How Does Muni Handle Medical Emergencies in Tunnels?

muni east portal by help
Photo by help

What should you (and SFMTA) do when there is a medical emergency on the train that’s in a tunnel? A rider sent in a story of witnessing a man who started to have a seizure on the train. But the train was stopped in the tunnel in what seemed like a perfect storm of a situation. From the eyewitness:

I am writing about an incident that occurred on a San Francisco Muni Metro train. I was a passenger on an Inbound L train a few minutes after 10am on Thursday, May 9th, 2013.

Around this time, a passenger in the front car experienced a medical emergency, fell out of his seat and landed face-first in the aisle. At the time, our train was stopped in the tunnel between Church station and Van Ness station. I rushed to the driver compartment to alert the driver we needed immediate medical assistance, while two other passengers knelt over the man on the floor. The man on the floor began to have a seizure.

I said to the train driver that a man had collapsed and that we needed medical help. She proceeded to radio in to muni dispatch on a radio channel she described as, “for emergencies, when lives are in danger.” She told me that since our train was in the tunnel it was under automatic control, and we couldn’t advance forward to the Van Ness station. As I stood by her compartment door, she approached the passengers attending to the man in distress. She advised them to move him onto his side for his safety.

Several minutes went by without any response from a dispatcher on the “emergency, when lives are in danger” radio channel. I checked my phone to see if I could even contact 911 myself, since the muni emergency radio channel seemed to be unmanned. However, at the position we were at in the tunnel, there was absolutely no cell service. Enough time passed that the driver even made an announcement to both cars of the train stating that a passenger was experiencing a medical emergency, that she had radioed for help and hadn’t gotten a response, and that she was doing all that she could.

When the driver finally received a response on the radio, she was advised to switch the train to manual control, and pull it forward to the Van Ness platform. We reached the Van Ness platform approximately 5-10 minutes after the passenger collapsed. However, we were not greeted by EMS or police. In fact, we weren’t met by any official personnel at all. About a minute after pulling into the station, a Muni custodian came over and asked if anyone had come to us yet. The driver even was appalled by the slow response time, and began trying to reach 911 on her cell phone.

At this point the passenger that had experienced the seizure was conscious, but still laying on the floor. He looked around and seemed a bit dazed. He pulled himself up off the floor and into the seat he had been in near the middle doors of the train.

A man carrying a walkie-talkie that seemed like a Muni supervisor came down the stairs to the platform and approached the driver looking for the passenger that had experienced the seizures. The supervisor was directed to the dazed man now sitting in his seat. He asked the passenger if he could walk. The passenger did not respond. The Muni supervisor asked the man if he could talk. The passenger did not respond. An older Asian male passenger asked the man if he spoke Chinese. The passenger did not respond, and seemed to be in a complete daze.

At this point, the Muni supervisor helped the passenger up out of his seat and off the train. Rather than taking him to a place to sit down, the passenger was made to stand on the platform at Van Ness. Then the Muni supervisor directed the driver to get the train moving. At this point, we still had not seen any emergency or medical personnel. The train then pulled away with a man that had just collapsed from seizures standing with a Muni supervisor on the Van Ness station platform. At this point, it was about 10:20 am.

I am really concerned with the procedures, response times and handling of this situation by the Muni staff. If this had been a life-threatening emergency like a heart attack, I have no doubt in my mind that the afflicted would have perished on the floor of the train. I am further concerned for my safety and the safety of other passengers in the event of a larger emergency like an earthquake or a criminal situation.

The driver seemed to have been doing everything she could do, but I’m surprised she was not met by paramedics when the train finally arrived at the station. Have you been or witnessed in a similar emergency?


  • Kim Kibler via Facebook

    muni doesn’t have a plan for anything. i’ve had to walk through the tunnels several times after trains were sounds like the driver did the best that she could. the dispatcher should have had an ambulance waiting, and EMT’s on the platform. sad, sad, sad. i hope he is ok.

  • Lani Rovzar via Facebook

    this is so scary, and totally unprofessional in handling. Will this get forwarded to a supervisor?

  • this is disgusting, the lack of emergency assistance for this man. why the F didn’t they call 911??

  • Rob Nagle

    I was on a J train that was delayed because of this incident, was probably one or two trains behind the L. When we finally did get through Van Ness I saw a man surrounded by medics, so looks like they eventually made it there.

  • Yikes, not very good response time. Public safety is yet another reason we need cell service in the tunnels.

  • Megan

    I was on that train and was similarly horrified with SFMTA’s handling of the situation. As soon as we reached the Van Ness station I rushed out of the train, planning to ask the station booth attendant to call 911. Except when I reached the booth there was no attendant! I dashed up the next escalator, and thankfully a police officer was right at the top of the escalator, and he radioed in the call for help.

    I called SFMTA and lodged a formal complaint with a very sympathetic individual, but I agree with my fellow eyewitness that this does not instill me with confidence in SFMTA’s ability to handle actual emergencies.

    On the tiny silver lining side, I was impressed with the behavior of our driver and my fellow passengers, who very calmly and capably did everything they could for a stranger in a terrible situation.

  • Brit

    MUNI is definitely a mess and I’ve had similar thoughts/worries about how they handle medical emergencies incredibly poorly. A few months ago, I was on an outbound N coming out of the Church St. tunnel near Safeway, when a girl collapsed onto the floor next to me, dead-eyed and unresponsive. It was rush hour and I was crammed in the center of the car so I asked if someone closer to the intercom could reach the driver and explain what happened — and one guy did — but the driver either didn’t understand the passenger, or didn’t care, because after the driver radioed back “ok” the train kept rolling along as if nothing had happened, up the hill and on its way to the Sunset tunnel.

    The driver’s other communications (like stop announcements, etc) to us were in broken English, and I have nothing against not being a native English speaker but…if he really and truly didn’t understand something basic like the passenger’s words “we have a medical emergency,” that’s just not safe, for reasons just like this. You need to be able to communicate with passengers about stuff related to their safety and the general safety of the train — it’s not enough to just be able to drive the train. I guess I’d rather chalk it up to a language barrier rather than actually not caring (which seems less likely) but…either way, the outcome was the same, and it’s obviously not ideal at the least and potentially deadly at the worst.

    Anyway, as that other passenger radioed the driver, I’d separately called 911 to ask for paramedics (as the girl was still out cold and had been for about ten seconds). What I also found odd was, the 911 operator asked me for all kinds of details (where we were, what line the train was, what direction, etc), and she told me “ok, we’ll communicate with the driver and get the train stopped.” However, it sounds like she was actually unable to do that in the end (since we kept moving! at least the train was headed towards two hospitals anyway, but still 🙂

    Maybe the 911 operator tried to communicate with the driver and he just didn’t understand, or maybe that line of communication between 911 and the driver actually didn’t exist. But again, either outcome isn’t ideal. At a basic level, I’d think there’d have to be some sort of private MUNI operator radio frequency that the 911 operator could access, to say “hi, would the driver of the N at Church please stop and wait for medics” (or to relay any other information in the event of, say, a city-wide emergency that’s quickly becoming apparent). Outside of the frequency mentioned in the article, I thought there was also an operator-only frequency where MUNI central command can communicate with all of the drivers? That’d obviously be useful in a number of situations — if that doesn’t exist, then I’m even more shocked.

    By the time we got to Duboce Park, the girl was regaining consciousness (though she’d been out cold for about a minute) and shrugged off numerous passengers’ offers to help (as well as medical attention, once I mentioned that paramedics were on the way). Since there was nothing else I could do at that point, I hopped off there before the train went into the tunnel since I had originally planned to get off at the Church stop. When I got back down the hill to the Church stop, some SF firefighters were standing there clearly waiting for our train, so I explained that I’d called 911 but that the train had moved on and that the girl was luckily ok, They’d been waiting there thinking a train with an unconscious passenger must still actually be on its way out of the tunnel, since there was no train standing there as they expected. As an aside and to their credit, they were really nice and their response time had been really fast, so that’s one good thing about SF’s response to stuff like this 🙂

    All in all, though, the entire situation was just really weird for something that I thought should be very simple. I lived in Chicago for five years before SF, and the one time I was on a train with a guy who collapsed from a heart attack, someone told the driver, we stopped at the next stop, the medics came to the stop and took him to an ambulance, and that was that. Unfortunately, medical emergencies on transit aren’t *that* uncommon, and other cities seem to have figured out how to get their response down to a science. Not sure why it’s so hard for MUNI…but issues like this and others make me look for alternatives to MUNI whenever possible. Which is not what a public transit system is supposed to make city residents want to do 🙂

  • We’ve asked the SFMTA spokespeople for the proper protocol in such an emergency (and what that protocol is). brb.

  • Gordon

    The problem is that the phone on muni buses and trains only connects to Central Control and it really takes a while sometimes to get a response from them. So there’s no way the driver can directly communicate with anybody else like a 911 operator. The closest thing they have, at least on the buses, is a silent alarm type of button that alerts the police.

  • Please call 311 or go to to report this, even if it is duplicate. Don’t just put it on MD (but thanks for posting this!).

    Train drivers can’t go out of ATCS without permission from Central Control, this is due to the train collision at West Portal a while back.

    Central Control only has a single channel (seriously), which probably delayed response. There is a capital project underway to address this.

    If you report this to 311, it will go to the transit director and he will take corrective action — I bet he probably already knows about this flub up.

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