State, county and federal agencies are investigating the cause of a fire that broke out in an ambulance as it approached a hospital’s driveway, killing the 91-year-old patient inside and injuring a paramedic, officials said Thursday.

The ambulance was transporting the man, who was in serious condition, on what was described as a routine call from Kaneohe Bay when it burst into flames Wednesday evening outside Adventist Health Castle medical center in Kailua, Honolulu Emergency Services Director Jim Ireland said at a press conference.

Ireland said he has been working in the field for decades and has “never seen anything like this.”

The EMT who was driving immediately jumped out of the vehicle and tried to open the back doors to render aid, but the fire was too intense, Ireland said. The paramedic in the back was able to escape from the ambulance, but the patient couldn’t be saved, he added.

Adventist Health Castle.
The ambulance was transporting a 91-year-old man in serious condition from Kaneohe Bay to the Adventist Health Castle medical center in Kailua when it caught fire. Cory Lum/Civil Beat/2021

The 36-year-old paramedic was treated for injuries at the hospital, then transported to Straub Medical Center’s burn unit, where he remains in critical condition, according to a press release. The names of the patient who died and the injured paramedic were not released out of respect for privacy, Ireland said.

“I will say he’s a family man,” Ireland said about the paramedic. “He’s a 10-year veteran of our department and (a) well-respected paramedic and member of our team.”

Ireland declined to speculate on the cause of the fire, saying “everything is on the table,” including the possibility of problems with medical equipment and the vehicle, which he said was six years old.

The Honolulu Fire Department is leading the investigation that involves several agencies including the U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives, Hawaii’s Occupational Safety and Health Administration, the state Department of Labor and Industrial Relations and the Honolulu Police Department.

“We’re making all records available to these agencies because I want answers,” Ireland said. “We want answers because we want to know what happened, and we want to make sure this never happens again.”

It was unclear how long the investigation would take. The fire department said a fire investigator arrived at the scene at 9:23 p.m. Wednesday, just over an hour after the fire broke out.

Honolulu EMS Director Jim Ireland speaks with Mayor Blangiardi at a press conference held at Honolulu Hale on the ambulance that caught fire. Ireland said that the Honolulu Fire Department was taking the lead on the fire investigation.
Honolulu EMS Director Jim Ireland was emotional as he described the ambulance fire that killed a 91-year-old patient and critically injured a paramedic. Cory Lum/Civil Beat/2022

“I cannot give you a timeline for the investigative process as it varies from case to case,” HFD spokesperson Jaimie Kinard said in an email.

Ireland said that EMS will not change how it operates pending the completion of the investigation.

Ireland said older ambulances are either decommissioned, repurposed for the city’s Crisis Outreach Response and Engagement program, donated to the Department of Education or put up for city auctions. He didn’t comment on the condition of the ambulance that burned.

EMS responds to 100,000 calls a year in Honolulu and has 21 ambulances responding to emergency calls and 25 others on standby, including vehicles stationed in Waimanalo, Kailua, Kaneohe and Kahuku, Ireland said.

He expressed confidence the loss of the ambulance wouldn’t affect services, adding that the private medical transportation company American Medical Response was helping to cover the Windward side of Oahu.

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