EXCLUSIVE: As Astroworld disaster unfolded, Houston Fire Department lost contact with private medic group

Corrections & Clarifications: An earlier version of this story misstated when the department called in an “EMS Task Force.”

HOUSTON – The panicked call crackled over the handheld police radio around 9:30 p.m. Friday from a Houston police officer witnessing the melee at the Astroworld Festival.

“Cardiac arrest!” the officer said, a rising urgency in her tone. “CPR needed!”

The call bounced into a pop-up camper parked in a corner of the sprawling NRG Park grounds, used as a command center for a handful of Houston Fire Department officials. The officials tensed, realizing the situation was quickly turning dire.

On stage, rapper Travis Scott jumped and bellowed lyrics as thousands of followers below him surged toward the stage, crushing and trampling others. Unconscious victims were crowd-surfed to medics as EMTs and concertgoers rushed to revive them.

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As one of the deadliest concert disasters in U.S. history unfolded, Houston fire officials – perched outside the festival grounds – had no way to directly communicate with medics from ParaDocs Worldwide, the festival medic group contracted to provide treatment to fans.

Houston fire officials shared two-way radios with police but only had cellphone numbers for ParaDoc medics – which didn’t work or weren’t answered in the frenzy of the night, fire officials said.

The ParaDocs team of doctors, nurses and paramedics, who more commonly treat dehydration and overdoses at concerts, was suddenly inundated with crushed bodies and unconscious, dying visitors.

“They weren’t equipped to handle the sheer number and complexity of patients that presented themselves,” Houston Fire Chief Samuel Peña said. “They were quickly overwhelmed.”

So were security forces in the melee when audience members in the crowd of more than 55,000 surged to the stage.

The breakdown in communication with ParaDocs cost the Houston Fire Department valuable minutes in launching a robust medical response as people were trampled, crushed and gasping for final breaths while authorities struggled to get information and create a rescue plan, fire officials said. Eight people, ranging in age from 14 to 27, died after being pulled from the crowds. Dozens more were ferried to nearby hospitals.

“We all had to help each other and fight for our own lives at the concert,” said Alyssa Cortes, 20, of Houston, who was trapped in the crowd and described a breakdown of control by security and medical personnel. “People died trying to have fun.”

528 police officers, only 5 firefighters

In a statement, ParaDocs, a New York City-based company that has worked at hundreds of music festivals and concerts, said its core staff has "an average of 12 years medical and extreme trauma experience" and has provided care for more than 300,000 people at events for more than seven years. The statement said ParaDocs was well-equipped and prepared for the crowds at Friday's event.

"We cannot stress enough how saddened we are," it read. "It is the essence of what we do and must face, and we mourn the losses and console those hurt and all of the families and friends affected."

A criminal investigation was launched into the event, and multiple lawsuits were filed against Scott and the promoter, Live Nation Entertainment. Part of the investigation will center on how private medical teams responded to the emergency and how closely they adhered to contingency plans.

Interviews with senior fire officials and documents detailing the night’s events reviewed by USA TODAY show how the severity of injuries rapidly escalated as Scott took the stage and how quickly ParaDocs was overwhelmed, forcing Houston fire officials to assume authority and deploy resources to the scene.

They highlight a debate over whether to mandate more fire personnel at large events. There were 528 Houston police officers at Astroworld Friday night, along with 755 private security personnel – but just five Houston fire officials.

For years, officials with the Houston Professional Firefighters Association, a union, have urged leaders to compel promoters of large events to use fire personnel to oversee medical response but to no avail, said Patrick M. "Marty" Lancton, a firefighter and the union’s president.

Giving firefighters “command and control” of such events would help have more paramedics and ambulances at the ready in case of a mass casualty incident, and firefighters are better trained to confront those situations, he said.

“You want the men and women there who have more experience than anyone else,” Lancton said. “It’s a safety issue for our citizens.”

To provide medical response, the promoter, Live Nation Entertainment, contracted ParaDocs. A 22-page medical plan filed by ParaDocs for the Astroworld Festival states the company expected 70,000 people at the event – not the 55,000 estimated Friday night – and planned to staff it with nearly 90 paramedics, nurses and emergency room doctors. A separate company would operate five ambulances at the event.

The plan describes a command center and a two-way radio system. "Medical Staff will be equipped with ... 2-way radios along with remote speaker mic or in-ear surveillance kit to ensure they are able to clearly hear any dispatches," it read.

It's not clear whether ParaDocs personnel used the radios to speak with each other or other agencies.

Judge Lina Hidalgo, Harris County’s top executive, said she directed investigators to look into how closely ParaDocs and the promoters stuck to their plans and what, if anything, should be changed to prevent tragedies.

“Let’s find out what happened,” she said. “If it’s something systemic, it needs to change.”

Gate crashing and other troubling signs

The Houston Fire Department’s command camper arrived at NRG Park just before 7 a.m. and set up in a far east corner parking lot, about a mile from the stage and outside the event's barriers.

Inside the camper were two computer monitors displaying calls coming into the Houston emergency call center and six Motorola handheld radios to talk directly with police inside the festival. An officer was also stationed inside the command post for better access.

To reach ParaDocs, the fire officials were given only a handful of cellphone numbers, according to several officials.

Peña said he directed the command post to set up at the festival as a precautionary measure.

“It’s our responsibility to anticipate these things and plan for contingency,” he said. “If nothing happens, that’s great.”

Even before the festival opened, police and fire officials sensed trouble. Police noted “rioter tactics” in the crowds of visitors waiting to get in, including people covering faces with towels or blankets as they hurled items at police, said one senior fire official, who asked not to be named since the matter is still under investigation.

Around 9 a.m., crowds stormed over barricades at the front gate, rushed past COVID-19 checkpoint stations and ran to vendor tables selling Astroworld T-shirts, hoodies and other merchandise. Onsite medics treated people hurt in the rush; at least one person was taken to a hospital.

“It was a full stampede,” the official said.

Nafeh Saemdahr, 21, from Los Angeles, arrived hours before the main gate opened to buy souvenirs before supplies ran out, he said. As he pushed toward the front of the line to buy a hoodie and a few T-shirts, a stampede broke out behind him, wedging him between the merchandise table and the crowd. Police closed down the vendors.

“I couldn’t breathe,” Saemdahr said. “People just went crazy.”

Throughout the day, fire officials overheard troubling calls over the police radio: people breaking through gates and sneaking in; “dangerous crowd conditions” near one of the stages; participants detained by police; police officials requesting riot gear.

By the time flares lit up the stage at 9:15 p.m. and Scott launched into his set with his song “Escape Plan,” calls were cascading over the radio. As cases mounted, fire officials tried to reach ParaDocs to ask if they needed help or were overcapacity, but no one answered, officials said.

“When you don’t have the ability to communicate, the system’s broken,” Lancton said. “It’s not running the way it should be.”

'Multiple persons down'

Suddenly, calls erupted over police radios:

•9:30 p.m.: "Multiple people trampled, passed out at front of stage."

•9:32 p.m.: "Unconscious female in middle of crowd."

•9:33 p.m.: "Report of multiple persons down in the crowd."

•9:35 p.m.: "At least five 911 calls related to unconscious persons in crowd."

Two minutes later, after the female officer called in the cardiac arrest, the Houston fire incident commander on scene called in an “EMS Task Force,” which moved five units – a combination of ambulances and ladder trucks – and a dozen or so paramedics from nearby District 21 to the festival grounds.

Sandwiched amid the throngs was Cortes, who attended the concert with her friends Leo Fuentes, 22, and Juan Garcia, 22, all from Houston. It was the group’s sixth Scott concert, so she thought she knew what to expect, she said. But nothing prepared her for the wall of people that came at her.

Standing to the left of center stage, the crowds pushed and yanked at her relentlessly, starting at Scott's first song, she said. People fell all around her. Suddenly, someone bit her ankle. She looked down to see a woman screaming on the ground, pleading for help, just as someone shoved Cortes to the ground, she said. Garcia helped yank her back up.

As she tried to push her way toward a side gate to exit the concert, Cortes said she noticed an opening in the crowd. It was layered with people who had fallen and were trying to claw their way back up, she said. Some weren’t moving.

“Think of a mosh-pit-sized opening, but instead of people shoving each other, they’re all on the floor, falling on top of each other,” Cortes said. “All you hear is people screaming and crying, screaming and crying. You can’t get it out of your head.”

'There was no control'

Some concertgoers said they saw the red-shirted ParaDocs medics working frantically on people in the crowd, but they were outmatched by the deluge of unconscious bodies. Jessica Ramirez, 29, from Los Angeles, was watching the show from an accessible seating area for people with disabilities as security officers and concertgoers carried five unconscious bodies into her section.

The ParaDocs medics worked to revive them, in some cases using a defibrillator, but some of them were trampled by people escaping the crush, she said. One unconscious woman had to be dragged to three different spots to avoid trampling by concertgoers. When the bodies outnumbered EMTs, fans jumped in and tried to perform CPR on victims, Ramirez said.

“There was no control,” she said.

At the Houston fire command center outside the festival, officials listened as more cardiac arrest cases were barked over the radio. More than 20 minutes after the chaos began to unfold, the decision was made at 9:52 p.m. to upgrade to a “Mass Casualty Incident, Level 1,” which brought more ambulances and larger ladder trucks, as well as more paramedics, to the event.

ParaDoc's medical tent – about 100 yards south of the main stage – became a chaotic triage point, looking more like a combat field hospital than a music festival, officials said. At one point, medics and firefighters were performing 11 CPRs at once – a feat that, under normal circumstances, would typically require more than 45 doctors, nurses and technicians. A few paramedics and at least one doctor were crying, overwhelmed by the scene.

At 9:55 p.m., the Houston Fire Department upgraded the scene to “Mass Casualty Incident, Level 2,” flooding the grounds with more paramedics, EMTs and firefighters. Injured concertgoers kept streaming in from the crowds near the stage. Doctors and medics darted from patient to patient. Nearly 30 ambulances waited to carry away the injured.

An hour later, all the wounded had been transported to hospitals, according to fire department records. It was nearly 11 p.m. – more than 18 hours after fire personnel first arrived on the scene.

“I’m very happy … and thankful we were able to respond,” Peña said, “even though it wasn’t part of the plan.”

Follow Jervis on Twitter: @MrRJervis.

This article originally appeared on USA TODAY: As Astroworld disaster unfolded, private medics and city fire lost touch