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Home > Topics > EMS Training
October 25, 2013

Fired NM medic's report raises red flags

Of the 300 reports reviewed, a third were cancellations and another third showed "inadequate assessments"

The Albuquerque Journal

ALBUQUERQUE, N.M. — Alvira Chavez’s chronic diabetic condition is so severe that one year she spent more time in the hospital than at home.

Then-Albuquerque paramedic Brad Tate had been to her West Side house in the past on 911 calls, but the day came when he refused to allow her to be transported to the hospital, Chavez testified Thursday at a city personnel hearing.

“He came in and said, ‘This is another attention-grabber; she’s faking it; there’s nothing wrong with her,’ ” Chavez said. After Tate continued to balk at authorizing her transport to the hospital, despite her vomiting and other symptoms, she said her family used a car with bad brakes to drive her themselves. She was hospitalized for the next seven days.

Her treatment by Tate became part of the Albuquerque Fire Department’s basis for firing the 10-year paramedic lieutenant last January. A five-month internal investigation of Tate’s conduct turned up so many serious instances of misconduct that AFD Chief James Breen testified this week that he didn’t consider rehabilitation, suspensions or other type of lesser discipline.

Tate testified Thursday that he has made mistakes in the past but was willing to work on his job performance.

But, “when other guys are given the benefit of the doubt, I was labeled a problem,” he said. “I’m not the best, and I definitely am not saying I’m the worst (paramedic). This is correctable.”

The misconduct cited during the four-day hearing on Tate’s appeal of his firing included exhibiting a lack of compassion for patients and their families, filing incomplete and false reports and providing inadequate medical treatment to patients who needed to be taken to the hospital.

The AFD undertook an investigation that included a review of 18 months of 911 calls that involved Tate.

Of the 300 or so reports Tate filed on those calls, about two-thirds raised red flags or showed some type of problems, according to testimony from now-retired fire department EMS commander Jon Sigurdson.

One-third of the reports showed “inadequate assessments” of patients’ medical conditions, and another third were cancellations after Tate had been called out on a 911 call, Sigurdson testified. The percentage of Tate’s cancellations was higher than the AFD average, which is about 10 percent to 15 percent, Sigurdson said.

‘Virtually negligence’

One call was labeled cancelled by Tate in a report, even though the patient showed abnormal heart rhythms at the scene and wasn’t transported.

Some 911 calls appeared to be dismissed as “anxiety attacks,” even though paramedics aren’t supposed to diagnose patients, testimony showed.

Many of Tate’s reports “were so grossly inadequate it was virtually negligence,” Sigurd-son said.

Breen testified that before becoming chief four years ago, he had supervised Tate and mentored him.

“This is someone I believed in,” Breen said. “Although I think he has a good heart, which is in the right places at times, he’s very immature and needs a very high level of supervision to keep him operating in a professional manner.”

Breen said other firefighters have had problems with medical treatment of patients or inadequate report writing, but Tate’s case was unique because of the number of infractions and their seriousness.

Tate, who lives in Las Vegas, Nev., but commuted to his AFD job in Albuquerque, testified that he was never given a chance to correct his performance and realized that his height at 6-foot-2 and appearance might intimidate patients. He also said his report writing improved after the records management section notified him about incomplete reports.

“Every patient is not a perfect patient,” Tate added. “Sometimes it’s very high stress, and sometimes we get yelled at. You can’t always be nice.” Two of his co-workers testified that they got along with Tate and sometimes asked for his advice on AFD matters.

‘Him, again’

Linda Montoya called 911 for help in getting her 79-year-old ill father, Jimmi Montoya, to the hospital in December 2011. She testified this week that Tate was a “bully” when he arrived on the scene and made a bad situation worse.

Tate ordered the family out of the kitchen, where her father was sitting mute, and spilled one of her father’s medications, she said. Tate began yelling and asking whether her father was an alcoholic and looked into the refrigerator and cupboards.

Her father, who it turned out was in renal failure, “wasn’t expecting any of this” and was refusing to go to the hospital, she testified.

“He (her father) couldn’t get up to help me” deal with Tate, she said, “I can still see that horrified look on his face that he wasn’t helping me.”

Montoya testified that employees from Albuquerque Ambulance, which usually shows up for 911 calls, later apologized for Tate’s behavior. She said an Albuquerque police officer called to the scene amid the tension saw Tate and remarked, “Him, again.”

Tate left the house. Her father finally agreed to be transported about an hour and a half later, after AFD Capt. Chad Kim and a doctor on call intervened, Kim testified. Montoya said her father died three days later.

Testimony showed that Tate’s “bedside manner” provoked complaints from patients and their families in the past, but not until another AFD lieutenant complained about Tate’s treatment of his 16-year-old daughter last year did AFD officials look at his standard of medical care to patients.

“There hadn’t been any patient harm done yet,” testified Sigerson. The girl had a ruptured appendix, but Tate didn’t transport her to the hospital after concluding she had a “stomach bug.” The incident led to the city’s settlement of the family’s claims for $49,500.

Breen said another complaint involved Tate’s treatment of an elderly relative of Breen’s former girlfriend.

There was no immediate decision on Tate’s appeal by city hearing officer Barbara Albin, who will send her findings to the city Personnel Board for a final ruling.

Copyright 2013 The Albuquerque Journal

McClatchy-Tribune News Service


All Rights Reserved

Comments
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Jenny L. Austin Jenny L. Austin Friday, October 25, 2013 2:51:30 PM It is paramedics like him that give EMS a bad name. It sounds like he should have been fired a long time ago! In my EMS system, if someone calls 911, and still want to be transported to the hospital when we arrive, they get a ride, regardless of how sick or injured they are. I treat them all the same, whether they have a finger injury or are having a heart attack.
Robbie Mellott Robbie Mellott Friday, October 25, 2013 2:51:44 PM I don't care how many times you go to a person's house for an emergency you still need to treat them with dignity and professional ism
Antoinette Toni Uglow Antoinette Toni Uglow Friday, October 25, 2013 2:59:06 PM Well said Robbie Mellott!
Eric Warren Eric Warren Friday, October 25, 2013 3:15:55 PM Agree, where's the service's quality control program? Didn't they notice all the refusals monthly? In my past municipal employment, internal reports from co workers are ignored by management until its in the media. Negligent Retention!
Les Putnam Les Putnam Friday, October 25, 2013 3:45:25 PM I have to wonder abour the culture of Albuerque Fire Department that would tolerate and condone this type of behavior from the individual described. There had to be a pattern of neglect that should have been confronted by someone in a position of authority. I didn't see any mention of a training officer, Batallion Chief, or Medical Program Director who might have recognized a personnel problem early on and managed this, the culture present in that department allowed this to persist!
Kyle Eaton Kyle Eaton Friday, October 25, 2013 6:06:55 PM He received what he deserved, admittedly many years late. Investigation needs to be made in to the administration who let this go on despite many complaints on record.
Colleen Smith Ashlin Colleen Smith Ashlin Friday, October 25, 2013 6:37:28 PM So many people don't!!!!!
Andy Monce Andy Monce Friday, October 25, 2013 6:51:07 PM not only does he need to be fired the state needs to take a serious look at suspending or revoking his license. this guy has no business in ems.
Michael Swan Michael Swan Friday, October 25, 2013 7:24:51 PM How did he get through that long, Does no one review any of the charting? A decent QA/QI department would have saved a lot of time and grief.
Sheila Romney Sheila Romney Friday, October 25, 2013 8:08:38 PM Where is the dept's QA/QI on this "paramedic?" He could have learned his lesson from a responsible review of his calls. Resource hospital never found anything to report on? Plus after the ruptured appendix incident, he really should have used that to learn and not feel enabled/entitled.
Frank Cantone Frank Cantone Friday, October 25, 2013 8:40:58 PM I wonder why he drove so far to a job when he could have worked in lv?
Sheila Romney Sheila Romney Friday, October 25, 2013 8:58:10 PM Just noticed I'm echoing so many people's opinions...oh well. Like I learned from my mentor, treat people like you want your grandparents to be treated.
Elizabeth Miller Elizabeth Miller Sunday, October 27, 2013 1:44:09 PM You're right; this is a QA/QI failure. I would be just as surprised as he was if I wrote 200 bad reports with no remediation, and then suddenly got fired. Time for a round table, I suspect.
Gail Beard Montgomery Gail Beard Montgomery Monday, November 04, 2013 9:52:09 AM Why did it take that long to find the problems. QC ing paperwork and conduct would have told the story a long time ago.
John Hosie John Hosie Thursday, November 14, 2013 9:37:21 PM sad, but true. it seems the pac northwest has a different heart when it comes to the delivery of high performance paramedicine. Thats what I recall from riding with les in the evergreen M23 days.

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