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Goliad EMS administrator keeps job despite medical directors' concerns

By Sara Sneath
April 15, 2014 at 11 p.m.
Updated April 14, 2014 at 11:15 p.m.

Peggy Fonseca

Goliad County Judge David Bowman said Tuesday that it is safe to be transported in a Goliad County ambulance, offering his support for the county's emergency medical services administrator, Peggy Fonseca.

"I have the highest confidence in Peggy's ability as our EMS administrator. We heard the allegations and conducted a full investigation," Bowman said.

The commissioners court accepted the resignation late Monday of two EMS medical directors who questioned Fonseca's practices.

At issue was a protocol that tells paramedics how to care for patients while they are en route to the hospital, said Dr. Claire Zengerle, one of the EMS medical directors who resigned. Ambulance services are required to have a doctor serve in the role of medical director.

Some of the medications called for in the protocol did not match the medications carried on the ambulances, she said. She approached Fonseca about the discrepancies and was given a document different from the protocol being carried on the ambulances, she said.

Zengerle said she lost trust in Fonseca, feeling lied to when the two protocols did not match. As a result, Zengerle wanted to see the matter dealt with the same way she would if she had lost trust in an employee: She wanted Fonseca out of the position.

Drs. Zengerle and Mark Heard gave the commissioners court an ultimatum: Either Fonseca needed to go, or they would.

In addition to hearing the testimony of the doctors, Fonseca and EMS employees, the court received several letters of endorsement from area health providers.

Lisa Price, director of trauma services and emergency management with DeTar Healthcare System, wrote in a letter that in a county with no hospital resource, a strong EMS is crucial.

"Goliad EMS has demonstrated time and time again a commitment to excellence and a desire to provide the best patient care possible for the residents of Goliad County and those passing through," she wrote in the letter.

After nine hours in a closed-door meeting Monday, the commissioners court chose to keep Fonseca and drop the two doctors.

Commissioners Julian Flores, Ronald Bailey and Bowman voted to bring on Dr. Sharon Malone as the new medical director. Commissioner Ted Long voted against the new hire. Commissioner Alonzo Morales abstained from the vote because his wife works in the EMS department.

Sherman, where the new medical director lives, is about six hours north of Goliad.

There is no requirement that a medical director be located within the area the EMS provider serves, said Texas Department of State Health Services spokesman Chris Van Deusen.

A day after the commissioners court concluded its debate over Fonseca's job, she received a surprise inspection from Texas Department of State Health Services.

The inspection came after a tipster told the state that the EMS may be out of compliance, Van Deusen said. The results of the inspection and the person who tipped off the state department are not available to the public, he said.

Fonseca, though, said the inspection went well. The few problems that were spotted were minor and were fixed during the inspection, including a no- smoking sign not openly displayed in the ambulance, she said.

The EMS protocols in question were last updated in late 2011, she said.

"We run a good service. Our license has never been in jeopardy. The ambulance is very safe," Fonseca said.

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