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At This Hour

San Bernardino Officials Press Conference. Aired 11-11:30a ET

Aired December 07, 2015 - 11:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

[11:00:00] DR. MICHAEL NEEKI, ARROWHEAD REGIONAL MEDICAL CENTER: Being a physician, they don't want me to get hurt, so I'm -- they're willing to take bullets for me and I'm willing to take bullets for them. This is the commitment that I have to this community. It's been a privilege since I came here from Ohio in 2006 to be part of the Arrowhead Regional Medical Center and this community. We have had tremendous support from the Board of Supervisor, especially emotionally. I'm very connected to Supervisor Gonzalez. We have tried so many different things to make this community better. And I'm there for this event. We stayed there till 6:30. After the debriefing, I came back to the hospital where I had to do due diligence of my responsibilities. Then I communicated that my chief, Dr. Borger, to make sure everything went well before I head home. And that said, I'm honored and privileged to be here as a physician to work in this county. I don't look at it as work. We are committed to this service.

I'll stand back. If there's any question later on, I'll let my partner, Dr. Singh, comment about his experience.

Thank you.

UNIDENTIFIED REPORTER: Can you tell us where you emigrated from?

JAMES RAMOS, CHAIRMAN, SAN BERNARDINO BOARD OF SUPERVISORS: We'll take questions from the end. I apologize.

DR. SAKONA SINGH, ARROWHEAD REGIONAL MEDICAL CENTER: Good morning. My name is Sakona Singh. I work at Arrowhead Regional Medical Center, been there for about seven years. As Dr. Neeki explained, I was called in to assist with the care of these victims. My thoughts and prayers and deepest condolences to the families of the victims.

It started out as a regular day. I was on campus doing administrative work when received call of this incident, as Dr. Neeki mentioned his efforts in the field, as well as Dr. Ewing, Dr. GnanaDev. Trauma is a team endeavor. And there are a multitude of departments involved besides emergency medicine, trauma, nursing, all to radiology techs. This is a huge mobilization of resources. That, in fact, was the biggest challenge of the day. We initially received reports we would be getting anywhere from 12 to 20 gunshot victims. So, we had to prepare for those types of numbers. That was the challenge. We are at Arrowhead Regional a very busy trauma center and well equipped to deal with multiple patients at once. But, obviously, these were extreme numbers that even for our facility was challenging. Everything started roughly at 11:00 or so. We received six patients in total. Again, I can't speak enough on the efforts of the entire team to take care of those six victims. Happy to report those six seem to be doing well, as Dr. GnanaDev mentioned earlier. Again, you know, we're very, very sad here at Arrowhead about those events. At the same time we would like to extend that we're here and we're ready to serve our community in whatever form or fashion that is need. And we'll continue to do so, despite these tragic events.

Thank you very much.

RAMOS: Thank you.

Our next speakers are the very reason that we're here today, representing the departments of those that have been affected drastically by this horrific event. We have the director of public health, Trudy Raymundo; and deputy director of public health, Corwin Porter, as they come up.

[11:04:53] TRUDY RAYMUNDO, DIRECTOR, SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH: Thank you.

Good morning. The outpouring of love and support has been incredible. I want to thank all of our law enforcement partners that so bravely came in and guided us to safety and continue to shield us from any further harm. I want to thank all of the first responders and all of the EMS personnel that were there, treating our injured and treating our wounded. And I want to thank the incredible outpouring of support nationally and internationally. We have received your words of support, your offers of condolence and your offers of help. And we are grateful for them.

Today, I want to ask the community to mourn with us, to come with us and mourn with us the loss of our colleagues, of our friends, of our families and our loved ones. I ask that you come together and hold each other strong because it is the strength that will help us heal. And I want you to every day be grateful for those of us that were spared and those that are still different today.

To my amazing family, I want you to know, we are strong. We are a family. We held each other and we protected each other through this horrific event. And we will continue to hold each other and protect each other through what will be unimaginable weeks and months ahead. We will get through this day by day, minute by minute, if we need to. But we will heal, we will rebuild and we will be stronger when we get to that other side.

Thank you.

CORWIN PORTER, ASSISTANT DIRECTOR, SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH: Good morning. My name is Corwin Porter. I'm assistant director for Department of Public Health. As of two months ago, was the director of Environmental Health Services.

I, too, want to extend my deepest appreciation for the law enforcement that arrived so quickly to guide our staff out of harm's way and to protect them, also to the speed of the other responders and getting to the scene to provide treatment to those who have been injured and to help our staff on the road to recovery from their wounds. I had the opportunity to visit several of our staff in the local hospitals. I was encouraged by their optimism and their dedication to their profession.

We have a tremendous group of employees, extremely talented. They are behind the scenes protecting each one of us from the ravages of a disease and injury and very rarely are ever recognized for that effort. They were there to receive training and to improve their skill sets to better protect the public that they serve. They are extremely dedicated and they love their profession. My heart goes out to my staff who have suffered such tremendous loss. And their families, their friends, their brothers and sisters, that have gathered with us to mourn. It has been a very difficult time. We appreciate the outpouring of love from the community and for our staff who have come together to support each other through this trying time. They are showing great strength as they support each other through this difficult time period. And as Trudy said, they are strong. As an organization we are strong. We will bond together and we will make it through this very, very difficult time. Thank you.

Thank you.

[11:10:01] RAMOS: Thank you.

At this time, we would take questions that pertain to the role of the County Board of Supervisors and the speakers that were here in front of you.

(INAUDIBLE)

UNIDENTIFIED REPORTER: What was it like in the emergency room --

RAMOS: Dr. GnanaDev?

UNIDENTIFIED REPORTER: (INAUDIBLE)

DR. DEV GNANADEV, ARROWHEAD REGIONAL MEDICAL CENTER: Any time in a trauma center you have, once a disaster is activated, usually you -- you go on and alert multiple teams. So we had about 40 to 50 doctors with multiple trauma teams ready to go into action. There were, like you heard, we heard that initially 12, then they said 25. And then we heard rumors it could be 100. We heard rumors there could be a second site or third site. So, you need to be prepared for all of that. And our goal was to take care of them, stabilize them and really send them where they belong appropriately. That is, in our -- six went to operating room, two to C.T. and ICU. You want those trauma beds ready when the next victims come.

SINGH: Like I mentioned before, I think mobilization of resources was the toughest challenge, as well as keeping clear lines of communication. To answer your question, any time a trauma activation goes off, we generally mobilize all our efforts, services involved, E.R., anesthesia and trauma surgery. Those doctors come and report. For this particular day, because we had reports of so many victims, we had to extend those things outside of our trauma base. Our department is made out of multiple pods. And you have to appreciate the incredible work that took place to mobilize those resources. So, existing patients in those beds needed to be moved upstairs. Room had to be made. You had to allocate for all the resources you have, ventilators, blood products, I.V. fluids to make sure had you enough on hand to take care of whatever came through those doors. That was the biggest challenge. As we were receiving multiple reports of different numbers, that was the fear. You know, that we would run out of supplies or resources. But thankfully, we didn't.

UNIDENTIFIED REPORTER: Dr. Singh, I imagine a situation like this, everybody jumps into action and it's go-mode. Watching you and hearing you speak up here today, it seems like there is something different about this. You seem almost emotional talking about what happened in the E.R. that day. Can you speak to whether there was a difference between this and other trauma incidents you've worked on?

SINGH: Sure. I think part of it is usually you're working on a shift. And so when you're, quote/unquote, "off duty" and you get a call, that's unexpected. To see something of this magnitude is unexpected. To have it occur in our county is unexpected. You can't quantify loss of life, right, whether it be a terrorism attack or, you know, a car accident or something like that. But, yeah, it's -- it sort of tests your faith in humanity in some respects to hear that this happened, but if you were there, if you were on site, if you sort of looked into the eyes of the people who were working, they put us out of emotions to take care of these six people. That's something special. That should restore some faith in humanity.

RAMOS: Any questions?

UNIDENTIFIED REPORTER: At your hospital, in your emergency room, you're not unfamiliar with treating gunshot wounds. Was there a difference in these wounds, in these people coming in?

GNANADEV: Other than the number of people that came in at same time, a number of people expected, as far as the injuries, they're not much different. We get even worse injuries with routine trauma calls. So, that aspect was not but just the number. We had multiple disasters before, a train accident, bus rollover, but there were blunt trauma with them. So many gunshot wounds coming at same time is different rather than gunshot wounds themselves.

UNIDENTIFIED REPORTER: And the circumstances of these gunshot wounds made it different?

[11:15:09] GNANADEV: It does, in your mind. These were the innocent people. Gathered for -- just to spend -- look at the event. What hard work they did. So, it does affect. Remember, physicians are human beings, too. They're not machines who take care of things. But when it comes to staying care of, you just follow the standard protocols, which is triage, that is you triage the right people to the right place. You follow the A, B, Cs. So, you do the standard stuff, which you have to do. That's the only way you can save as many trauma victims as you can.

RAMOS: Any other questions over here? Any over here first? I know you -- someone had one over here first. UNIDENTIFIED REPORTER: I was curious where the doctor emigrated from.

NEEKI: I'm emigrated from -- a lot of curiosity came out of this thing. I basically was a political opponent to the Iranian regime when they took over in 1979, so I had a run-in with them. Served that country by going to war for two years, where I grew up, the Iran/Iraq war, so mentally and tactically a little more ready than the other physician that you see here, seeing mass casualty and war wound. But then all those -- I try to take all those as a positive experience in my life and move forward. And I still do.

UNIDENTIFIED REPORTER: (INAUDIBLE QUESTION)

NEEKI: Pardon me?

UNIDENTIFIED REPORTER: I don't know if you had a chance to see the president's speech. Your thoughts on that.

NEEKI: It's not really a time for that. I portray my personal -- you know, my opinions.

RAMOS: Any other questions over here?

UNIDENTIFIED REPORTER: I have two questions. First of all, can you tell us how many of the patients or victims who were admitted to the hospital have gone home? You mentioned many had gone home. Secondly, if I could, to the supervisors, are there any other steps -- you mentioned tightened security at county facilities. Are there any other steps that are being taken that would delay service, at least temporarily?

GNANADEV: Out of six victims who came, one is still in the hospital. Some went home, one got transferred elsewhere.

RAMOS: On the San Bernardino County Board of Supervisors, as far as the security features taking place, we are having additional security features today. We are looking at plans in the future. The Board of Supervisors, we actually -- as soon as this happened at 11:00, we had an emergency board meeting at 1:00. We've been in that emergency meeting mode. Certain things have been approved. We did approve and give direction to our CEO, Greg Devaraux, who's here. The Board of Supervisors gave direction to move forward and look at already the security features we were moving forward in to expedite some of those and look at additional features moving forward. The Board of Supervisors gave clear direction to expedite that. And that's what the CEO's office is working on. So, the security features is first and foremost, in our minds, as the Board of Supervisors because our employees are important to us and their safety. Those are some of the things we're doing.

UNIDENTIFIED REPORTER: Just to clarify. You're considering implementing additional security --

(CROSSTALK)

RAMOS: Additional security measures, additional security measures are taking place today as county buildings are starting to open up. We're looking at additional features for permanency in areas that are out there also. Again, the Board of Supervisors was quick to react. We formed an emergency meeting. We still stay in that emergency meeting, approving things and giving direction to our CEO to move forward and to implement these procedures.

UNIDENTIFIED REPORTER: Can you specify some of the procedures?

RAMOS: Some of the procedures that we're looking at, we've increased from level 1 to level 3 security around the area. We have worked with the sheriff's department to identify some of those areas. We're continuing to look at and hear from the employees what it is they would like to see that would make them feel safe in their environment. These are things that we're looking at. Certainly, this has really hit us hard. And time is of the essence. We moved forward in short term. We're looking at long-term security features that are there.

UNIDENTIFIED REPORTER: Going from level 1 to level 3 means increased staffing? What does that mean, level 1 to level 3.

RAMOS: Ray?

[11:20:25] UNIDENTIFIED MALE: The chairman is referring to the level of training of the hired security guards. Level 1 are observe-and- report guards. They are not armed. Level 3 are actually armed with side arms and are permanented to detain people, are permanented to engage in any kind of threat.

UNIDENTIFIED REPORTER: So the difference today is that the security guards in place will actually be armed? And will there be a greater number of them or --

(CROSSTALK)

UNIDENTIFIED MALE: There will be a greater number of them. Many of them will be armed. In addition to that, the sheriff's department has increased patrol at many of our facilities and does have additional deputies available to us.

UNIDENTIFIED REPORTER: And that is a temporary measure?

UNIDENTIFIED MALE: Well, some of them are permanent measures. Some of them are temporary for this week as we assess what level we need. I do want to be clear that we continually look at security within our buildings. We had already redoubled efforts to look at physical security and the layout of our buildings and whether there were measures that we could take. In several facilities we had already begun additional physical measures that would impede someone from coming into a facility.

UNIDENTIFIED REPORTER: Will there be structural changes?

UNIDENTIFIED MALE: Yes, there will be changes in some structures. Understand, we are a very large property owner. And we are a very large renter. We have over 10 million square feet of office space within the county. I know some of you understand this, but we are an extremely large county. There are over 3200 counties in the United States. Geographically, we are the largest. We have more geographic area than nine states from a population standpoint out of that 3200 counties. We are the 12th largest. We have more population than 14 states. So, we have hundreds of facilities. We'll be assessing all of them to see if we should make or need to make physical changes.

RAMOS: I think it's also important to note that this horrific event did not take place at a county building, but the importance of security for our employees is something this board takes seriously. And we did give the authorization for the CEO to move forward and to stream line that process.

Any other questions?

UNIDENTIFIED REPORTER: I'm wondering how the employees are doing. (INAUDIBLE). Can you speak to what they're doing during this healing time? Are they leaning on each other or --

RAMOS: I think one thing we always have to remember is that the EHS family has been drastically affected by this. So asking for the media's respect and respecting the families as they go through these trying times. We have EHS family members that are going through the tragic things of family. We also have EHS members that are going forward, trying to cope with life, to move forward. And I know that there's been some media outreach to some of the homes of our employees. We're asking again for the media to respect the families during these times. We've come here today and called this press conference to answer the questions in hope that you would hear that message because it's -- it's hard for us as a family, as a county, to honor those families because they're going through things that we've never seen before. I'm asking for the respect of those families, from the media. We'll be here to answer those questions. If things come up, call the county Board of Supervisor's offices and we'll try to answer some of those questions for you. But at this time, we're calling on everybody to continue your prayers for the families that have been affected by this. Continue your prayers as a unity. We've come together in a unified voice at the city, county, state, federal levels, all for one common cause, and that's to show our employees that we care for them. So, we need to care for them more and more these coming up weeks because it's them why we're assembled here today. It's not because of the political people that are here. It's because of them and what they went through, Trudy Raymundo, Mr. Porter, they're employees. That should be first and foremost in all of our minds. We should continue to support them through these atrocities.

At this time, we'll conclude this event.

[11:25:15] UNIDENTIFIED REPORTER: The Environmental Health Division -- (INAUDIBLE).

RAMOS: The Environmental Health Services, we've actually put them up for another week and re-evaluating that.

UNIDENTIFIED REPORTER: Is that the only (INAUDIBLE)?

RAMOS: Yes.

One more question.

UNIDENTIFIED REPORTER: (INAUDIBLE QUESTION)

RAMOS: Trudy and Corwin, you can answer.

RAYMUNDO: Yes, we were at the event. We both arrived about an hour before it happened. When we arrived, they were upbeat, they were happy, they were learning from each other, which is indicative of what this group has always been. I want to make it clear. This is a very tight, close-knit group. They have always supported each other. They have been -- they are beyond coworkers. They are friends and they are family. And they are tight and we are holding onto each other right now because that strength is what is going to help us get through.

CORWIN: You're all holding on to get together through this, including our staff. Yes, we are supporting one another. We are strengthening one another and we will get through this.

UNIDENTIFIED REPORTER: What do you remember about Mr. Farook? Did you have any interaction with him?

CORWIN: I would prefer not to answer that question at this venue.

UNIDENTIFIED REPORTER: Can you speak to what happened? There have been reports of some kind of argument that he may have had, you know, prior to leaving. Can you give us any insight?

UNIDENTIFIED MALE: I don't think they have any comment about that. Thank you.

RAMOS: Any other questions?

UNIDENTIFIED MALE: Right here. Right here.

RAMOS: Where at?

UNIDENTIFIED REPORTER: Right here. What's the county doing for grief counseling for the other county employees? There's been no discussion of that. But that's very important. Can you discuss some grief counseling available for all the county employees?

RAMOS: The County Board of Supervisors has moved forward and established a crisis hot line. We have pushed that out to our employees in forms of written communication and social media, because the county family has been affected by this. So, we're offering those services that are there. We have a crisis hot line for them. And certainly, that's open to not only the employees of San Bernardino County, but also to their immediate family.

UNIDENTIFIED MALE: I would also like to say we do have teams that are reaching out to all of the families of the deceased, the injured and the people in the room. So, we do have a significant number of crisis teams, psychologists, social workers, that are reaching out to all of those employees affected. RAMOS: Any other questions? Right here.

UNIDENTIFIED REPORTER: Dr. Neeki, if he can talk more about what he did on the scene.

NEEKI: I just want to be discreet and have the respect for the victims and their families. Really, I didn't have any direct care in the people who are perished in this terrible incident. By the time I got there, the crew that were triaged at the end of it, and they were in ambulances. The program we are pushing here, the tactical medicine is actually -- it's a support from various groups, including Scott Smith, who is not here. We do multiple triage scenarios in the hospital to get ourselves ready for this particular. And this incident actually brought up some of the shortcomings we need to improve on. I had my bag, my advanced bag of medical care if there were any other necessary things I need. By the time I got there, as I said, the active shooter was converting to hostage rescue, suspecting that one of the assailants would be in the adjacent building. So we spent another two hours with my own SWAT team going room to room to try to make sure that people are safe. My services needed in there. We were also at the scene of the assailants being subdued but there was nothing for us to do because of the danger.

UNIDENTIFIED REPORTER: How many doctors were with your SWAT team?

NEEKI: This is one in 1,000 because of the regulations and the time required, lack of budget. Most of the equipment comes from my own funding. Most of my training comes from my own funding.