Heather Bynum won't be at Camp Bisco this year.

She'll be in a spare bedroom of her mother's Schenectady house, in a wheelchair, boosting those who love her every time she wiggles her foot.

That shows she's aware of her surroundings.

Before last year's Bisco, Heather was like any other hardworking 24-year-old who wanted to unwind on a long weekend with her fiance at Indian Lookout Country Club in Mariaville. They splurged for VIP tickets at the annual music festival, now in its 12th year.

Hours later, when she suffered a seizure and stopped breathing, her fiance, Ron Elwertowski, ran and shouted into the darkness until he found someone to radio the EMTs. It would be 15 minutes before a paramedic could help Bynum, he said. Now her family blames festival organizers for failing to provide adequate emergency services. Those responsible for taking care of the Bisco victims are questioning the safety procedures of the event, which starts Wednesday and runs through Sunday.

"She can't walk, she can't hold a spoon, she can do absolutely nothing for herself," said Debbie Bynum, Heather's mother. "Before she was an extreme overachiever, she worked two jobs, she put away money. Now, she can't even brush her teeth."

The annual festival hosted by the Philadelphia-based band The Disco Biscuits attracts about 20,000 people who pay $200 to camp on a 200-acre spread and hear some of the top electronic musical acts in the world. But along with all of those fans comes a massive open-air drug market, one revelers tout on blog and Facebook posts as being far more drug-centered than other large concert gatherings. Compared to other, similar-size concert gatherings, including Phish's three-day run at the Saratoga Performing Arts Center this weekend, it sends more people to area hospitals in serious condition, emergency room doctors say, especially when combined with the heat, the duration of the festival and the massive crowd.

Over the years of Bisco at Indian Lookout, one patron has died, dozens have been hospitalized in serious condition and hundreds have been arrested for a range of crimes, most related to drugs and alcohol. Emergency responders are preparing for yet another wave of victims.

The drugs at Bisco are so easily obtained that a secondary market has evolved of dealers who sell drug-testing kits. Buyers can perform their own chemical tests on the purity of the pills, and a color rating system shows what type of ingredients are found in the drug.

A reporter walking the grounds last year found that pills and many other types of drugs are easily found among the tents, and RVs, largely sold by dealers who claim they're peddling something that will get you high and not take your life.

Bisco happens at the height of the summer, and temperatures last year soared into the 90s. Its dusty fields are trampled by young people intoxicated by music and the pills and powder strangers sell to them. Beer is sold on the premises, and those in attendance are allowed to bring in alcohol as long as it is in a can. They are monitored by a security force that consists of hundreds of bikers who check the bags and cars of everyone who enters.

State Police and sheriff's deputies aren't allowed on the property, though they search some cars on the roads leading inside. The biker security force searches festival-goers once they get inside the gate.

Every year, dozens of ambulances race to and from the festival to transport the victims. Yet those who take care of the injured and police the roads leading to Bisco question how the festival is allowed to go on when it presents such a significant health risk. Last year, the festival grounds were visited by a hearse.

"If lives are being lost, you have to say is it worth this," said Dr. Roger Barrowman, chairman of the Department of Emergency Medicine at Ellis Hospital in Schenectady, where most of victims end up. "When you have people going to the ICU — not one, not two, but several — you have a public health issue."

In the last two years, about a dozen people from Camp Bisco have ended up on ventilators at Ellis, he said, and one died. Patients were also transported to at least two other hospitals, and more than 50 were transported directly from last year's festival. The drugs that sent people to the emergency room include ketamine, bath salts, Ecstasy and synthetic fentanyl, he said. On a short stroll of the grounds last year, virtually all of those substances were offered to a reporter.

St. Mary's Hospital in Amsterdam also sees an influx in patients arriving from Bisco, said Patricia Green, the facility's director of emergency services. Last year, about 15 patients were admitted to the emergency room, and their bizarre behavior so rattled staff that they have since undergone poison control training to know how to deal with those who overdose on designer drugs.

"You couldn't reason with these patients," she said. "Some of them were screaming uncontrollably."

Determining exactly how many people attend the festival can be a shell game. It depends whom you ask. Buses shuttle visitors from Baltimore, Philadelphia and New York City and cars clog the roads.

In a 2012 permit, festival organizers claimed 10,000 people would attend, which allowed them to have less costly medical care facilities on site, according to records obtained by the Times Union. Schenectady County officials readily grant the permits, even though Bisco promoters were widely quoted in newspaper reports saying that at least 20,000 were on hand. The land where the festival is held is owned by Frank Potter, a former chairman of the Schenectady County Legislature.

Based on ticket prices and on-site alcohol sales, the event brings in at least $2 million to $4 million, but Potter said he makes far less than a million dollars on the proceedings.

Potter said he doesn't know how many people attend the festival, which also includes thousands of volunteers, stagehands, EMTs, band members and their entourages. He said promoters inflate the number of attendees to make the festival seem more popular. He said 50 EMTs will be on hand for this year's Bisco, as will a doctor.

Inviting police to the festival would not cut down on illegal activity, he said, because drug use is a problem everywhere in the country, not just at Bisco. He said Bisco is a place where the "leaders of tomorrow" can go to unwind and that very few caused a problem with drug use.

More Information Drugs of Camp Bisco Dr. Roger Barrowman from Ellis Hospital said these are the drugs that brought the most people to the emergency room from Camp Bisco: MDMA (Molly, Ecstasy) Arguably the most popular drug in rave circles, MDMA comes in pill and powder form. Known for its euphoric effects, it's also notoriously impure and can lead to increased body temperature and dehydration. Ketamine (Special K) Used primarily by veterinarians for anesthesia, ketamine produces psychedelic and dissociative effects in humans. It's usually snorted but can also be injected, and can cause severe confusion as well as depressed heart rate and breathing. MDPV (Bath salts) A newcomer to the drug scene, little is known about this "designer drug," and the chemical composition of what's sold as bath salts can vary widely. A stimulant, the effects can be similar to cocaine, and users have been known to display psychotic behavior at high doses. Fentanyl (China white, Percopop) A powerful pain reliever, fentanyl is a synthetic opioid prescribed for moderate to severe pain, yet variations of the drug are illegally produced in clandestine labs. The high is similar to heroin, and so are the risks of overdose. See More Collapse

"People have the right to assemble in a peaceful and orderly fashion," he said. "This is the United States of America. We're not a police state, and we should remain that way."

The festival has a zero tolerance for drugs, spokesman Chad David Shearer said in a statement, and relies on the community of fans looking out for each other.

He acknowledged that organizers are "constantly improving" their medical response and claimed that attendees are urged to familiarize themselves with the layout of the grounds so they know where to find medical help.

Heather Bynum's family filed a notice of claim — a precursor to a lawsuit — against festival organizers, the town of Duanesburg and Schenectady County last year contending that the festival was not equipped to properly handle medical emergencies.

Elwertowski, Heather's fiance, recalled in a recent interview how she collapsed to the floor of their tent, foaming at the mouth, in a seizure. He sprinted to find help, but no staff members were at their post in the camping area. He said the two had been drinking for hours and had taken "molly," or MDMA. Debbie Bynum, however, says her daughter did not have a history of substance abuse, and her attorney, Paul Wein, says a drug was probably given to Heather without her knowledge. "We don't know that she voluntarily took it," Wein said.

"I was desperate," Elwertowski said. He shouted and waved his cellphone in the air, praying someone would see its glow. "My fiancee was dying in that tent."

Heather was stiff, her lips blue, said Elwertowski, when emergency medical staff put her in an ambulance waiting elsewhere on site. He was horrified when that ambulance stopped on the way to Ellis Hospital, at the Plotterkill Fire Department, to pick up equipment and paramedics.

"They were understaffed and undersupplied," said Elwertowski. "It wasn't the medical response I expected."

It took so long to get Heather prompt medical attention, her family contends in the notice of claim, that Heather barely survived and will likely never talk again.

Melissa Renaud, who runs the medical response team for Camp Bisco, acknowledged that medical tents had not yet been fully set up because the festival was not yet in full swing when Bynum had her seizure.

Still, she said the response time was quick and that the ambulance stopped to pick up paramedics, who have more advanced medical training. Usually, there is one main medical tent and five satellite tents, she said, but this year there will be an additional large medical tent to supplement their emergency response.

Such a facility is required by state law when crowds exceed 15,000, which Bisco organizers now claim the festival will on this year's permit.

Still, at least two medical responders in previous years have arrived at the medical tent to find people who were overdosing hogtied so they couldn't move. They were tied down by a biker who said they were out of control, said the responders, who commented anonymously for fear of reprisal.

Bisco organizers claim their event pumps millions of dollars into the local economy, but those responsible for taking care of the wounded, including Dr. Barrowman, worry that has blinded the community to the dangers of Bisco. Last year, 29-year-old William Graumann of New Jersey was found dead in his tent, and State Police said they found Xanax and hydrocodone nearby.

Schenectady County Sheriff Dominic Dagostino said the festival does nothing for the county but tax its resources for four or five days. He said law enforcement and emergency officials don't even know what they face every year until people start overdosing. His greatest fear is a mass-casualty event — severe weather or bad drugs circulating through the crowd — that will incapacitate more people than the resources on site and in the county can handle.

"It's coming," he said. "It's a matter of when."

swaldman@timesunion.com • 518-454-5080 • @518Schools