Paramedic Hurt Patient on Purpose, Then Bragged about It on Facebook, State Says

Two years ago an East Tennessee paramedic bragged on Facebook that he intentionally drilled into a patient’s bone without anesthesia, then allegedly told other first responders this was a “teachable moment” on how to deal with troublesome patients.

The paramedic also instructed another first responder to insert a plastic breathing tube deep into the same patient’s nose but told her to coat the tube with alcohol-based hand sanitizer instead of lubricant.

“If you should ever find yourself drunk in my ambulance, do not become belligerent,” the paramedic wrote on Facebook during the incident. “I have a drill and I ain’t scared for a second to use it.”

Gordon Brett Stokes, 43, of Chattanooga, is accused of abusing the patient while responding to an emergency call about a drug overdose in Blount County during the summer of 2016. Details of the incident became public only recently after the Tennessee Board of Emergency Medical Services revoked Stokes' paramedic license last month.

When reached for comment on Friday, Stokes defended his actions and said his intentions had been twisted by state officials to inflate the case against him. Stokes said he was legitimately attempting to help the patient by injecting drugs into his bone marrow and clearing his airway and that he was teaching these techniques to his colleagues but that someone had "backstabbed" him by reporting him to authorities.

Stokes said he now intends to sue the state to have his license revocation reversed.

“It’s ridiculous. This was all a little witch hunt they did off a stupid Facebook post," Stokes told The Tennessean. "I was trying to teach them something. I don’t know if they weren’t interested in learning or trying to save their own skin, but needless to say the whole thing came back and bit me in the a--.”

The government says that Stokes not only harmed the patient with a bone drill and the nasal tube, but he also did so while his patient was suffering from an opioid overdose and needed to be rushed to a hospital. Additionally, instead of drilling the bone or inserting the tube himself, Stokes allegedly instructed two less-experienced emergency medical technicians to do so under the guise of conducting a training drill.

Finally, the state records say Stokes posted a photo of the patient on Facebook during the bone injection. Someone then commented on Stokes’ post, referring to the patient as an obvious drug user, records state.

Stokes responded: “Naaa I actually like the drill and ‘forgot’ the lidocaine bolus for this (expletive). Lubed his (nasopharyngeal airway) with alcohol hand sanitizer too. :-)”

The Tennessean has not independently reviewed Stokes' Facebook post because it is not publicly available online and no screenshots are included in state discipline records. However, the statements are recounted in the records and Stokes admitted to making the post, dismissing it as “ridiculous bravado" that did not accurately represent what occurred during the incident.

Stokes said he had been a paramedic for 14 years and previously worked in Alaska, Florida, Hawaii and Afghanistan. He worked for AMR Rural Metro Blount County at the time of the incident but was fired soon after his actions were reported. Stokes said he no longer works as a paramedic but wants his license revocation reversed because he has long-term goals of pursing a career as a nurse.

Records: Paramedic in no rush to help

The incident at the center of this case occurred on June 10, 2016, when Stokes responded to a call for help in Blount County, a suburban area south of Knoxville that has been hit particularly hard by the opioid crisis. The patient — who was wearing a neck brace and back brace from a prior injury — appeared to be suffering from a drug overdose after drinking heavily and consuming some hydrocodone.

The patient was then moved into an ambulance, at which point Stokes summoned two advanced emergency medical technicians (or AEMTs) to join him in the back of the vehicle. AEMTs are similar to paramedics but generally have less training and can perform fewer procedures.

State records say Stokes then began to conduct a “drill,” quizzing the AEMTs on what could be wrong with the patient. The AEMTs responded by saying he was suffering from an “obvious overdose” and that there was no time to “conduct class” when they needed to hurry to the hospital.

Stokes then instructed one of the AEMTs to give the patient Narcan — a drug that is used to reverse opioids — through an “intraosseous line,” which is an injection directly into a patient's bone marrow, most often in the tibia bone in the patient’s leg.

According to state records, the procedure was not appropriate for at least two reasons: AEMTs are not permitted to make these injections, and protocol justifies this type of injection only if the patient was in a much deeper state of unconsciousness.

During his phone interview with The Tennessean, Stokes defended the injection as both necessary and safely performed. Stokes said he guided the hands of the AEMT through the procedure and that the patient was more unconscious than what was reflected in state records.

“At this point, this guy was not going to die," Stokes said. "So I thought it was a great training opportunity for these guys."

A 'teachable moment'

After the bone injection, Stokes told the other AEMT to insert the breathing tube, known as a nasopharyngeal airway, which extends into a person's nose and reaches into the back of their throat.

The AEMT initially questioned this decision, insisting that the patient “had a good airway,” but Stokes told her “that he would explain later,” according to state records. The AEMT then began to put lubricant on the nasal tube, but Stokes “stopped her and instructed her to use hand sanitizer” instead.

Once the tube had been coated in hand sanitizer and inserted into the patient’s nose, Stokes removed it — revealing it was not necessary — and told the AEMT this had been a “teachable moment on how to deal with belligerent patients,” according to state records.

Stokes describes this conversation differently. He told The Tennessean that his "teachable moment" comment was in reference to how to deal with a drug overdose, not belligerent patients. Stokes also said he was teaching the AEMT that hand sanitizer could be used as an impromptu replacement for lubricant.

“I was taught that technique by an Army surgeon in Afghanistan,” Stokes said. “Everybody thinks that’s the craziest s--- in the world, but it’s actually not.”

The Tennessee Department of Health petitioned to revoke Stokes' paramedic license in September, with government attorney Paul Richardson describing the former paramedic as "reckless and macho" during a discipline hearing. The decision was unanimously approved by members of the Emergency Medical Services Board.

Stokes did not attend the hearing, but he sent a letter to state attorneys encouraging them to make his license "null and void."

“I have absolutely no interest in working as a paramedic again,” Stokes wrote. “Please mark me as never being eligible to reapply in case nostalgia gets the best of me."

State officials interpreted the letter as Stokes encouraging a full revocation of his license, but Stokes now argues a "null and void" finding is a lesser discipline than a revocation, which he says will prevent him from pursuing a career as a nurse.

https://www.tennessean.com/story/news/health/2018/10/30/tennessee-paramedic-intentionally-harmed-patient-opioid-overdose/1700902002/?fbclid=IwAR1mbsbEgp7OoHEGCHY_dm1M8_hqHkIaP3X6-Lz0INn2KSadqVBzbzKzuSs