Airway & Respiratory, News, Patient Care, Trauma

Paramedics Not Out of the Woods

SAN ANTONIO — A state agency that certifies paramedics wants to punish four emergency responders in the San Antonio Fire Department who were involved in a bungled emergency response last year, including one who reportedly “witnessed the patient move” and yet failed to treat her, according to a notice of violation sent to the paramedic last week.

The Texas Department of State Health Services mailed notices to Mike Gardner, William Bullock, Jeremy Huntsman and Michael Collins. The Fire Department had already disciplined them for their roles in the assessment of Erica Nicole Smith, whose vital signs were not checked after a head-on collision in December.

Smith, a 23-year-old Texas State University student who was awaiting certification as a respiratory therapist, suffered severe head injuries in the wreck and was left untreated at the scene for hours. She died the next day.

Weeks later, the Fire Department permanently barred Gardner from working as a paramedic in San Antonio and transferred him to the firefighting division. It also de-authorized Huntsman, Bullock and Collins as San Antonio paramedics for an indeterminate length of time and transferred them to the firefighting division, where they remained Thursday.

In the June 6 letters, the state agency proposes suspending the paramedic certifications of Gardner, Bullock and Huntsman for one year and reprimanding Collins. Each has about a week to request a conference or hearing on the proposed punishment.

Fire Union President Chris Steele said the paramedics were weighing their options Thursday and suggested the high profile of the case led to the state agency’s action.

“They’ve already been punished,” Steele said. “The guys are already not on the ambulance, so it’s kind of redundant.”

Fire Chief Charles Hood on Thursday declined to comment. But Assistant Fire Chief Mario Guerra said it’s the state agency’s prerogative to make decisions that relate to any paramedic’s certification or license.

“That’s the state’s call,” said Guerra, who oversees the EMS division of the Fire Department.

Since 2004, the agency has investigated cases involving the city’s fire department 11 times, although violations were not necessarily found in every case.

About 4 a.m. on Dec. 16, a Pontiac GS driven by Jenny Ann Ybarra of Seguin veered into oncoming traffic on Loop 410 near Rigsby Road and collided with a Honda Accord in which Smith was the front-seat passenger, police said.

On Thursday, a grand jury indicted Ybarra for both intoxication manslaughter and intoxication assault.

At the crash site, Collins treated Ybarra, who was complaining of back pain. The state agency is accusing Collins of not making “direct voice contact with medical control,” a standard procedure for San Antonio paramedics who remain at a scene for more than 20 minutes.

Meanwhile, Gardner treated two victims in the Accord: Sabrina Shaner, the driver, who police said was intoxicated, and Amber Wilson, a passenger in the back seat. Both had minor injuries. Smith, her brain exposed and blood streaked down her face, was left untreated in the Accord.

The state agency in part is accusing Gardner of failing to check for Smith’s vital signs even after he “witnessed the patient move” – an allegation that had not previously been levied publicly against Gardner.

“Such failure(s) resulted in your incorrect conclusion that the person was deceased or near deceased and therefore did not need medical care,” the notice says.

None of the men could be reached Thursday.

According to a medical examiner’s investigation report released in February, a police detective and an evidence technician told a medical examiner’s investigator that Gardner and Collins left the scene “despite police having pointed out to the paramedics that the victim continued to take breaths.”

When the detective lifted the tarp, the investigator “could hear and see that (Smith) was breathing short, shallow breaths,” the report said.

The investigator asked police to request that paramedics return to the crash site. Bullock and Huntsman arrived about 5:45 a.m., and the investigator told them Smith was still breathing.

Huntsman “advised me that the victim was dead, and that Dr. (Donald) Gordon would be upset if they hooked the monitor up to a dead body,” the report said.

The state agency in part is accusing Huntsman and Bullock of “not making physical contact with that patient to check or measure the patients (sic) vital signs.”

Huntsman eventually agreed to call the Fire Department to free Smith from the car, the report said. She died about 30 hours later.

Staff Writer Elizabeth Allen contributed to this report.