Updated

Five District of Columbia firefighters were aware that a man needed medical attention across the street from a fire station, but none of them went to help the man, who later died, according to an internal investigation released Friday.

The investigative report recommends disciplinary action against the five firefighters as well as four employees of the city's 911 call center for their roles in sending an ambulance to the wrong address.

Medric Cecil Mills Jr., 77, a longtime city employee, went into cardiac arrest in a shopping center parking lot across from a fire station on Jan. 25. According to the report, at least two people went across the street to the fire station and asked for help, but Mills did not receive aid until a police officer flagged down a passing ambulance. More than 22 minutes after he collapsed, he was taken to a hospital, where he died.

Mayor Vincent Gray has called the incident "an outrage" and said the firefighters at the station failed to show "common decency."

According to the report, the people who went to the station spoke to a probationary firefighter, who twice asked his lieutenant over the station's public-address system to come to the watch desk. The lieutenant, previously identified as Kellene Davis, did not respond, the report said.

Three other firefighters were in the station and heard the PA announcement. One of them spoke to the probationary firefighter, and then to the lieutenant, telling her that a man was down across the street and asking if she would send them to help, the report said. The lieutenant asked the firefighter to return with an exact address, which the firefighter did not do, and when Davis spoke to him later, he was lying on a bunk bed, studying, the report said.

Meanwhile, the employee who took the initial 911 call assumed that the address was in the city's northwest quadrant, when in fact it was in northeast, the report said. The caller corrected the call taker, but others did not notice the corrected address until an ambulance had already arrived at the wrong location, according to the report.

The report did not specify what discipline the firefighters and call center employees would face, although it could range from a reprimand to firing. Davis and the three firefighters would face a trial board, while the probationary firefighter is subject to a different disciplinary process that could result in him failing to pass his probation.

A listed phone number for Davis was disconnected, and firefighters' union officials did not immediately return message seeking comment.

Karen Evans, an attorney for Mills' relatives, said the family wants assurance that something similar won't happen again, and she said they'd continue to push for appropriate discipline.

"There was a breakdown at almost every step in the process," Evans said. "From our perspective, it's just absolutely unacceptable and we still want accountability for all involved."

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