Former paramedic suspected in Texas hospital deaths

[Dustdevil]

http://www.kxan.com/dpp/news/crime/Nurse_i...wrongful_deaths

Nurse investigated for

wrongful deaths

Military investigators are handling

the case

Updated: Tuesday, 17 Mar 2009, 11:04 PM CDT

Published : Tuesday, 17 Mar 2009, 12:45 PM CDT

Shane Allen

Karen Brooks

AUSTIN (KXAN) - A former Austin nurse has been charged in the deaths of three of his patients at a San Antonio military hospital. Capt. Michael Fontana was a nurse at Seton in Austin and a paramedic for the Austin-Travis County EMS.

KXAN has not been able to reach Fontana, but on his Facebook page, he said he is innocent.

"All I gotta say is, a Civilian made a false accusation, but the [Air Force] is obligated to investigate and charge," he wrote on the Web site. "So I get to grin and bear it."

According to officials, Capt. Fontana administered lethal doses of medication to terminally ill patients in San Antonio. He faces charges of deliberate administration of lethal amounts of medication and conduct unbecoming of an officer for changing a medical document.

The punishment for these charges could lead to a court martial. The case started after irregularities were discovered in Capt. Fontana's administration of medications which may have resulted in the death of an end-of-life patient. During a subsequent investigation, other potential incidents were uncovered, which results in two other charges of a similar nature being filed.

Warren Hassinger, the spokesperson for Austin-Travis County EMS, said Capt. Fontana did not have any clinical investigations while he was working for them and says he had a clean record. The only other issue he mentioned was when, at one point, they looked into if he improperly back-boarded someone, which is a minor offense by EMS standards.

Hassinger said he is upset the investigators let other media outlets know of the charges before they called EMS to give them a heads up. EMS said they will not open up an investigation, because there were no clinical issues while he was employed at EMS. The EMS released this statement Tuesday afternoon:

Austin-Travis County EMS has confirmed Michael Vincent Fontana was hired by the EMS department on March 27, 2000. Mr. Fontana resigned from the department on May 11, 2006 to pursue military service. He left the ATCEMS Department in good standing.

During his tenure at ATCEMS, Michael Fontana had no clinical performance issues, based on a retrospective review of his clinical performance by the ATCEMS Office of the Medical Director.

St. David's Hospital spokesperson said "A review of his personnel records reflected nothing out of the ordinary. He left the hospital voluntarily to pursue other employment."

The military did not identify the patients called into question. The Wilford Medical Center mentioned "During the thorough investigation of that incident, other potential incidents were uncovered which resulted in two other charges of a similar nature being filed."

On Tuesday afternoon, Fontana posted some of the media coverage on his Facebook page and wrote, "This is the drama going on in my unit. Thanks you guys for being supportive. We'll go to trial soon, and hopefully all of this will be clear soon. Thanks again."

Fontana's site shows a popular guy with lots of friends, and an interest in hunting, outdoor activities and coming to Austin for events like Carnaval. He likes to go by the nickname "Foxy" and writes that he planned to one day open a liquor store.

He also noted with some humor that the coverage included descriptions of him like "Hottie."

The page filled with encouraging words from friends.

"Foxy, I'm thinking about you! Stay strong

"

"im sorry 2 hear about the insain crazyness ur having to deal with. stay strong and positive sweetie."

"Hey, dude, I am thinking of you and am sure it will all work out."

An obvious sense of humor runs through his page, in which he claims affiliation to the "Jamaican Labour Party." His interests, he writes, are water skiing, four-wheeling and snow-skiing.

His favorite quote is "Sorry, visiting hours are now over," and describes himself as "a fun, crazy, serious (when I have to be), sarcastic, hottie." He lists American Idol as his favorite TV show, Baghdad ER as his favorite movie, and he is a fan of author Michael Connelly, who specializes in detective novels.

[spenac]

Be interesting to see how this turns out.

[ERDoc]

I'd like to think that the fact his favorite TV show is American Idol is enough for a court martial.

[spenac]

I'd like to think that the fact his favorite TV show is American Idol is enough for a court martial.

Lol. Automatic death by firing squad.

[Dustdevil]

CLEARED!!

http://news.yahoo.com/s/ap/20091122/ap_on_re_us/us_military_nurse_trial

• Ex-Air Force nurse acquitted of killing patients
  
  Associated Press
  
  By PAUL J. WEBER, Associated Press Writer – Sun Nov 22, 2:40 am ET
  
  SAN ANTONIO – A court-martial acquitted a former military nurse of murder Saturday after he was accused of giving lethal doses of painkillers to hasten the deaths of three terminally ill patients at the Air Force's largest hospital.
  
  Capt. Michael Fontana, wearing his Air Force uniform, showed no emotion as a military judge cleared him of three counts of murder, then collapsed into the arms of weeping family members inside a Lackland Air Force Base courtroom.
  
  Military prosecutors had painted Fontana as a rogue and arrogant nurse who pumped patients full of fentanyl and morphine when they were not "dying quick enough." After the ruling, Fontana said he never second-guessed his treatment or dosages.
  
  "My intention the whole time was to take care of dying patients," Fontana said.
  
  Fontana, 36, said he wants to return to nursing.
  
  Seeing the verdict as a validation, Fontana said he hoped the ruling would serve as a lesson for others tasked with making sure the terminally sick are comfortable. One doctor testified in the court-martial that he worried the case would chill the use of painkillers on the gravely ill.
  
  Elizabeth Higginbotham, Fontana's attorney, said during closing arguments that a guilty verdict would open the "floodgates" for lawsuits against nurses when a dying patient finally goes.
  
  Col. William Burd, the military judge, also acquitted Fontana on one count of conduct unbecoming an officer for altering medical records.
  
  "We have great confidence in our military justice system and we believe a fair verdict was reached today," the 59th Medical Wing said in a statement.
  
  The hospital said Fontana will now undergo a clinical competency evaluation to determine whether he can return to being an Air Force nurse at the Wilford Hall Medical Center. He continued working at Wilford Hall while awaiting trial, though was stationed in the library.
  
  During the weeklong trial, Air Force prosecutors accused Fontana of changing hospital records, trying to cover-up his tracks and chastising other nurses for not being aggressive enough in treating the end-of-life patients. They argued that Fontana knew the lethal effect of the dosages he was giving.
  
  Fontana has been in the Air Force since 2006 and served a tour in Iraq in 2007. He worked as an intensive care nurse at Wilford Hall, which primarily serves military personnel and retirees but provides emergency and trauma care to some civilians.

[VentMedic]

The issue for end of life are not always clear cut and somewhat ridiculous when one considers them. Comfort care is with the intent that the patient will die but there is always the concern of over dosing a dying patient as the body starts to shut down and thus, some RNs do or even must back off on the meds with it being either the physician's or the family's request.

In the ICU I, as an RRT, also see a lot of this where the physicians are afraid to give a decent dose of pain and sedation medications in fear of the fine line of euthanasia but yet, I'm pulling the life support ventilator and removing the ETT in the process to leave the patient on room air or 2 liters NC with the intent for the medications to be the comfort part.

If the patient dies quickly after the ETT is removed, we all breathe a sigh of relief. However, if the patient continues to live for several hours or even days, keeping that patient comfortable and not having them begging us to put the tube back in becomes a stessor for all especially if they are a "noisy" breather in their final days which puts a strain on the family members who remain at the bedside as well as the health care providers.

Edited November 22, 2009 by VentMedic

[itku2er]

The issue for end of life are not always clear cut and somewhat ridiculous when one considers them. Comfort care is with the intent that the patient will die but there is always the concern of over dosing a dying patient as the body starts to shut down and thus, some RNs do or even must back off on the meds with it being either the physician's or the family's request.

I so agree with you its not always as the public views it they do not know what the Nurses (or others that are close to the daily care) go through emotionally when these things happen. The worse thing for me is when they deny the patient nurishment.

Edited November 22, 2009 by itku2er

[croaker260]

I so agree with you its not always as the public views it they do not know what the Nurses (or others that are close to the daily care) go through emotionally when these things happen. The worse thing for me is when they deny the patient nurishment.

I love how chastising other nurses for not doing their job is "proof" that he was overdoseing patients. If that was the case, Im a serial killer!

I don't know this, but I read between the lines a Nurse (who used to be a paramedic) who didn't fit in with "traditional nurses" clique (probably because of his "paramedic" upbringing and attitude) , rubbed them the wrong way, and now became a target...but thats just me. Seen that before with some medics who transitioned over to the other side.

[VentMedic]

I love how chastising other nurses for not doing their job is "proof" that he was overdoseing patients. If that was the case, Im a serial killer!

I don't know this, but I read between the lines a Nurse (who used to be a paramedic) who didn't fit in with "traditional nurses" clique (probably because of his "paramedic" upbringing and attitude) , rubbed them the wrong way, and now became a target...but thats just me. Seen that before with some medics who transitioned over to the other side.

Was it nursing or the military with their rules and regulations for end of life care and protocols that he did not fit into? I also get a little frustrated with the way the VAMCs handle end of life issues.

Col. William Burd, the military judge, also acquitted Fontana on one count of conduct unbecoming an officer for altering medical records.

I wish there was more information on this part.

[croaker260]

Was it nursing or the military with their rules and regulations for end of life care and protocols that he did not fit into? I also get a little frustrated with the way the VAMCs handle end of life issues.

I wish there was more information on this part.

Interesting point. However, the VA and the military medical systems are not/nowhere near the same. Granted its been a while, but when I was active and associated with a military hospital, someone would get more than an ass whooping for doing the crap I (we all? ) see going on in VAMCs across the nation every day.

Its the difference between a military run medical system (still far from perfect) and a civilian run government system. Though admittedly I've never seen them handle end of life issues (out side the ER/ICU) that much.