Massachusetts Department Of Public Health Announces Regulatory Action Against Town Of Hamilton And 24 EMS Workers

Main Category: Regulatory Affairs / Drug Approvals
Also Included In: Litigation / Medical Malpractice
Article Date: 12 Dec 2008 - 7:00 PDT

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The Massachusetts Department of Public Health (DPH) today announced that it has suspended the ambulance license for the town of Hamilton based on an investigation of the training and certifications of a number of the town's emergency medical technicians (EMT). The Department has proposed that the license be revoked for a minimum of one year.

Investigators from DPH's Office of Emergency Medical Services found systemic and long-standing violations of training and certification requirements for Hamilton's ambulance service, which is operated by the Hamilton Police Department. Specifically, investigators found numerous instances of falsified training records, which stated that personnel had completed training and certification requirements when in fact they had not.

"This investigation has revealed serious problems in the way that the emergency medical services were delivered in the town of Hamilton," said Paul Dreyer, DPH's Director of the Bureau of Health Care Safety and Quality. "Training requirements are in place for a reason: to insure the highest quality of care for the residents of the Commonwealth. We take violations of these standards very seriously and the steps taken today show that the Department will take strong action for violation of these rules."

EMTs and paramedics in Massachusetts are required to undergo a minimum of 28 hours of continuing education, and complete an annual refresher course to maintain state certification.

In addition to training violations, investigators found that the town had:

- employed EMS personnel who were not properly certified and/or qualified to provide basic level care to patients;
- submitted false documentation to the Department to enable its EMTs to receive recertification credits;
- failed to ensure that its training programs were properly administered and conducted;
- violated the conditions of licensure by failing to establish and maintain a valid Memorandum of Agreement ("MOA") with a hospital-based physician for medical oversight (medical oversight for administration of epinephrine auto-injectors and the diagnostic use of glucometers);
- utilized an outdated version (2006) of Statewide Treatment Protocols;
- failed to provide training in the diagnostic use of glucometers or training in connection with changes to any Statewide Treatment Protocols;
- violated Drug Control Program regulations; and
- failed to ensure proper trip record reporting by its EMTs.

Based on these findings, DPH has also suspended the certification of 12 EMTs who signed falsified training rosters that were submitted to the Department. Those rosters were the only record of training submitted for these EMTs, and investigators found that the training did not take place. DPH has proposed that the EMS certification of these 12 EMTs be revoked for six months. DPH has also suspended the certification of the town's EMS Training Officer, and proposed that that individual's EMS certification be revoked for one year.

Eleven other EMTs received letters of reprimand for falsifying training rosters for a portion of their continuing education requirements. Four other Hamilton EMTs were cleared of any wrongdoing.

This is the first time that DPH has revoked a municipal ambulance services license, a fact that reflects the serious findings documented during the investigation.

The town of Hamilton has not operated its ambulance service since September, when DPH issued Notices of Serious Deficiencies to the town, pending the outcome of its investigation. The town voluntarily suspended operation of their ambulance service at that time. Since then, Lyons Ambulance Service, a private ambulance company, has provided emergency response service for the community. That service will continue and DPH (and EMS region 3) will work with Lyons Ambulance to ensure the highest quality of service is delivered to town residents.

Those whose certification has been suspended are entitled to appeal the decision, however the suspension is immediate and will remain in place during the appeals process.

A copy of DPH's investigation report can be found by visiting the DPH web site at http://www.mass.gov/dph.

Massachusetts Department of Public Health