Aurora Bridge Bus Crash Review of a Mass Casualty Event Pre-hospital and Hospital Response, Lessons Learned

Abstract

At 11:11 a.m. on September 24, 2015 an amphibious ‘DUKW’ tourist vehicle with a driver and 36 passengers lost control due to a catastrophic left front axle mechanical failure. The vehicle crossed the center line into oncoming traffic and struck a charter bus transporting 50 members of an international college group including students and staff. This event occurred on an urban bridge with heavy traffic, causing complete closure of the roadway in both directions. Based on Emergency Medical Service (EMS) calls, a Mass Casualty Incident (MCI) response was activated at the levels of EMS, the inter-hospital EMS coordinating system: Disaster Medical Control Center (DMCC), the regional inter-hospital coordination group Northwest Healthcare Response Network (NWHRN) and the City of Seattle. Forty-nine patients were transported via the EMS system to 8 area hospitals. There were 4 deaths at the scene and one victim later died of his injuries. The incident had many unique features that affected the incident response including: location on a bridge with limited access points, involvement of an amphibious DUKW vehicle, involvement of two commercial vehicles mandating investigation of the National Traffic Safety Board, the incomplete manifest of the tourist vehicle, large numbers of foreign nationals, and the timing of the event (mid-day in the middle of the week) allowing robust involvement of the all parts the health care system. This mass casualty event demonstrates the challenges to a complex mass casualty response and how many aspects of our disaster response system met those challenges.