Scotland EMS Faces a State Probe After a Wagram Death

North Carolina’s Office of Emergency Medical Services opened a review of Scotland County EMS after Stacy T. Britt died of a heart attack at his Wagram home on Jan. 25. Crews reached him in roughly 19 minutes. His niece, Sharon Cripe of Clover, S.C., says they walked in without a cardiac monitor, started CPR five minutes after he went into asystole, and then spent weeks keeping the family from his patient care report.

The state file was still open on Oct. 2. EMS Director Robert Sampson’s last day is Oct. 21. Five medic seats are empty, and the county that just voted 4-3 to keep running the service itself is now asking two hospital systems to prop it up.

Chest Pain at 8 p.m. in Wagram

Britt had lived in Wagram more than 40 years. The obituary for Stacy Timothy Britt gives his full name as Stacy “Smokey” Timothy Britt, born Aug. 13, 1967. He was 58. He left his wife of 37 years, Mary Ann Starner Britt.

About three days before he died, he called his doctor with acid reflux and was prescribed Nexium, Cripe said. That Sunday he stayed on the couch with cold-like symptoms. The family wondered about pneumonia. That night he said he was “feeling funny in his chest.” His wife called Cripe’s mother, her sister-in-law, who dialed 911 just after 8 p.m. so the wife could stay with him.

Cripe’s mother told dispatchers it could be a heart attack and started running across the yard to the house next door. At 8:05 p.m., EMS was rolling. Around 8:19 or 8:20 p.m. she called 911 again. He was having trouble breathing.

THE NIGHT OF JAN. 25

1. 8:05 p.m.: EMS is dispatched to Britt’s house in Wagram after a chest-pain call.
2. 8:24 p.m.: Crews arrive, about 19 minutes after they were sent. He is alert and sitting up when vitals are taken a few minutes later.
3. 8:40 p.m.: The first oxygen is recorded on his patient care report, 16 minutes after arrival.
4. 8:42 p.m.: He codes. The ECG shows asystole, a flatline with no electrical activity, Cripe said.
5. About 8:47 p.m.: CPR begins, five minutes after the flatline. Oxygen and IV therapy are listed in the minutes before that.
6. 9:31 p.m.: After more than 30 minutes of CPR and medications with no change, crews stop. He is gone.

A private autopsy a little over a week later confirmed a heart attack, Cripe said. Her fight is not with that finding. It is with the clock inside the house.

“When they entered the residence, they did not take in an oxygen machine, and they also didn’t go in with the cardiac monitor,” she said. North Carolina’s model cardiac monitor and a 12-lead ECG sit at the top of the chest-pain protocol, with a scene-time goal under 15 minutes. A DHHS spokesperson said local EMS systems set their own rules on dispatch, equipment, and care, so the state will not recite a single packing list for a chest-pain call.

Cripe’s question on CPR is simpler. “Why did it take 5 minutes to begin CPR if he had coded at 8:42?” she asked. The model cardiac-arrest protocol used across North Carolina tells crews to start continuous compressions and hold pulse checks to 10 seconds or less. Whether Scotland’s crew met its own signed protocols is what OEMS now has on its desk.

The State Opened a File It Usually Closes

The day after Britt died, Cripe said she spoke with Sampson. He told her he had read the report himself and that “everything was done by the book.” He said her aunt, as next of kin, could pick up the patient care report the next morning at the EMS building in Laurinburg.

When the aunt arrived, staff asked for a power of attorney. She got one and brought it back. Then she was told to wait for a call. Then she was told the county attorney had to be involved. The report finally reached the family in March, Cripe said, after weeks of back-and-forth.

On March 23 she sent letters to county administration and to OEMS, which sits inside the N.C. Department of Health and Human Services, with the report, a timeline, and a request for a review. The county never answered her, she said. County Manager April Snead later told a reporter in the spring that her inbox held no EMS complaints since January 2025 and that the county had no formal log of them.

Based on the information provided, it has been determined further review regarding the circumstances surrounding this allegation is warranted.

North Carolina Office of Emergency Medical Services, May 13 letter to Sharon Cripe

Cripe said an OEMS official told her there is usually a gray area, and that the office typically does not launch an investigation. He wanted her to know this case was the exception. The letter made her feel “relieved and hopeful,” she said. DHHS confirmed on Oct. 2 that the review was still open and that more detail would wait until it closed.

OEMS has opened 56 investigations this year on emergency responses, a pace DHHS called consistent with prior years. When the office is notified, staff look at what happened, what the local system already did, and whether state rules on EMS complaint cases or a statute may have been broken. Those rules also require local administrators and medical directors to notify OEMS of listed violations within 30 days of finding them.

An $80,000 Code Fight Emptied Wagram’s Bay

Scotland County covers roughly 320 square miles and more than 33,000 people. The central EMS base is in Laurinburg, the county seat. Wagram sits out on the rural edge, and that is where the clock is longest.

The county ran two ambulances until 2012, when it tried a third unit for Wagram, according to its own continuous-improvement analysis for fiscal 2025-2026. Crews were posted at the community center and expected to work 24-hour shifts. State building codes blocked overnight stays unless the county spent about $80,000 on fixes. After about six months, staff went back to Laurinburg. The parking area outside the Wagram Recreation Center on Marlboro Street no longer holds an emergency vehicle.

The same analysis says talks with the Wagram Fire Department could put a unit back in town. Cripe is not sure that would have changed her uncle’s night. “That’s possible, but I think it comes down to overall a leadership, training and an accountability issue, not directly tied to a unit needing to be in Wagram 24/7,” she said.

That is the split at the center of this case. The family is asking what the crew did in the room. The county’s own paperwork is asking why the nearest truck still lives in Laurinburg.

How Long Scotland EMS Takes to Reach Wagram

Call volume is not the same service it was when the Wagram experiment ended. The county’s request for proposals says Scotland EMS answers about 7,100 emergency incidents a year, about 20 calls a day, with volume up an average of 11.7 percent a year and fiscal 2024-2025 the busiest on record at about 7,900 incidents. Total response time rose from 16 minutes 17 seconds in fiscal 2019-2020 to 17 minutes 48 seconds in fiscal 2024-2025, the analysis said.

Turnout time, the gap between the alert and wheels rolling, ran from 2 minutes 41 seconds to 3 minutes 31 seconds. The analysis compared that with a national mark of one minute. Once the truck is moving, Wagram still sits at the back of the list.

RESPONSE TIMES ON THE RECORD

Commissioners were told only one area of the county met a 14-minute mark. That is the same number the county wrote into its bid package when it tried to hire a contractor. The RFP told any private operator it would have to hit a 14-minute goal on 90 percent of calls, measured from the ambulance’s location, with stations placed to cut travel time. Wagram’s 22 minutes 39 seconds is not close to that bar. Britt’s 19-minute run beat the Wagram average and still left him coding 18 minutes after crews walked in.

Sampson Walks Out With Five Seats Empty

The county website still describes a service founded in 1974, licensed by OEMS, with 21 full-time paramedics and three ambulances, plus three administrative staff, about 20 part-time clinicians, and one supervisor quick-response vehicle on 24-hour shifts. Patients go to Scotland Memorial Hospital or Moore Regional Hospital. Dr. Douglas Nederostek, the emergency-department medical director at Scotland Memorial, is also the EMS medical director. The headquarters at 1403 West Boulevard in Laurinburg opened in July 1987 and still houses EMS and emergency management under one roof.

That roster is not the roster Snead described on Oct. 2. She told commissioners the department had five EMT and paramedic vacancies across all shifts, and that the assistant director job was vacant too. The system is built to run three ambulances around the clock. Staffing gaps have left it short of that. Some employees have worked more than 24 hours straight, she said.

Sampson is leaving in the middle of it. He is listed as public safety director, a registered nurse and paramedic who also runs emergency-management planning, serves as a county medical examiner, and is the point of contact with the Office of the State Fire Marshal. His Sept. 21 letter said he would take “a new professional opportunity” and that the choice was not made lightly. The letter set his last day as Oct. 21.

Snead recommended putting the county fire marshal in as interim emergency-operations coordinator so the state requirement stays filled, and calling N.C. Emergency Management for backup in hurricane season. Finance would handle EMS purchasing. Human resources would handle personnel. “That is common anytime we have a department head that has resigned,” she said.

The 4-3 Vote That Kept EMS In-House

Snead has said the department costs about $4 million a year to run. In May, after a closed session, commissioners unanimously told staff to publish a request for proposals to hand the work to a private operator. Vice Chair Ed O’Neal made the motion. Commissioner Jeff Shelley seconded it. The same night, the board voted to ask state Sen. Danny Britt for a five-year extension of EMS-building money, after Snead said a short extension would not cover construction.

The RFP went out June 12 and closed July 24. Interviews were on the calendar in August. A board award was penciled in for Oct. 5. In September the board instead heard Atrium Health, Cape Fear Valley Health, MedEx Medical Transport, AMR, and AmeriPro. County staff scored experience, service, cost, staffing, and northern response. Matt Lewis, speaking for Atrium and the Scotland Health network, told the board his team would add a Wagram posting and use space with Scotland Health, including an existing clinic building, so the county would not have to build. Cody Chavis of Cape Fear Valley Health talked about matching local fees and paying regional wages to hold staff.

Then Commissioner Clarence McPhatter II moved to stop the outsourcing and keep working with the county department. Commissioner Tanya Edge seconded. The motion passed 4-3, with Edge, Darwin Williams, Tim Ivey, and McPhatter in favor and Bo Frizzell, Shelley, and O’Neal against. The bid process that was supposed to produce a contractor by Oct. 5 produced a split vote to stay public instead.

Hospitals Are Being Asked to Staff Wagram Again

Killing the bid did not fill the trucks. At a special meeting on Oct. 2, after nearly an hour in closed session, Snead said she had been directed to call Atrium Health and Cape Fear about a 90-day on-site management contract while the county hunts for a new director. Outside managers would report to her and to the medical director.

“We think we need to find a company that we can contract with temporarily to make sure the director’s position is filled while we are searching for a new EMS director,” she said.

WHAT THE COUNTY ASKED THE HOSPITALS TO PRICE

• Interim boss: A qualified manager on site for 90 days while the county searches for a new EMS director.
• Three trucks: Extra people so all three ambulances can run 24 hours a day.
• Wagram peak unit: Enough help to park at least a peak-time ambulance back in Wagram.

That last item is the 2012 idea in a shorter form. A full-time Wagram post died over an $80,000 code bill. The board that just refused to sell the department is now asking hospital systems to price a daytime truck for the same town. Snead said she would bring those numbers back. County officials later declined to discuss the privatization path, the Wagram post, or Cripe’s claims. “Given the nature of the story, I don’t think it would be appropriate to answer these questions at this time,” Snead said.

Cripe is not waiting on a vendor matrix. She said she will keep pushing until she sees a real focus on accountability and training, including for people who call 911 alone. “The difference in my uncle’s situation is he has family there with him, and he also has family that cares enough about him to make sure that his memory lives on,” she said. The state review is still open. Sampson’s last scheduled day is Oct. 21.

Disclaimer: This article is news reporting on a death, a pending state review, and county EMS operations. It is informational only and is not medical, legal, or emergency-care advice. It does not judge whether any paramedic, physician, or county official met the standard of care in Stacy T. Britt’s case, and it should not be used to make treatment, complaint, or litigation decisions. Readers with a medical emergency should call 911, and anyone considering a legal claim should consult a licensed North Carolina attorney. Figures, job titles, and the status of the OEMS file reflect the documents and statements cited here and may change when the investigation closes or when the county fills the director’s job.