An Oak Bluffs paramedic is accused of stealing morphine from a pre-filled syringe available on board an ambulance to treat patients, and replacing the narcotic with saline solution to cover up his theft, police said.
Edgartown police issued a summons to Tony White, 45, of Oak Bluffs to appear in court on a charge of larceny of a drug from an authorized dispenser. Mr. White, a staff paramedic for the Oak Bluffs emergency medical service, was filling a shift for the Edgartown emergency medical service at the time of the drug theft.
Mr. White admitted to police he used morphine, according to a police report. The sentence for that crime ranges from zero to ten years in state prison.
The Edgartown District Court will decide whether there is enough evidence to file a criminal complaint. Mr. White has not yet been charged or arraigned by the court. He told police he is seeking treatment at an off-Island facility.
“It’s an ongoing investigation,” Oak Bluffs ambulance chief John Rose said. “He has resigned from his position as a paramedic for the town of Oak Bluffs.”
Police questioned, but did not charge, Mr. White about the theft of a large amount of narcotics from a Tisbury ambulance in late December of last year. That investigation remains open. Mr. White told Martha’s Vineyard Drug Task Force investigators that he is addicted to opiates, but has not been involved in any other narcotics thefts.
According to the police report, Edgartown fire department deputy chief Alex Schaeffer, who manages the ambulance department, suspected something was amiss after he and Mr. White responded to an emergency on July 14. At the hospital, and during the return trip to Edgartown, Mr. White conducted an inventory of medications, part of the routine protocols to prepare the ambulance for the next run.
“Paramedic Tony White presented a pre-filled morphine sulfate syringe to Schaeffer,” wrote Edgartown detective sergeant Chris Dolby, who questioned Mr. White with other members of the drug task force. “White pointed out to Schaeffer that the seal (on the syringe) had been broken, however the syringe appeared to contain the proper amount of clear fluid. Schaeffer kept the syringe and they finished up their post call activity. Schaeffer then closely examined the syringe and made observations that were suspicious and concerned him.
“Schaeffer explained to me that he suspected that perhaps someone had removed the morphine from the pre-filled syringe and possibly replaced it with saline,” Det. Sgt. Dolby wrote.
Mr. Schaeffer told police he was aware of speculation among other Island emergency medical personnel that Mr. White might have substance abuse issues, according to the report.
“Given the circumstances Schaeffer wished to pursue testing of the liquid that was in the syringe,” Det. Sgt. Dolby wrote.
The test results Mr. Schaeffer got from a private lab on August 9 confirmed his suspicions.
“The full syringe should have contained 10/mg of morphine,” Det. Sgt. Dolby wrote. “The results indicated that the syringe only contained a very small amount of morphine. The amount which would be consistent with the residual amount after the narcotic had been administered. The lab was unable to identify the other substance in the syringe but it was not what it was supposed to be.”
On August 16, Mr. White voluntarily went to the Edgartown police station for questioning. “White said that he would speak to me without a lawyer as he just wanted to get this over with before he headed off-Island to a treatment facility,” Det. Sgt. Dolby wrote in his report. “White stated that yes he did take the morphine out. White said that that he used another syringe to remove the morphine and then injected saline back into the original pre-filled syringe. He said that he did this in the back of the ambulance while on the way back to Edgartown from the hospital.
According to the report, White told police he alerted Mr. Schaeffer to the broken seal on the syringe “to be sure that there was no possibility that the syringe, which now contained only saline, would be used on a patient. White then said that he took the morphine home and administered it to himself there.”
Policies and procedures
Once Mr. Schaeffer became suspicious, he did not schedule Mr. White for any more work on the Edgartown ambulance. The town hired Mr. White on a per diem basis to fill vacant shifts, and it was not contractually obligated to keep him on the schedule.
That was not the case in Oak Bluffs, where suspicions had also been raised about Mr. White. Asked why he did not take action prior to the incident, Chief Rose said he is bound by town personnel policies and cannot act based on speculation or rumors.
Once police decided to charge Mr. White, the Oak Bluffs ambulance department took immediate action, Chief Rose said.
“We have policies and procedures in place to handle such incidents,” Mr. Rose said. “Once the situation was brought to our attention, we followed those procedures. That’s the way we would handle any situation.”
Only so safe
Island emergency medical services work closely with the Martha’s Vineyard Hospital to prevent theft or tampering with medications. Following every ambulance run, emergency medical personnel restock any medications or equipment they used. They restock from the hospital pharmacy. Only hospital personnel have access to the pharmacy, and their entrance is recorded electronically. They must witness the restocking, and both hospital personnel and ambulance personnel must sign for the medications.
In the ambulance, narcotics are kept in a locked and sealed cabinet. After every run, a paramedic takes an inventory of the cabinet, resupplies it if necessary, and then locks and seals it again. The paramedic must account for all medications, and complete paperwork certifying that everything is in order. The seal would reveal if anyone subsequently opened the medication cabinet without authorization, which would trigger an investigation.
Mr. Rose said even with all the safeguards, protocols are based on a certain amount of trust in the ambulance personnel.
“There is always somebody responsible for the medications when they are put away,” Mr. Rose said. “We have it as tight as it can be, but there’s always room for something like this to happen.”
Reassess and review
Dr. Jeffrey Zack, emergency services director at Martha’s Vineyard Hospital, works closely with the Island’s first responders. His responsibilities include overseeing medical controls for the ambulance services and maintaining a working and teaching relationship with EMTs.
Dr. Zack said he is involved with every aspect of quality and safety and has been involved in the investigation process but could not discuss specifics.
“Working with our pharmacist, Dave Caron, and the state I believe that we have sufficient guidelines in place to ensure that this does not happen,” he said. “But certainly you always reassess what you are doing and maybe make some small adjustments.”