Did the 'Emergency Medical System' Function Properly on the Day of the Itaewon Disaster... Ongoing Disputes

Discrepancies Between On-Site and Government Explanations on Transport Methods for Dead and Injured
Ministry of Health and Welfare: "Responded According to Manual but Response Inadequate Due to Large Scale"

During the national mourning period following the Itaewon large-scale crush disaster, visitors continue to pay their respects at the memorial space set up near Itaewon Station in Yongsan-gu, Seoul, on the 2nd. Photo by Jinhyung Kang aymsdream@

[Asia Economy Reporter Jo In-kyung] There have been ongoing criticisms that the disaster emergency medical system, including the dispatch of the Disaster Medical Assistance Team (DMAT), did not function properly immediately after the Itaewon tragedy. The government denied that there were major problems with patient transport and securing hospital beds at the time, but stated that it would work on improving the manuals.

Disaster Medical Team Arrived at the Scene Only After One Hour of the Incident

At the National Assembly Health and Welfare Committee meeting held on the 7th, lawmakers from both ruling and opposition parties criticized the Ministry of Health and Welfare for the delayed initial response and the absence of an on-site control tower during the Itaewon tragedy that occurred on the 29th of last month.

Lee Jong-sung, a member of the People Power Party, said, "A report of injured persons was received by 119 at 10:15, but 119 contacted the Central Emergency Medical Situation Room only at 10:38, 23 minutes later, and the situation room decided to dispatch medical personnel about 10 minutes after that. The DMAT arrived at the scene at 11:20. The overall control tower did not function properly, which is the problem."

Kang Sun-woo of the Democratic Party of Korea said, "It is questionable whether communication between disaster control towers was established," and pointed out, "The Central Emergency Medical Situation Room requested dispatch to only four teams, including the Seoul National University Hospital team, before midnight. This means accurate information was not conveyed."

Kim Won-i, also from the same party, pointed out, "According to the patient transport manual in disaster situations, patients should be moved in order of emergency, urgent, non-urgent, and deceased to the nearest location, but at the Itaewon tragedy site, 20 to 30 patients classified as severe cases such as unconsciousness, respiratory distress, fainting, and paralysis were mostly transported to places 6 to 27 km away," adding, "52 patients were transported to Soonchunhyang University Seoul Hospital, the closest hospital to the disaster site, and most of them were near death."

Kim Min-seok of the Democratic Party of Korea also said, "At the disaster site, the head of the public health center commanded the scene and decided to transport casualties to the emergency room. In fact, some patients were sent to places without emergency patient capacity and had to wait before being admitted."

Nam In-soon of the Democratic Party of Korea emphasized the lack of intensive care unit (ICU) beds, stating, "Between 11:00 and 11:15 after the disaster, four ICU beds were secured. Even after nearly two hours, resources to handle 20 critical patients were not properly secured."

[Image source=Yonhap News]

Confusion in Patient Transport... Over 70 Deceased Concentrated in One Hospital

At the time of the Itaewon tragedy, the number of ICU beds available in nearby general hospitals was very limited, and there was severe confusion as too many deceased and patients were concentrated at the closest hospital at once.

According to data submitted by the Ministry of Health and Welfare to Rep. Shin Hyun-young of the Democratic Party of Korea, at 11:11 p.m. on the day, the 'capacity of hospitals within a 10 km radius of the accident site to accommodate casualties' was only six ICU beds in total: 1 at the National Medical Center, 1 at the National Medical Center Trauma Center, 2 at Korea University Anam Hospital, 1 at Kangbuk Samsung Hospital, and 1 at Hallym University Gangnam Sacred Heart Hospital.

Later, at 11:18 p.m., the radius was expanded to 21 km to check casualty accommodation capacity, adding about one bed each at Ewha Womans University Mokdong Hospital and Konkuk University Hospital. After the disaster hotline for medical institutions was activated, by 1:43 a.m. on the 30th, the number of available ICU beds increased to 22, but this was still insufficient.

Furthermore, an excessive number of casualties, especially deceased, were transported to Soonchunhyang University Seoul Hospital, the closest hospital to the accident site, to the extent that the hospital requested a halt to further transports.

Records of the response activities of the head of Yongsan-gu Public Health Center at the scene noted at 1:30 a.m., "Recognized multiple deceased transported to Soonchunhyang University Hospital," "Dispatched two members of Yongsan-gu rapid response team to Soonchunhyang University Hospital," and at 2:10 a.m., "Received request from Soonchunhyang University Hospital to stop transporting deceased," and "Searched for temporary morgue location."

According to the medical response status records, at 1:37 a.m. on the 30th, the Central Emergency Medical Situation Team issued a directive stating, "Do not transport minor injuries and deceased until critical patients are transported." The number of deceased temporarily waiting in the emergency room of Soonchunhyang University Seoul Hospital and later moved to a temporary morgue after 3:10 a.m. on the 30th was 72.

Minister of Health and Welfare Cho Kyu-hong is responding to lawmakers' questions at the Health and Welfare Committee plenary meeting held at the National Assembly in Yeouido, Seoul, on the 7th. [Image source=Yonhap News]

Ministry of Health and Welfare’s Defense: "No Disruption to Emergency Medical Care"

Regarding these criticisms, Lim In-taek, Director of Health and Medical Policy at the Ministry of Health and Welfare, said at a briefing of the Central Disaster and Safety Countermeasures Headquarters on the day, "We judge that there was no disruption to emergency medical care at Soonchunhyang University Seoul Hospital due to the transport of deceased," explaining, "At the time, the entire medical staff of Soonchunhyang University Seoul Hospital was on standby, and critically injured patients had already been transported there and were receiving appropriate treatment before the deceased were transported."

Regarding the criticism that critically ill patients were not transported to the nearest Soonchunhyang University Seoul Hospital but to more distant hospitals, he emphasized, "Usually, hospital emergency rooms have about one resuscitation room. When transporting critically ill patients, the hospital’s capacity, the availability of multiple medical personnel to treat critically ill patients simultaneously, and equipment status must be comprehensively considered," adding, "There are many factors to consider beyond prioritizing nearby hospitals." The Ministry of Health and Welfare also stated in explanatory materials that "critically ill patients were mostly dispersed and transported in groups of 1 to 2 per hospital, up to a maximum of 4 to 5."

Regarding the criticism that DMAT dispatch was delayed, Director Lim explained, "Dispatch was made sequentially according to the on-site situation assessment." However, the only team that arrived at the scene before midnight was the Seoul National University Hospital team among the 15 DMAT teams from the Seoul and Gyeonggi areas.

The Ministry of Health and Welfare stated that it would thoroughly inspect whether the DMAT system functioned properly during the response to this incident and improve and supplement any deficiencies.

Minister Cho Kyu-hong of the Ministry of Health and Welfare said at the National Assembly Health and Welfare Committee, "The initial response operated according to the disaster emergency medical emergency manual," but added, "The scale of the accident was too large, so there were shortcomings. I think 119, police, the emergency medical situation room, and DMAT should share information smoothly and request medical personnel dispatch. Smooth communication between the on-site emergency medical post and DMAT, which commanded the scene, is also necessary." He continued, "Institutionally, we need to consider expanding personnel and equipment and introduce a system where DMAT automatically dispatches in disaster situations."

This content was produced with the assistance of AI translation services.