CLEVELAND -- Some private ambulances in Northeast Ohio lack basic life-saving equipment, like CPR masks and heart-starting defibrillators, while others are stocked with expired medications, a Channel 3 News investigation found.
The station also uncovered patients being put at risk by drivers who drank on the job, didn't know what they were doing, or didn't pay attention.
Private ambulances and ambulettes -- modified vehicles that transport wheelchaired patients -- transport more than 1.5 million people each year to the hospital, doctors appointments and other destinations.
One of those companies, Community Care, dispatched an ambulance to Rita Bush's home in Ashtabula after she passed out on the floor.
"It was two women -- they were pretty small -- lifting a 350-pound woman onto a tiny cot," said Bush.
The women, who radioed the company for help only to be joined by two older men, tried to take Bush down the front steps of her home, Bush said.
"I told them, 'Don't drop me, don't drop me, you're going to drop me,'" Bush said. "All I remember is waking up to the cot going down on the ground. I went from the top step to the bottom step. My head was hanging to the side."
Bush said the paramedics ignored protocol in lifting her and refused to call the local fire department for assistance, even though she told them to do so.
Channel 3 News reviewed state records on 40 private ambulance and ambulette companies in Northeast Ohio and found they have been slapped with 284 violations since 2010 for everything from expired drugs to broken equipment.
The station also uncovered cases like Bush's where patients were put at risk.
"I've seen some screwed up things," one driver told the Investigator Tom Meyer, like the time he saw another driver leave a patient in a wheelchair in the middle of a busy street and walk away. "I've seen someone (in a wheelchair) fall off the ramp (of an ambulette). I don't know how that happened."
A family of a suicidal patient sued American Medical Response, a national chain that operates in Northeast Ohio, after the patient escaped from a moving ambulance and jumped from a highway overpass into oncoming traffic.
In the lawsuit, which was later dismissed following a confidential settlement, the family said the drivers left the patient unstrapped and alone -- even though they knew she was a threat to kill herself.
Poor patient care is only part of the problem.
Our investigation found ambulance companies with missing blood pressure cuffs and heart-starting defibrillators.
Ambulances and ambulettes were cited for faulty brakes and tires, while some drivers lacked required medical training, background checks and driver's licenses.
American Medical Response was cited the most -- 43 times -- with violations that included a broken heart monitor, missing CPR mask and expired drugs.
American Medical Response says that all violations have been corrected, that they're in good standing with the the state, and their license has been renewed.
A former employee of Ohio Ambulance, which had 20 violations, said the company routinely overlooked major infractions.
She said that some ambulette drivers would be on the road with patients, either drinking and driving or still drunk from the previous night. "Management knew" but didn't do anything about it, the former employee said.
Jerry Dozier, general manager of Ohio Ambulance, said, "We've never actually caught people drinking on the job, but we have sent home employees who were suspected of drinking, and suspended or terminated them"
The former employee said Ohio Ambulance also kept dangerous vehicles on the streets.
She routinely drove vehicles that smelled so strongly of gas fumes that patients would become ill. She also drove vehicles with wheelchair lifts that leaked hydraulic fluid on the floor, putting patients at risk. And, she drove vehicles with bad brakes.
"You would call dispatch...and they'll tell you, 'See if you can do one more patient,'" the former employee said.
The general manager denied the allegation. "Anytime we have any complaint on a vehicle we take it very seriously," said Dozier. "We have full-time mechanics that work here."
The state Ohio Medical Transportation Board, which conducts regular inspections of private ambulance and ambulette companies, has prosecuted 20 companies since 2005 -- but none in the past 2 years.
A review of the actions also shows that every time the state board suspended a company's license, it still allowed the company to operate.
The Ohio Medical Transportation Board does not regulate patient care -- they leave that up to the companies and their medical directors.
And if a patient is injured, state law says that the patient may only sue if the injury is the result of willful and deliberate misconduct.
The law leaves many injured patients like Rita Bush, who still has back pain, uncompensated and angry.
"It's ridiculous," said Bush. "If it happens, it happens. You did it. It's your problem. It's your responsibility."