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Calif. FF-medics reinstated after initial refusal to enter care facility to treat patient

The Rialto firefighters maintained they were strictly adhering to COVID protocols in the 2021 incident

By Joe Nelson
San Bernardino County Sun

RIALTO, Calif. — Two Rialto firefighters who were fired and another who was suspended because they refused to enter a skilled nursing facility to treat a man in cardiac arrest, citing state COVID protocols, have won reversals of their discipline on appeal.

Capt. Josh Gilliam and Firefighter/Paramedic Matt Payne were fired for their conduct on the night in 2021 when patient Joseph Angulo died, and fire Engineer Mark Brady received a 10-shift suspension. All three appealed, pleading their cases at a five-day arbitration hearing in August.

[PREVIOUSLY: Report faults Calif. firefighters for not entering acute care center to treat dying patient in 2021]

In his Jan. 31 ruling, arbitrator Kenneth A. Perea concluded that while a “preponderance of the evidence” supported a finding that the three firefighters were liable for misconduct when they refused to enter Rialto Post Acute Care Center on Nov. 17, 2021, to treat Angulo, their punishment was unreasonable.

Reinstatement ordered

Perea ordered that Gilliam and Payne be reinstated to their positions with full seniority restored and that they receive back pay. Perea also ordered that Gilliam and Payne’s discipline be modified to a one-week suspension without pay, according to the 28-page ruling.

As for Brady, Perea ordered that his suspension be revoked and expunged “from all files and records” and that he receive back pay for the 10 work shifts he missed.

Attorneys Jason A. Ewert, who represented the firefighters during the arbitration, and Mark Meyerhoff and Stefanie Vaudreuil, who represented the city, did not respond to requests for comment.

City Manager David Carmany said he will meet in closed session with the City Council on Tuesday, Feb. 27, to discuss the implications of Perea’s ruling and next steps.

Multiple calls

According to the ruling, the three-man crew headed by Gilliam responded to three calls at the skilled nursing facility within two hours of one another on the night in question, and the firefighters had grown frustrated by the time they received the third call — about Angulo — at 7:51 p.m.

Gilliam, according to the ruling, was working overtime that night and assigned to the crew, which was from another station.

The ruling suggests that Gilliam and/or his crew entered and reentered the center during previous calls that night.

At 6:12 p.m., Gilliam’s crew, along with a medic ambulance manned by another crew, were dispatched to the Rialto Post Acute Care Center regarding a patient complaining of shortness of breath. The patient, however, declined to be taken to the hospital.

At 7:24 p.m., Gilliam’s crew and the ambulance crew were called back to the center, this time regarding an 81-year-old patient experiencing abdominal pain. However, Gilliam’s crew, not the ambulance crew, transported the patient to Arrowhead Regional Medical Center.

About 20 minutes later, Gilliam returned to Rialto Post Acute Care and “re-entered” the center, asking the nursing supervisor “Why are we being called on these inter-facility transfers?” The nursing supervisor told Gilliam that the ambulance service, American Medical Response, did not respond to “code 2" calls for service, which are urgent but noncritical calls and do not require lights or sirens to be on.

Refused to enter

A few minutes later, Gilliam’s crew was called back to the center regarding Angulo. They arrived at 7:55 p.m. but refused to enter the facility, citing state COVID protocols. They stood outside the entrance and instructed staff to bring Angulo outside.

“Paramedic/firefighter Payne erroneously advised center staff that ‘state law’ prohibited the crew from entering the facility,” according to the ruling.

Rialto police Sgt. Ralph Ballew arrived a few minutes after Gilliam’s crew to find the three firefighters standing outside. One of the firefighters told Ballew, “The facility was becoming problematic as Rialto Fire was just here for an unrelated patient,” according to the ruling.

Meanwhile, staff inside the facility scrambled to try to get Angulo outside while also performing lifesaving measures. They pleaded with Gilliam’s crew, “Please come help, he’s having cardiac arrest!” One of the firefighters responded, “You are doing the same thing we would have to do if we went in, so hurry up and bring him out so we can help.”

Ballew entered the facility and assisted staff in pushing Angulo’s bed outside. As they were pushing the bed down the hallway, a nurse sat atop Angulo on the bed performing chest compressions. The pandemonium was recorded on Ballew’s body-worn camera.

Once outside, Angulo was taken to Arrowhead Regional Medical Center, where he died.

Rialto Post Acute Care Center is a 170-bed, licensed skilled nursing facility that provides post-hospital care to patients requiring rehabilitation or who are unable to care for themselves. The center, however, lacks advanced life-support capabilities, requiring paramedics to perform such functions, according to the ruling.

During the arbitration hearing, Kevin Dearden, an emergency medical services coordinator for the Rialto Fire Department, testified that cardiac arrest patients require immediate assessment and intervention because they are no longer breathing and their brain is no longer functioning.

Internal investigation

In November 2022, the city released a nearly 500-page report on its internal investigation, concluding the firefighters failed to provide “reasonable and professional care” and ignored pleas for help by nurses when they refused to enter the facility.

“The fire personnel charged with that responsibility in this instance failed to provide reasonable and professional patient care — or even adequate customer service — to the patient and facility staff,” the report stated. “Whether this was because they were frustrated with having to handle so many calls there previously, or whether they were just having a bad day, it was inappropriate and inexcusable.”

And while the firefighters maintained they were strictly adhering to COVID protocols, Rialto Fire Chief Brian Park said at the time that local or state emergency medical service providers, including Rialto’s, were never prohibited from entering skilled nursing facilities to provide care, especially for high-acuity patients or facilities needing assistance.

Additionally, Park said that by November 2021, due to widespread vaccination and improved knowledge, many COVID-related mandates had been lifted.

In January 2022, Angulo’s daughter, Bridgette Angulo, filed a $100 million wrongful death claim against the Rialto Fire Department, followed by a lawsuit against the city in August 2022. Her attorney, William D. Shapiro, declined to comment.

According to a document filed in San Bernardino Superior Court on Feb. 13 , the city and Angulo have entered into a settlement agreement that must be approved by the city.

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