving the center as much information as he had about those who needed medical treatment. LERN is a state-run center that keeps tabs on hospital operations and directs ambulances to facilities that are most equipped to handle the situation.

One patient was ready to go, but that’s all he could convey at the time.

“Be prepared,” he told them.

Kordisch, one of LGMC’s on-duty ER doctors, recalled a busy night when they got the call that it would be even busier. Kordisch has treated multiple gunshot wound patients at a time before — while doing his residency at the old Charity Hospital in New Orleans and through 19 years with the U.S. Army Reserve.

“But not in Lafayette,” he said.

“There was a different energy to it,” Kordisch added. “When something big like that is happening, it’s definitely different than a regular shift in the emergency room. There was a different environment.”

Amid a 7 p.m. shift change at LGMC, on-duty nurses who were preparing to leave stuck around. Off-duty nurses, meanwhile, showed up to help, Kordisch said. He said he too stayed hours beyond his usual knock-off time. And the doctor who was scheduled to come in after Kordisch got there an hour early. About that time, the hospital went on lockdown as frantic friends and family members began arriving.

“We know that family members want to see their loved ones, but our manpower is stretched to take care of patients. And there’s a security risk,” Kordisch said.

The high-profile shooting also led administrators at Regional Medical Center of Acadiana to beef up security around the hospital, where on-call certified physician assistant John Hendrick arrived about 9:30 p.m. to evaluate a patient shot in the chest at the theater.

“Because this story was already on the news and on social media, people working in the emergency department knew the events in a way they don’t normally know about the patients. That is unusual,” recalled Hendrick, whose work specializes in lung and vascular surgery.

Like Hendrick, who was called from a family dinner to evaluate one of two shooting victims treated at Regional, general surgeon Dr. Josh Landes was called from the dinner table to treat shooting victims at Our Lady of Lourdes Regional Medical Center.

Landes, too, trained at the old Charity hospital in New Orleans, in one episode treating seven shooting victims at once, he said.

“In this situation, obviously, we didn’t have time to wait. It was amazing how quickly everybody got in and how smoothly we got the (critical) patient to the operating room,” Landes recalled.

One of two shooting victims treated at Lourdes remained in stable condition there as of Tuesday afternoon. Another Lourdes patient, along with five shooting victims who received treatment at LGMC and two at Regional Medical Center of Acadiana, were released within a week of the shooting.

Jillian Johnson, 33, of Lafayette, died on her way to Lourdes, and Mayci Breaux, 21, of Franklin, died in the theater. Families buried both women on July 27.

The response

Government officials have lauded the response and coordination of local, state and federal police agencies and the firefighters and medical professionals who worked that night.

Craft, Lafayette’s police chief, said he’s received commendations from around the country.

Gov. Bobby Jindal, who arrived at the theater within an hour-and-a-half after the gunman opened fire, offered the same.

The first responders “ran toward shots fired — toward danger, not away from it,” Jindal said.

In the two weeks since the shooting, the community has poured itself into public services and displays of support for those affected.

A prayer service last Wednesday organized by about 50 area churches at Crossroads Church on Verona Drive summoned more than double the church’s 1,500-patron capacity, and a city-organized event the following night at Blackham Coliseum drew hundreds.

Traffic backed up on Bertrand Drive for hours one night last week, when a local printing company sold yard signs and apparel declaring a sentiment repeated often since the shooting: “Lafayette Strong.”

All over social media, personal avatars and page designs were altered to capture the same message, also displayed on billboards and marquees around the city.

Numerous fundraisers continued this week, with the United Way of Acadiana on Tuesday hosting a coordinating meeting in effort to efficiently distribute a growing amount of at least $200,000 in donations to the victims and their families.

“We certainly hope something like this doesn’t happen, but we train for it,” Craft told the Lafayette City-Parish Council at its regular meeting on July 28, five days after the shooting. “We had all the support and resources we needed.”