Clearwater – City paramedics kept shoddy, incomplete records of the narcotics they handled, often neglecting to update logs for days, copying down incorrect information and whiting out other mistakes – all in violation of required routine practices, a county audit of the troubled department has found.
From January 2004 to May 2005, paramedics failed to sign their names nearly 1,000 separate times in the log that tracked the department’s most powerful narcotics, according to the Pinellas County medical director’s audit.
The audit, ordered after a veteran paramedic stole a drug 100 times stronger than heroin from a rescue vehicle, recommended wholesale changes in how the department tracks and monitors its drug supplies.
Fire Chief Jamie Geer said he has already implemented a new series of checks that he thinks will prevent further thefts.
The gaping holes in the department’s records suggest stolen drugs could have gone unnoticed for years. But there is no way to tell for sure.
“The system was flawed for quite some time,” said Geer, who became chief in September. “It was sloppy enough that (the abuse) could have happened at any time, and we wouldn’t be able to detect it.”
The monthslong audit unearthed rampant violations of common medical documentation procedures and specific countywide requirements.
Among the findings:
Paramedics tracked narcotics such as morphine using spiral notebooks with unnumbered pages, instead of hardbound journals that make tampering more difficult.
They went as many as seven days without accounting for any drug in the notebook, and incorrectly identified drugs 95 times in 16 months.
None of the drug records of the city’s special SWAT-medical team have been found, and Geer does not expect the files will ever be recovered, if they even exist, he said. The team controls the department’s most powerful drugs, including a drug that stops people from breathing.
The problems spanned all of the department’s eight stations.
The medical director, Dr. Laurie Romig, said her audit was not intended to uncover additional drug thefts by city firefighters, but focused on their record keeping. Firefighters will not be punished for their failures, Romig said.
“I don’t know how you would discipline an entire department,” Romig said. “I need to help the department work toward compliance.”
The director’s recommendations included adding locks to keep narcotics out of the hands of all but on-duty paramedics, increased training and spot inspections.
Other changes could come countywide, Romig said. Among them: one uniform, hardbound narcotics log.
“The good news is this will lead to a collaborative effort that will improve the system countywide,” Geer said.
Scrutiny of the department’s drug policies emerged in May after Darren Keith, an 18-year city paramedic, admitted to stealing two vials of the powerful drug fentanyl to satisfy a longtime drug addiction.
Keith had switched the 500-microgram vials with saline during an overtime shift at the Sand Key station March 27. He later told his supervisor that the vials may have been spoiled.
Keith, 44, who resigned and was later arrested, told investigators that his drug addiction was related to back pain. He injected the narcotic at home the next day, he told police.
More problems soon appeared at Station 49 where Keith normally worked, a separate police investigation found.
On April 6, Keith’s partner reported that a one-dose morphine syringe had been tampered with, but it was disposed of before being tested.
Later, a second dose of morphine was taken from a plastic container in an unlocked fire lieutenant’s truck, police found.
No one has been arrested for stealing the morphine, but police ruled out Keith, who is allergic to the drug. The investigation has been closed.
Geer fears what remains unanswered.
“My first thought was: “Holy Cow. Is that it? Or do we have a more widespread problem?’ ” Geer said. “There’s no way you can determine with certainty, with the kind of documentation we had in place.”