The Inspectorate-General for Health Activities (IGAS) report concerning a delay in emergency response by the Urgent Patient Guidance Center (CODU) of the National Institute of Medical Emergency (INEM, I.P.) following the death of a patient in Pombal in 2024 due to a myocardial infarction highlights a critical issue. When calls for help are disconnected and new ones are made, additional incidents are created, which disrupts case handling.
IGAS linked the death of the Pombal patient on November 4, 2024, to the delayed emergency response. It noted that during periods of high workload and staff shortages—as was the case during two simultaneous strikes—calls might go unanswered beyond the 15-minute threshold.
The victim’s wife reported to media that INEM returned her call 24 hours later, explaining that the initial plea for help was not promptly addressed.
Although a dispatcher is supposed to be assigned nationally to monitor and return missed calls, this did not happen in Pombal due to workload and resource constraints.
IGAS advises that health literacy efforts must be amplified in media channels. It’s the role of INEM to define, organize, coordinate, participate, and assess activities, ensuring that Mainland Portugal’s Integrated Medical Emergency System (SIEM) provides prompt and adequate health care to victims of accidents or sudden illness.
Relating to the response time in this case, it took an hour and 50 minutes from the first contact with 112 until the Medical Emergency Vehicle (VMER) arrived, a situation demanding serious reflection and correction by INEM.
INEM was found not to have fully complied with its obligations, particularly regarding the emergency call handling.
It is perplexing that multiple contact attempts failed, indicating an issue that must be internally resolved to prevent harm to INEM’s reputation and honor.
The inspection data revealed the first emergency call made at 13:12 on November 4, 2024, took over 10 minutes to be answered by 112, which instructed the patient to await emergency services.
The call was only transferred to CODU Coimbra at 13:49—over 25 minutes after being answered by 112—and the first ambulance, from the Pombal Volunteer Firefighters-Albergaria dos Doze Section, was activated at 14:04.
The differentiated resource—a Life Support Ambulance from Pombal—was only activated at 14:33, with the first assessment by the ambulance team at 14:48, one hour and 26 minutes after the first call was answered.
Additionally, the Leiria VMER, activated at 14:25, only reached the victim at 15:02, one hour and 50 minutes post-initial contact with 112.
IGAS assigned responsibility to two health professionals—a Pre-Hospital Emergency Technician (TEPH) and a doctor (service provider). INEM announced a disciplinary process against the TEPH.
