Sedgwick County (KS) EMS Employees Say Relationship with Leaders Too Broken to Fix

A man on a stretcher is loaded into the back of an ambulance.
Photo/Sedgwick County Government Facebook)

Michael Stavola and Chance Swaim

The Wichita Eagle

(MCT)

Wichita once had one of the best EMS departments in the Midwest, pioneering resuscitation techniques and winning national awards for saving lives.

Sedgwick County EMS employees say the current department has been reduced to “a laughingstock at a national level” and “a joke.”

The massive shift came under Dr. John Gallagher, who was named director in 2019.

Since then, more than a third of Gallagher’s original workforce has left, leaving Sedgwick County with fewer ambulances on the street and dangerously slower response times.

Sedgwick County EMS is now a deeply divided and disillusioned department, a Wichita Eagle investigation found. Rank-and-file employees say their relationship with EMS administrators is beyond repair.

Two closed-door meetings three months ago illustrate the depth of the rift. In late April, more than 120 EMS employees attended a meeting where they urged Sedgwick County Manager Tom Stolz and Deputy County Manager Rusty Leeds to remove Gallagher. The Eagle obtained audio of both meetings from multiple sources.

Thirty-nine employees addressed Stolz and Leeds during the two meetings.

“The employees in attendance are stating, explicitly, that we can no longer bear the burden of continuing mismanagement and demand the immediate removal of Dr. Gallagher as both our service and medical director,” said Brendan McGreevy, Sedgwick County paramedic.

Several employees in the training division also called for the removal of Dr. Carolina Pereira, deputy medical director hired by Gallagher in March 2020.

At the meetings, EMS employees took turns describing a miserable workplace with belittling bosses, discrimination and perilously vague protocols that are driving away experienced paramedics. They also warned of slow response times, ambulance shutdowns and a disregard for human life.

“The Gallagher regime doesn’t care,” said Cole Mitchell, a paramedic who has been with the county for 15 years. “Everyone is expendable.”

At the core of the fraught relationship between Gallagher and EMS workers is a decision he made in 2019 not to transport a man with a self-inflicted gunshot wound to the head, even though the patient had a pulse and was breathing for several hours.

National EMS commentators have called the decision “a Titanic (expletive) up.”

Stolz, who sat through nearly four hours of unified opposition to Gallagher from past and present EMS employees, told the group it was powerful to hear from them.

Stolz promised the employees immunity for their comments and that there would be no retribution by the county for anything they said. He also told them he would be sending the audio to Sedgwick County commissioners. He insisted they remain professional no matter how extreme the leadership.

“Whether Adolf Hitler is running the organization, I have faith that this group is professional,” he said of the EMS employees. “But yet at the same time, we owe you a work environment that is professional.”

Gallagher acknowledged in an interview with The Eagle that his leadership style doesn’t “jibe with everyone” but said he has no plans to resign.

“I intend to be here for years,” he said.

Pereira, deputy medical director, turned in her 90-day notice of resignation on Wednesday. Pereira reportedly said she was “scared to do her job” and needed to leave, citing a work environment where EMS employees “are allowed to have secret meetings with commissioner(s) and are able to send things to the media or place on social media with no discussion, communication, or ramification.”

BEHIND OUR REPORTING

How we did this story

Eagle reporters sifted through 495,729 records documenting ambulance response times from Sedgwick County 911 and Sedgwick County EMS to determine how quickly patients received care between 2017 and mid-2021. To track EMS staffing changes, we compared detailed employee rosters. Ambulance shortage data came from analyzing more than 2,700 records pulled from the county’s MARVLIS software. Hundreds of emails, more than 10 hours of audio recordings of meetings between county officials and EMS employees in 2019 and 2021, 911 audio, and our own interviews with more than 50 people informed our reporting. We obtained the records through Kansas Open Records Act requests and from county sources.

Why did we report this story?

Sedgwick County EMS has been saving lives since 1975. But Sedgwick County EMS employees have warned county leaders that poor leadership is driving away paramedics, cutting down the number of ambulances on the street and delaying response times to life-saving rescues.

Who did we speak to?

We talked to families affected by EMS response times. We interviewed past and present frontline EMS workers, EMS middle management, advanced paramedics, captains, lieutenants, shift commanders, training staff, paramedic students and EMS and 911 administrators. We talked to all five Sedgwick County Commissioners and the county manager. We reached out to the nation’s leading experts in EMS response times.

Old Wounds

Today’s troubles with Sedgwick County EMS started two years ago, when a coalition of powerful local authorities successfully pushed Gallagher’s promotion to EMS director against the wishes of more than 100 street-level EMS employees.

EMS employees have not forgotten.

“The wounds from 2019 remain until this day, and are very vivid in the memories of many of the employees seated before you,” Caleb Yoder, an EMS paramedic, said at one of the April meetings.

An Eagle investigation found that in the months leading up to Gallagher’s promotion, those same authorities helped downplay Gallagher’s decision to deny an ambulance to the man who shot himself. His handling of that patient has led to a state investigation that could put his medical license and the careers of seven first responders in jeopardy.

The Kansas Board of EMS has asked the Kansas Board of Healing Arts to launch an investigation into Gallagher’s handling of the call, potentially endangering his license to practice medicine in Kansas.

The controversial case has proven to be a breaking point for many EMS employees, who say they no longer trust Gallagher and that working under him requires them to compromise their personal integrity.

“What once was a progressive and innovative service that defined current practice has now become an embarrassment, not only locally but nationally, because of Dr. Gallagher’s actions,” said Ryan Kilby, an EMS paramedic. “He has created distrust between the public and our organization, he has put the health and well being of our employees and community at risk.”

“We are all appalled by that decision,” said Brad Crowe, another paramedic. “None of us in this room would have made that decision (not to transport the patient). And we can’t understand how that happened.”

“And I don’t understand how the county leadership can’t make the decision to put us out of our misery and get rid of this guy,” Crowe said.

Sedgwick County Commissioners, EMS employees and the general public were kept in the dark about the details for nearly two years. During that time, the commission approved a 5-year contract worth more than $1 million with Gallagher while more than a third of his original workforce left the department.

Gallagher’s promotion followed several months of protest by EMS employees, who gathered more than 100 signatures endorsing a letter sent to commissioners that raised concerns about Gallagher’s fitness to lead and asked for an open and competitive hiring process.

Instead, Stolz promoted Gallagher, who had been the county’s medical director, putting him in charge of a $21 million budget and more than 200 employees.

County Commissioner Jim Howell said if the details of the gunshot patient’s case had been disclosed earlier, Gallagher likely wouldn’t have been promoted. He told The Eagle he wants Gallagher to be placed on administrative leave, based on complaints by EMS employees and a report issued by the Kansas Board of EMS that called for the Kansas Board of Healing Arts to investigate Gallagher.

The Kansas Board of EMS case could have a hearing as early as October. The Kansas Board of Healing Arts is barred by state law from disclosing complaints and investigations, which can take months or years to conclude.

“I believe the county has been largely dismissive of the findings of that report,” Howell said. “We can’t wait until all of the investigations are over to take action. It appears the county is trying to sweep this under the rug.”

“Unsalvageable”

The case at issue involved a 31-year-old patient who had apparently shot himself in the head on June 19, 2019. Response time was not a problem that day. Within minutes, EMS determined the man had a pulse and was breathing.

Sedgwick County EMS protocols call for paramedics to transport patients who have a pulse and are breathing to an emergency room. But Gallagher ordered Sedgwick County EMS and Wichita Fire Department first responders to stand down and wait for the man to die.

Ascension Via Christi St. Francis hospital was a mile away.

One hour after the shooting, the patient had a strong pulse and continued breathing. But Gallagher, who came to assess the situation in person, decided the patient was “unsalvageable,” a summary order by the Kansas Board of EMS says.

Gallagher ordered EMS paramedics to clear the scene and leave the patient with the Wichita Police Department, to whom he gave instructions to call him back when the patient “concluded dying.”

Police officers refused and returned to their vehicles. Stephen Runyan, a Wichita Fire Department EMT on the scene, said he wasn’t comfortable with Gallagher’s suggestion to leave the patient, according to the order. Firefighters remained with the patient after Gallagher ordered EMS to leave.

The man was left on the floor of his downtown Wichita apartment for five hours. At times, he appeared to be in pain, “groaning loudly” while emergency medical providers stood by, “watching and doing nothing,” according to the summary.

During that time, Gallagher approved two maximum doses of ketamine, totaling 1,000 mg, for pain management.

The patient — still alive — was later covered with a white sheet and taken to hospice, not the emergency room, where he died more than 10 1/2 hours after the shooting.

Gallagher’s role in that decision became public for the first time in March when The Eagle reported the details, which had previously been toned-down by county management and the Medical Society of Sedgwick County in emails to Sedgwick County Commissioners, records show.

County Leaders Sanitize Details

The day after the suicide, Assistant County Manager of Public Safety Rusty Leeds and Stolz, the county manager, seized control of the narrative, emails obtained by The Eagle show.

Leeds and Stolz had spearheaded the campaign to promote Gallagher to EMS director through a merger between the Office of the Medical Director and EMS.

In a series of emails sent to county commissioners, Leeds and Stolz presented a cleaned-up version of how the patient was handled.

It failed to mention any details about the man’s apparent suffering for hours on the floor of an apartment instead of an emergency room a mile away.

“Yesterday there was an incident,” an email from Leeds begins, “currently under investigation as a suicide by firearm, in west Wichita.

“The head injury was identified as unsurvivable by the Medical Director. In consultation with the ER physician, it was determined that the body should not be delivered to the ER.”

The Kansas Board of EMS report makes no mention of any discussion between Gallagher and any emergency room physicians. It notes that he spoke with a hospice nurse.

“Arrangements were made and the body was moved to an alternative facility to manage the body until the reflexive functions ceased,” Leeds wrote.

“It became controversial because the timeline from time of call to body removal was about 4.5 hours,” Leeds added. “The Medical Director is developing protocol to manage these rare occurrences in a timely, structured manner going forward.”

“In the interim, should a similar situation occur, the body will be moved to the most appropriate care facility if reflexive functions do not cease in a short period of time,” Leeds wrote.

Leeds said news coverage could follow but that the county’s strategic communications department was managing the situation.

Stolz sent a follow-up email assuring commissioners that Gallagher simply validated the assessment of EMS staff at the scene.

However, it was actually EMS staff who asked Gallagher to assess the patient, the Kansas Board of EMS investigation found.

Medical Society Backs Gallagher

After the suicide call, Gallagher turned to the Medical Society of Sedgwick County for a review of the case.

Gallagher is a member of the Medical Society and serves on its EMS physicians advisory committee. In a closed-door process, that same committee reviewed the suicide case at his request.

“One of the advantages in the peer-review system is the people who are involved already know the case,” Gallagher said in a June interview. “And so you have more information than anybody who could ever review it, so people go into peer-review confident of the outcome.”

Gallagher said he doesn’t think his membership on the committee that investigated him is a conflict of interest. “That’s the way physician peer-review works,” he said. “I mean, hence the name.”

“I know there’s been allegations of, ‘Oh, it was a handpicked group of all of Gallagher’s buddies’ and all this, and while I do know the people on the committee … it’s a committee I can’t vote on,” he said.

No one will say what information the committee reviewed, but the foundation of the Kansas Board of EMS’s findings was Wichita police body-camera footage.

A month after the patient’s death, Phillip Brownlee, the executive director of the Sedgwick County Medical Society and a former Eagle editorial page editor, sent County Commissioners a two-sentence summary that attempted to clear Gallagher of any wrongdoing.

The summary said the Medical Society had completed an assessment of the EMS care and a peer-review of Gallagher. It found “the EMS providers delivered appropriate care within their protocols and their scope of practice,” and “the EMS physicians provided care that fully meets the standard of care.” No further details were provided.

At the time, the Medical Society was also actively lobbying commissioners in favor of the merger that placed Gallagher atop Sedgwick County EMS, The Eagle found.

Brownlee, on behalf of the Medical Society of Sedgwick County, had pitched the idea as one that would make dollars and sense, two days before the suicide call.

“Having a physician lead the merged system could help ensure that operations make the most medical sense,” Brownlee’s letter to commissioners said. “It could also better inform (Medical Society of Sedgwick County) physicians about the budgetary limitations facing (Sedgwick County EMS), helping ensure that medical recommendations are made in a cost-effective manner.”

Brownlee told an Eagle reporter he didn’t think there was a conflict of interest in the committee investigating an incident that involved one of its members. The Medical Society does not have a conflict of interest policy, according to its nonprofit tax form.

“This is the process that is used,” he said. “We have a committee that oversees EMS. This is what they do. These are professionals. They take their jobs extremely seriously.”

Neither Brownlee nor Gallagher would provide a list of physicians who reviewed the case.

“Doctor Untouchable”?

The suicide call gained national attention within the EMS community, with paramedics across the country decrying Gallagher’s handling of the case on social media and national figures weighing in.

EMS law expert Davit Givot wrote a column on the case for EMS1.com, saying it appeared Gallagher acted properly, based on the findings of the Medical Society of Sedgwick County. But he couldn’t say the same for the EMS providers who followed Gallagher’s orders.

“As much as I want to tell you that I believe the EMS crew acted reasonably in following Dr. Gallagher’s order, I simply cannot,” he wrote, adding that the first two rules of EMS are “first do no harm” and “err on the side of the patient.”

The Overrun, a popular EMS podcast, dedicated an entire episode to the suicide call, titled “What the actual, Sedgwick?”

Co-hosts Ed Bauter and Dan Schwester, both experienced EMS paramedics, were highly critical of the Sedgwick County response, calling it “astonishingly bad judgment.”

“It was a systemic failure, from the top down, and the accountability falls on the people who were ordered to do things by their medical director,” Bauter said.

A Wichita emergency room nurse, who asked not to be named so she could speak freely without fear of retribution from her employer, said she believed the suicide call has created massive distrust in the emergency rooms around town where Gallagher works.

Gallagher’s contract with the county allows him to work six days each month as a physician at Ascension Via Christi and Wesley Medical Center, which pay him an undisclosed amount of remuneration on top of his $222,142.65 base salary from Sedgwick County.

Nurses rearrange their schedules to avoid working with him and doctors complain he doesn’t clean up his messes, she said. She said she thought the amount of ketamine approved by Gallagher was inappropriate and appeared to be an attempt to hasten the patient’s death.

“That amount of ketamine would kill me,” she said.

Gallagher defended the two maximum doses. “That’s the right dose for the patient,” he said.

She called Gallagher “Doctor Untouchable.”

“The difference between John Gallagher and God is, God knows he’s not John Gallagher,” she said.

“Nobody wants to work for him, because they don’t trust him,” she said. “I don’t respect him, I don’t trust him and I don’t want him on my team. No nurses want to work under him. I can’t believe that Ascension and Wesley — I can’t believe his privileges haven’t been revoked.”

The nurse said a decline in Sedgwick County EMS service means fewer patients reach the emergency room, where they have a better chance of being saved. “People are dying in the field,” she said. “I’m wondering how many lives have been lost because of it, and now that we don’t have enough paramedics to cover the calls, how many more are going to die.”

A Broken Relationship

The decade before Gallagher’s promotion, average paramedic turnover in Sedgwick County EMS hovered around 10%, county records show.

From 2011 to 2018, EMS lost an average of 17.5 full-time employees a year, including EMTs and paramedics.

Those retention numbers were well above the national average. But that changed after the county merged EMS with the Office of the Medical Director. Separations have nearly doubled since Gallagher’s promotion, with 68 separations in less than two years.

“Right now, our responders are broken, physically and mentally,” EMS Crew Leader Kyler Konda, a paramedic, told county leaders in April.

As of June 7, 47 full-time and six part-time paramedics had left EMS since Gallagher’s promotion.

Since then, at least five more paramedics have handed in resignations.

Former Sedgwick County EMS Capt. Cat Edison, an 8-year veteran paramedic and crew leader, is one of them.

On a Friday in June, Edison helped save a Wichita firefighter’s life after he suffered a cardiac arrest at the scene of a house fire in west Wichita. The following Monday, she handed in her resignation letter.

Edison said she quit because of Gallagher, who she said routinely “talks down” to street-level EMS employees.

“Nobody was ever as smart as him,” Edison said. “Nobody was ever as good as him. You couldn’t have a conversation with him without having him making it known that whatever your opinion was, [it] didn’t matter as much as his. You just never felt heard.”

Jaime McHugh, a 12-year paramedic who quit the same week as Edison, expressed similar concerns about Gallagher in a separate interview.

“I also feel like I have no voice here,” McHugh said. “(Gallagher’s) made it very, very clear with his decisions and his leadership that we do not matter here. We are not worth anything to him.”

Brownlee, executive director of the Sedgwick County Medical Society, said Gallagher is “extremely well-respected in the emergency medicine physician community.”

When asked for a peer of Gallagher’s to speak with, Brownlee recommended Dr. John McMaster. Sedgwick County Commission Chairman Pete Meitzner had also recommended McMaster as someone who could speak highly of Gallagher.

McMaster is the chair of the Medical Society’s EMS Physicians Advisory Committee, which cleared Gallagher and seven employees of any wrongdoing in the 2019 suicide call.

When reached for comment about Gallagher’s character, McMaster hung up on an Eagle reporter.

Jennifer Hopkins said she worked with Gallagher at St. Francis before recently leaving to take a job as a traveling nurse. She said she liked him as a person, but not a coworker.

“I think most people really truly didn’t care for him,” Hopkins said. “Personally, I would say that he maybe seemed a little arrogant.”

Sedgwick County EMS employees said they have also lost trust in the medical judgment of Gallagher and Pereira, a deputy medical director hired in March 2020 to improve training and protocols.

Pereira handed in her 90-day notice on Wednesday.

Zachariah Marrs, who is an EMT part-time while finishing paramedic school, told county leaders that he doesn’t trust the two EMS doctors.

“I would not want my family member to go to a hospital that was currently staffed by either (Dr.) Pereira or Dr. Gallagher,” Marrs said. “If I was given the choice, and I knew that they had to go to a hospital, I would ask which doctor was in charge that day. And that is not a stance that anybody in here should ever have to say about someone who is supposed to be our leader.”

Days after the second April meeting with EMS staff, Stolz announced he planned to hire auditing firm Allen, Gibbs & Houlik to assess EMS leadership and protocols, a move to restore trust in county leadership.

But EMS employees immediately raised concerns about ties between AGH CEO Paul Allen, Stolz and Meitzner. All three work as officers or members of the Greater Wichita Partnership, a quasi-public organization focused on economic growth.

Mitch Hansen, EMS shift commander, explained it in an email to Howell: “There is no trust at this present moment with any decisions at the county level … We keep hearing the same tune, same song, and seeing the same dance.”

By May 12, Stolz had backed away from the auditing firm. He instead suggested arbitration between EMS workers, Gallagher and Paul Misasi, deputy director of EMS operations, to “work their way through the issues” with an outside mediator, according to an email.

“Arbitration would insinuate that the relationship between Dr. Gallagher, Mr. Misasi and the employees of Sedgwick County EMS is repairable; which it is not,” EMS Capt. Brendan McGreevy wrote in a May 12 email to Stolz.

“As we stated, in both meetings held on the 26th and 28th of April, the employees of Sedgwick County EMS gave testimony and clearly stated a vote of no confidence in the clinical, operational, and administrative abilities of Dr. Gallagher, Dr. Pereira, and Mr. Misasi to lead the organization.

“A lack of leadership and the creation of a toxic, volatile, and unsafe work environment prevent the consensus of our colleagues the ability to negotiate any terms except the immediate termination or resignation of Dr. Gallagher, Dr. Pereira, and Mr. Misasi,” McGreevy wrote.

Two days later, the county hired local law firm Hite, Fanning & Honeyman to investigate.

___

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