On July 4 last year, Detroit paramedic and Emergency Medical Services assistant supervisor Al Saade was in the office when he received an urgent call to attend a multi-vehicle crash.
He arrived at a chaotic scene. Three of the people involved in the crash had injuries. Saade's EMS supervisor, Captain Robert Calandro, also just arrived, assigned him to do patient triage.
There was also a Fire Department Battalion Chief at the scene. Saade said the chief began issuing contradictory orders about how to do the triage. That shouldn't happen. State law mandates that the highest licensed medical authority responding to a call for emergency medical care has responsibility for directing the care — in this case, his EMS supervisor, Captain Calondro, a paramedic.
Saade ignored orders from the battalion chief and continued triage, even as the chief tried, without success, to pull Saade from his emergency medical response work to argue with him about chain of command.
Saade faced disciplinary action for insubordination for refusing to follow the battalion chief’s orders. Although the disciplinary action was eventually dismissed, the paramedic says the incident shows how wrong things can go when Fire Department officials try to take charge of emergency medical care.
"The chief called for EMS supervision because he needed our expertise," Saade said. "But once we arrived, that expertise was disregarded. What happens on the next complicated medical scene when EMS supervision is not there to intervene?"
Union says Fire Department has been mishandling medical emergencies for years
In 2021, Detroit's EMS division was consolidated with the Fire division.
Saade said last year’s July 4 incident was just one of many similar ones during the years since the consolidation, and that Fire Department supervisors had been interfering in non-fire medical emergency calls on a nearly daily basis.
Tensions came to a head at the start of last year when the Fire Department adopted a new standard operating procedure (SOP) that put battalion chiefs in charge of overseeing the overall incident command and scene management. It also required EMS supervisors to report to and coordinate all actions through the incident commander.
Representatives of the city’s EMS staff brought the issue to arbitration. In March, an arbitrator agreed with the EMS division's position on the SOP, saying the union had “articulated the disorder that has arisen in the field and the detrimental effects on patient care.”
"When you look at what this Department actually does every day, sometimes you have to be willing to say the uncomfortable part out loud: This is really an EMS department that puts out the occasional fire."
Al Saade, president, Emergency Medical Service Officers Association, Detroit
The order has made no difference, according to EMS representatives. They claim that the Fire Department is frequently declining to send available paramedics to "Code 1" calls, involving the most serious medical situations.
"There's literally no accountability,” Saade said. “It just gets worse and worse. It's really chaotic. And at the end of the day, it's the citizens of the city that end up paying heavily for it."
EMS workers have filed dozens of grievances, including some that followed the arbitrator’s order, to allow medically trained staff to take charge in medical emergencies.
Grievances filed by the Detroit EMS union include these incidents:
- In July 2023, a Fire Department supervisor failed to transmit an EMS paramedic supervisor's command that firefighters begin CPR on a drowning victim they'd pulled from the Detroit River. The victim later died.
- In January 2026, firefighters were given the wrong location for a medical emergency. They immediately broke down the door of the uninvolved citizen's house rather than waiting for an EMS supervisor to arrive, confirm the address, and direct them in how to respond.
- Firefighters delayed responding to two separate Code 1 (cardiac arrest) emergencies in July 2026 and August 2026.
Police Officers Association of Michigan becomes involved in the dispute
James Tignanelli is president of the Police Officers Association of Michigan. Normally, his association represents sheriff, police, and fire department unions. But he said the Detroit EMS union was left essentially with no representation due to the conflict with the Detroit Fire Department, so in January, 2025, his group agreed to take them on as members.
"I have been in this business for more than 30 years," Tignanelli said, and noted that even though they’re technically part of the same team, tensions between the Detroit Fire Department and its EMS Division have run especially high. "I've had more labor disputes involving this union than any group than I've ever had in my career. We get so many grievances — dozens — over the proper response issue in Detroit that we have to pick and choose which ones to arbitrate."
Tignanelli said the dispute should not be seen as a turf battle, but as a question of whether Detroiters are getting the emergency response they should in a medical crisis.
Tignanelli said the EMS union has documented more than 5,000 incidents since January 2025, in which Code 1 patients were treated by firefighters or EMTs in a Basic Life Support unit when the Fire Department should have sent an Advanced Life Support unit. The ALS unit has a paramedic on board along with the "drug box," containing medications only paramedics can administer in emergency situations.
There's no way to prove that people have died because of the Fire Department's actions, or inactions, he said, but he thinks it's likely.
"The odds are somebody didn't get the treatment they deserve,” he said. “Everybody loves firemen, I guess, but I wouldn't want a fireman working on me while I'm laying on my back needing a (para)medic.”
Detroit Fire Department response to allegations
In a statement, Executive Fire Commissioner Charles Simms said the Detroit Fire Department has slashed its Code 1 response time from nearly 20 minutes in 2014, to 7 1/2 minutes today.
"That means Detroit residents experiencing life threatening emergencies are receiving medical response faster than ever before, helping save lives,” Simms said.
"The Detroit Fire Department disputes any claims that it is withholding advanced life support from patients. The DFD is still rebuilding its EMS system. We need more paramedics to provide the level of care Detroit residents deserve. That challenge is not unique to Detroit; there is a national shortage of paramedics," said Simms.
Simms also said that the Fire Department is training more firefighters to be paramedics in efforts to create a fully “in-house” paramedic staff and reviewing deployment policies to ensure the proper response to Code 1 calls.
Simms did not address the issue of whether Fire Department supervisors are intervening in medical response decisions.
Does the Detroit Fire Department need an overhaul? And if so, what kind of overhaul?
The DFD says structure fires have declined by 50% in Detroit since 2017. Firefighting operations were required for 1,471 fires in the city in 2025.
Meanwhile, there are more than 160,000 calls for medical emergency assistance annually in Detroit — so many that the current firefighting and EMS staff can't keep up.
In June, Detroit's city council approved supplemental ambulance service contracts to augment the city's own emergency response services.
The approvals were delayed as council members discussed whether the city should be investing in its own EMS services instead. Fire Department officials have said that would require significant investments to accomplish, as reported by Bridge Detroit.
EMS union head Al Saade said he agrees the long-term goal should be for the Detroit Fire Department to handle the city's emergency medical calls in-house, without relying on private ambulance companies.
"I am not minimizing fires," Saade said. "When they happen, they are dangerous, labor-intensive events and Detroit needs enough firefighters and equipment to handle them safely. But it is impossible to look at the numbers and ignore where the overwhelming day-to-day demand for service exists."
The DFD needs an overhaul that includes a change in approach and a revamp of resource placement, Saade said, and EMS officials have not been asked to be involved in conversations about those goals.
"We need to stop treating EMS as the secondary mission when the data tells us otherwise. When you look at what this department actually does every day, sometimes you have to be willing to say the uncomfortable part out loud: This is really an EMS department that puts out the occasional fire."
