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Fla. firefighters sidelined from EMS calls after failing test

By Ryan Mills
Naples Daily News

COLLIER COUNTY, Fla. — It’s back to the books for a dozen Naples firefighters who are no longer able to work as paramedics after failing a test to prove they could function under Collier County’s medical protocol.

Until the firefighters complete a 40-hour remedial training course, the department has pulled paramedic equipment and medications off its fire engine at Naples Fire Station 1, 835 Eighth Ave. S.

The refresher training is scheduled for October, although exact dates haven’t been determined, said Naples Fire Chief Jim McEvoy.

McEvoy said he didn’t believe there was ever a threat to public safety nor a decline in the quality of medical service provided by his firefighters. However, Collier County Medical Director Robert Tober said in a prepared statement that the condition of the department’s medical services has been eroding for at least a year.

“Since ... May 2, 2007, the city of Naples continued to fail miserably in just about every facet within EMS operations - accreditation, training, quality assurance and patient care reporting,” Tober wrote.

Tober’s concerns date back to the implementation of an interlocal agreement between the county and the city in 2007 that established rules and guidelines for Collier paramedics, said Collier County EMS Deputy Chief Dan Bowman. All paramedics in Collier County operate under Tober’s medical license.

Bowman said the Naples fire department has struggled since the inception of the new agreement, as has the North Naples fire department.

When Bowman met with McEvoy in December, he said he determined the Naples fire department hadn’t made much progress and was not complying with training standards or completing trip tickets - the paperwork documenting medical calls.

McEvoy said his firefighters weren’t completing trip tickets because they didn’t have the proper software until just a few months ago. He said his firefighters have completed all of their required online training and have attended most of the available hands-on training available to them.

“We have done everything we can to comply with everything the Collier County Emergency Medical Services has asked us to do,” McEvoy said. “Our major concern is the citizens of Naples have the best-trained and most-skilled employees we can provide.”

Bowman conceded the Naples firefighters have done a good job attending training but said they failed to get certified by Tober in the first place.

In the spring, Bowman met with McEvoy again and determined the department still hadn’t progressed, he said. Tober suggested each of the department’s 14 firefighter/paramedics complete a 40-hour refresher course, but EMS Chief Jeff Page instead suggested a test consisting of a 25-question exam, a medical scenario and a trauma scenario.

When the firefighters took the test at the end of July, only two of the 14 passed. Some of the firefighters “failed miserably,” Bowman said.

“Everyone was surprised that this happened,” Bowman said.

On Aug. 15, Tober wrote a letter to McEvoy saying the majority of his firefighters were not prepared to work as paramedics at the necessary level without a refresher course.

“As the medical authority for Collier County, I cannot have personnel rendering care under my license who are so unprepared to meet the basic standard of care we have worked so hard to attain,” Tober wrote.

After learning of the test results, McEvoy removed the paramedic equipment and medication from his engine at station 1, even though county officials offered to swap personnel in order to keep the engine equipped. EMS ambulances are still operating out of Naples fire stations 1 and 2, and there is still an advanced life support-equipped fire engine operating out of station 2 on 26th Avenue North.

Naples firefighters are still able to provide basic life support, but most cannot perform intravenous therapy or provide medication.

“The major impact on all of our lives and safety comes from basic life support, which the firefighters have always done and do well,” Tober said.

Both Tober and McEvoy pointed out that in the year Naples firefighters have had advanced life support medications on the fire engine, there is no record they have ever been used.

“To arm them with a bunch of drugs that they won’t ever have the chance to use and to spend the enormous amount of time to teach them how to use those drugs is a waste of the entire system’s energies and efforts,” Tober said. “They haven’t ever used one of those drugs in the whole year that they’ve had them. Not once.”

McEvoy said he hopes to have the training scheduled sometime in October. He estimates it will take three to four weeks to get the 12 firefighters who failed the July test retrained.

“This is important,” McEvoy said. “It’s very important to the paramedics that they prove themselves as being capable to provide the best level of service. And it’s important to the citizens to know that they’re getting the best level of service we can provide.”