Decision Called ‘Good-Faith’ Gesture : Paramedic Reinstated Pending Investigation

Describing their action as a gesture of “good faith,” county officials Tuesday reinstated an Oceanside paramedic they had suspended just four days earlier for violating a trauma physician’s orders regarding the transport of an accident victim.

In a prepared statement, Chief Administrative Officer Clifford Graves announced that county health authorities had decided to reinstate David Snyder “at the request of the city pending a complete review of this incident and subsequent investigation.”

Graves described the action as one “taken in good faith” and intended to “hasten the resolution of the conflict between the county and the City of Oceanside” over trauma care and the transport of patients.

Snyder, 26, was suspended Friday in connection with the response to a traffic accident Aug. 5 in Oceanside. Members of the medical staff on duty at the Scripps Memorial Hospital trauma center in La Jolla the night of the accident had directed Snyder to take the victim to Palomar Memorial Hospital in Escondido, the nearest trauma center that could handle the case at the time.

But Snyder, bound by an Oceanside City Council policy that prohibits paramedics from taking patients outside the city limits in the absence of Life Flight helicopter service, refused. Instead, he took the victim to Tri-City Hospital, which repeatedly has failed to earn designation as a trauma center and is suing the county to be included in the emergency medical-care system.

The patient was released two days later, and no questions have been raised about the patient’s care while at Tri-City. But the county launched an investigation into the episode and suspended Snyder for refusing to follow the trauma physician’s orders.

In a telephone interview Tuesday, Snyder, an Oceanside paramedic for four years, said he was very happy to be reinstated but remains bitter that the county suspended him in the first place.

“It just seems really unjust,” said Snyder, who initially was upset by the action but now feels that “the worst is over.”

“I was just doing my job, following orders from the people who give me my paycheck and doing what I thought was the right thing for the patient. (The suspension) made me feel like they were putting my credibility on the line.”

Snyder also said he was troubled that he did not receive “any official explanation” for the suspension from the county nor a formal notice that the action had been taken. Snyder learned of his suspension when he read about it in a newspaper.

“It’s like they didn’t even make an effort to contact me,” Snyder said. “It’s kind of funny, because I just picked up my letter of reinstatement, but I never did get a letter informing me of the suspension.”

Snyder said that despite “100% support” from the city and assurances that “our jobs are not in jeopardy,” Oceanside’s paramedics are “pretty stressed out” by the city-county dispute and eager “to get this mess solved.”

“It’s always in the back of our minds and definitely adds to the stress of an already stressful job,” Snyder said. Still, he added philosophically, paramedics “can handle” being “pawns” in the trauma battle if “it helps rectify this problem.”

“Somebody has got to open their eyes and realize that North County has been left out of the trauma program,” he said. “If we (paramedics) are the ones who have to open the public’s eyes, then that’s the way it is.”

In fact, Snyder said, he would risk suspension and disobey a county trauma physician’s order again if faced with a situation similar to the one that occurred Aug. 5: “I’d stick with the city and do as I’ve been ordered--transport to Tri-City.”

County officials would not elaborate on why the suspension order had been lifted nor on any other aspect of the case, saying only that an investigation is continuing.

Asked whether it is possible that Snyder could be suspended again, depending on the outcome of the investigation, David Janssen, the county’s assistant chief administrative officer, said, “Any speculation is premature.”

Snyder’s reinstatement comes on the heels of threats by Oceanside officials to take the county to court in an effort to prevent further “interference” similar to the suspension. City leaders have hinted that they may seek a court injunction against the county until the trauma squabble is resolved.

On Tuesday, Oceanside officials changed their tune somewhat, however. Mayor Larry Bagley, who had called the suspension a “capricious and retaliatory action,” said that as long as “the suspension is lifted and the door is open for negotiations,” the city would not pursue legal action.

Officials will, however, stand by their policy prohibiting paramedics from transporting critically injured patients outside the city limits. They have argued that sending an ambulance to the nearest certified trauma center, Scripps Memorial Hospital in La Jolla, would leave the city vulnerable for too long in the event of another emergency.

“Our basic position hasn’t changed, and we will now work quickly with the county to come up with a long-range solution to the transport problem,” Councilman John MacDonald said. “I’m glad the county has agreed with us that it’s not fair to punish paramedics and put them in the middle of this controversy.”

Among alternatives being discussed is the placement of a county-funded backup ambulance in North County to serve Oceanside, Carlsbad, Vista and unincorporated areas.

Fire Chief James Rankin said that Snyder, who has been working as a firefighter since his suspension, will rejoin the force as a paramedic next week. Rankin also said that fire administrators have assured the city’s 22 certified paramedics, through written directives and in counseling sessions, that they “have our full support.”

“They are understandably concerned,” Rankin said. “But we’re doing our best to alleviate those concerns and let them know we will do whatever’s necessary to protect them from any penalty that may result from the city’s policy decision.”