Lawsuit alleges county concealed paramedics' misconduct

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Lawsuit alleges county concealed paramedics' misconduct

By CASSIE FOSS cfoss@islandpacket.com 843-706-8125
Published Saturday, May 21, 2011   |  1315 Words  |  

A Beaufort County paramedic photographed a naked patient and downloaded the pictures on his home computer -- one of several instances of misconduct county EMS officials didn't disclose to state regulators who were investigating whether the paramedic and his partner botched a different ambulance call, a lawsuit alleges.

The two paramedics were investigated by the state Department of Health and Environmental Control after being accused of mishandling treatment of Bluffton resident Brian Lanese, who was severely beaten in his backyard Oct. 30, 2008. Lanese and his wife filed suit against the county in October 2009.

Information gathered by their lawyer in preparation for trial indicates county EMS personnel "influenced" DHEC's investigation by not revealing previous instances of misconduct by the paramedics, according to an updated suit he has filed.

The attorney, Joel Bailey of Beaufort, filed the revised suit May 11, adding the new information gleaned from records and depositions since the original suit was filed. Circuit Judge Carmen Mullen is expected to rule in early June on whether to accept the revised suit.

Lanese and his wife, Tracy, seek up to $600,000 in damages. Brian Lanese was hospitalized for a month after the attack and still suffers physically and emotionally, the suit says.

Attempts this week to obtain comment from the two paramedics -- Jeffrey Knieling and Shayna Orsen -- were unsuccessful. Knieling referred questions to "management." Orsen could not be reached. Rusty Hollingsworth, the county's EMS director at the time, did not return phone messages. Current EMS Director Donna Ownby referred questions to county attorney Robert Achurch of Beaufort.

Achurch said Thursday he could not comment on ongoing litigation, saying only that the county is "vehemently" defending itself. If the judge accepts the revised lawsuit, Achurch said he will file a response before the trial, set for Nov. 28.

County administrator Gary Kubic also declined comment. "To say anything else would be prejudicial. It's complicated because there's (federal patient privacy) law and employee confidentiality agreements . . . ," he said.

'SELECTIVE' DISCLOSURE

The lawsuit says county EMS officials "selectively provided" information to the DHEC official assigned to investigate the paramedics' handling of the Lanese case. That investigator, Terry Horton, later acknowledged that his review "was closely coordinated with, and to some extent guided by, (former EMS director) Hollingsworth and Beaufort County EMS personnel," the lawsuit says.

After investigating, Horton submitted a report mildly critical of the two paramedics but silent on several key questions. Among them:

  • Why the paramedics concluded when they saw Lanese sprawled on the floor that he was drunk or on drugs. Lanese's wife had told them that he'd had nothing but iced tea.
  • Why they wanted to take Lanese to Hilton Head Hospital instead a Savannah hospital staffed and equipped to treat serious head injuries. They reversed course and headed for Savannah only after an emergency room doctor at Hilton Head Hospital directed them to do so.
  • Why Lanese's wife and a neighbor -- a paramedic himself who was off-duty -- had to carry Lanese to the ambulance with no help from Knieling or Orsen and without a backboard or neck collar to immobilize him.
  • Why the two paramedics spent nearly 20 minutes at the Lanese home, during which Lanese received little medical attention. EMS protocol recommends spending no more than 15 minutes.

    Horton's report included statements written by Orsen and Knieling -- but omitted those provided by Tracy Lanese and her neighbor.

    When Horton's report was released, two local legislators criticized it, saying it was "superficial," "incomplete" and raised "more questions than it answered."

    Contacted Thursday, Horton, who is now retired, said it would be improper to elaborate on statements attributed to him in lawsuit.

    WORK HISTORIES

    Horton acknowledged in a deposition, however, that if he'd known about Knieling's and Orsen's work histories, "his conclusions may have been different," the suit says.

    Horton also said Knieling's work record in years before the Lanese incident-- had DHEC known about it -- probably would have resulted in his EMT certificate being suspended or revoked, the suit says.

    Knieling joined Beaufort County EMS in May 1996; Orsen in March 2003. The Lanese lawyer's suit claims both had histories of misconduct.

    In one incident on March 2, 2007, EMS crew members saw Knieling videotaping and photographing a nude female patient with a head injury who was restrained, according to the suit.

    Knieling's co-workers reported what they'd seen to then-EMS director Ed Allen, who asked the Sheriff's Office to investigate.

    Knieling told deputies that he was "documenting" the patient's condition, had since erased the images and hadn't watched the video, showed it to anyone or downloaded it to any other computers.

    The lawsuit says Knieling agreed to a polygraph test, but failed it. Informed of the results, he admitted he downloaded the images and video to his personal computer but said he later deleted the files, the lawsuit says.

    Sheriff's Office investigators concluded Knieling had violated the patient's privacy under federal Health Insurance Portability and Accountability laws and broken county ethics and patient confidentiality codes. The suit states those findings were sent to Beaufort County officials, although it does not specify to whom. There is no record of Knieling being disciplined, the suit says.

    County documents show five other incidents in which co-workers or patients complained about Knieling's conduct, two of which resulted in warnings from his supervisors. One of the incidents involved a complaint from a female coworker who said Knieling "had made 'sexually inappropriate comments' concerning her to another coworker which were 'vulgar and demeaning,' " the lawsuit says. No disciplinary action was taken, it says.

    Orsen also had at least six warnings and reprimands, four of which were reviewed by EMS director Hollingsworth, according to the suit.

    In a 2003 incident, she was cited because she left the station in an ambulance without her partner, a violation of department policy that Hollingsworth called "poor judgment." In another 2003 incident, Orsen was heard saying she wanted to shoot a co-worker with a shotgun, an allegation also reviewed by Hollingsworth, who took no action, the suit says. In 2005, she was cited for having expired drugs on her ambulance. In 2007, she was cited for turning down her radio and missing an emergency call, the suit says.

    In August 2009, nine months after the Lanese call, Orsen was again cited for poor performance and carelessness when she "underestimated the need for additional resources to move a patient, which resulted in injury to the patient," according to the suit. Orsen's supervisor noted she was put on probation.

    It was unclear this week whether the paramedics are still employed by the county. Hollingsworth, the EMS director, retired in 2009 after announcing plans to leave several months before the Lanese incident.In concluding, the lawsuit alleges there was "an improper and unlawful attempt" by EMS officials to influence the outcome of DHEC's investigation and a propensity "not to document or report misconduct of its employees."

    In response to the Lanese case and other incidents that raised questions about the quality and speed of Beaufort County's EMS care, County Council hired a consultant in 2010 to review EMS operations.

    After months of visiting EMS stations, observing operations and interviewing employees, the consultants reported in January that the system provides "a sound level of service," but noted room for improvement.

    The consultants expressed satisfaction with ambulance response times, but said a streamlined dispatch process could speed departures from EMS stations.

    The consultants did not look specifically at the Lanese incident, but spoke highly of Beaufort County emergency personnel generally, calling them "great medics."