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October 25, 2013

Fired NM medic's report raises red flags

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

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