DENVER (AP) - Poor communication and a chaotic scene after the Colorado theater shootings made it difficult for medical personnel to reach the most badly injured victims and get them to hospitals, according to a study of the response to the shooting released Wednesday.
But the report also concludes that the problems did not cause any loss of life, and more could have died if quick-thinking officers had not taken patients to hospitals in their squad cars.
"Aurora should be proud of its response to the largest civilian shooting in U.S. history," the report concludes. "The outcome could not have been better in terms of lives saved and a rapid arrest."
James has pleaded not guilty by reason of insanity to multiple counts of murder and attempted murder and is awaiting trial. The study of the response to the July 2012 shooting that killed 12 people was commissioned by the Denver suburb of Aurora amid questions about why emergency medical personnel didn't get into the theater until nearly 24 minutes after the attack.
"The important thing to remember is that we got the bad guy, and all victims with survivable injuries were saved," Aurora Mayor Steve Hogan said in a statement, adding that the city has already made changes to improve its tactics and training.
Sections of the 188-page report are redacted - including Holmes' name - and the release was delayed for months over questions about whether it would violate a gag order covering the criminal case against Holmes.
Steve Zansberg, president of the Colorado Freedom of Information Coalition, said the report should have been released sooner because it could help police in future shootings. Zansberg, an attorney who has represented The Associated Press and other news organizations in access cases, also called the redactions excessive.
The study by TriData, a consulting company that also reviewed the massacres at Columbine High School and Virginia Tech, paints a portrait of the confusion and disarray, with paramedics fighting to get to the wounded against hundreds of fleeing moviegoers and a congested parking lot.
Police and emergency medical technicians were "besieged" by wounded victims and people asking for help for others, but most officers only had basic first-aid training and had no medical supplies, the report says.
And without a unified command, individual police officers radioed for medical help, adding to a high volume of radio traffic that caused some requests to get lost or misunderstood, the report says. The police and fire departments also had trouble communicating directly, even though their radio systems had the ability to work together, the report says.
About 30 minutes into the incident, one fire official told another, "So far, it's running pretty smooth," even though ambulances could not reach some of the wounded.
Police and medical responders did not discuss the risk inside the theater, which could have delayed aid to victims, the report said. And firefighters did not know Holmes had been arrested, according to the study.
First-responders also lacked a coordinated effort to get patients to hospitals. Police took at least 27 people in their squad cars without waiting for a supervisor's approval, which hospital officials said likely saved lives. There weren't enough ambulances on scene early enough to transport all of the most critically injured patients.
Ten people were pronounced dead at the scene.
Doctors and first-responders said neither of the other two people who died could have recovered from their injuries. One was pronounced dead on arrival at a hospital emergency room, and the other was pronounced dead after a short resuscitation attempt at a hospital.
Later, hospitals and victim advocates did not have adequate information to quickly answer families' questions.
But despite its 80 recommendations, some of which Aurora authorities have already adopted, the review credits responders' efforts during the unprecedented bedlam. It says the first police unit arrived at the theater within two minutes of the first 911 call.
It also praises the handling of explosives found in Holmes' apartment. Authorities have said the explosives were rigged to be detonated by unsuspecting passers-by, but no one did.
"These optimum results were obtained thanks to many individual officers and firefighters making sound emergency decisions under great pressure," the study says.
- By Sadie Gurman, AP Writer
Associated Press writers Dan Elliott, Kristen Wyatt and Ivan Moreno contributed to this report.
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