A Santa Ana Fire Department spokesman referred questions about the incident to an assistant city attorney, who declined to comment, citing confidential medical and personnel issues. One of the rescuers also declined to comment. The others could not be reached.
The case was not reported to county regulators, who pressed Times reporters for details.
In the case of Schroeder, the car crash victim, a spokesman for the ambulance contractor involved said the firm also saw no need for review by regulators, despite the lawsuit.
"There was nothing in the patient care record to indicate that an incident report should have been filed," said Jason Sorrick of American Medical Response, declining to comment further. The ambulance attendants could not be reached.
Schroeder declined to discuss the settlement, whose details were contained in the court record. Antelope Valley Hospital, also accused by Schroeder of delaying proper care of her eyes, paid her a $250,000 settlement. Officials there declined to comment.
Although Schroeder also sued the Los Angeles County Fire Department, it paid no settlement, records show. The department's emergency medicine experts did not review what happened until two years after the crash -- in response to inquiries from risk management staffers who assess financial exposure.
"There's nothing here that indicates these guys were being poor paramedics," said Chief Deputy Gary Lockhart. The paramedics said she complained about an oily substance but not about burning in her eyes, he added.
Schroeder, who is awaiting her second cornea transplant, said she is not bitter about what happened.
She said she retains the utmost respect for paramedics in general and holds no malice toward those involved in her own care. "I don't think they're bad people," she said.
If anything is to come out of her case, she said, she hopes it is a realization that oversight of rescuers should be tightened so patients are better protected.
As it is, "I don't trust this system," she said.
Times staff writer Doug Smith and researcher John Jackson contributed to this report.
(BEGIN TEXT OF INFOBOX)
A fractured system
Discipline of California's 85,000 emergency medical responders varies strikingly, both in number and severity, among the responsible local agencies, reflecting the lack of a comprehensive system for investigating and reporting misconduct. The selected counties include some of the state's largest agencies and some of the widest variation.
Emergency medical technicians
Emergency medical technicians are certified and disciplined locally. These figures represent actions reported to the state.
*--* No. of disciplinary Specific actions County/Re No.of per 10,000 cases of: gional Agency EMTs responders Probation Suspension Revocation Los 15,000 122 216 2 1 Angeles Inland** 2,775 27 10 0 1 Orange 2,500 15 2 0 3 Riverside 2,050 84 16 4 4 San Diego 1,764 19 2 2 1 Sacramento 1,514 0 0 0 0 Ventura 1,178 229 15 11 6 San Luis 550 549 33 0 6 Obispo
Paramedics are licensed by the state, but cases involving job-related misconduct can originate locally. These are the actions taken by the state agency based on complaints from the county agency, showing that such discipline is extremely rare.
*--* No. of disciplinary Specific actions County/ No.of per 10,000 cases of: Regiona l Agency Paramedics responders Probation Suspension Revocation Los 3,000 10 0 0 3 Angeles Inland* 1,232 16 0 1 1 Orange 890 11 1 0 0 Sacrame 882 0 0 0 0 nto San 804 50 0 3 1 Diego Riversi 792 63 1 3 1 de Ventura 219 0 0 0 0 San 160 0 0 0 0 Luis Obispo
* Figures for EMT'S are from 1999 to 2006; figures for paramedics are from 2000 to early 2007. Actions include probation, suspension and revocation of certificate or license. Numbers provided by the state can differ from those provided by the agency to The Times. Numbers of EMTs and paramedics are estimates provided by the agencies.
**Includes San Bernardino, Inyo and Mono counties.
Sources: California Emergency Medical Services Authority and the local agencies. Data analysis by Doug Smith
Several agencies began reevaluating their policies after The Times raised questions about inconsistent oversight:
* The director of the California Emergency Medical Services Authority sent a notice in February reminding all fire departments, ambulance companies and regional regulators that they are required by law to report internal suspensions or firings of paramedics and EMTs related to such issues as patient care, substance abuse and criminal convictions.
* In Sacramento County, the Emergency Medical Services Agency is considering requiring ambulance companies and fire departments to alert it to specific problems that could merit investigation and discipline of paramedics and EMTs.
Los Angeles, city and county
* The city Fire Department, which had not been reporting problems with paramedics to regulators as required, approved new procedures to ensure that the law is followed.
* The county Fire Department ordered all complaints and legal claims involving patient care issues to be reviewed by the medical director, a physician.
* The county Emergency Medical Services Agency is considering more specific criteria on the types of incidents that rescue providers must report, such as certain types of patient deaths.