Tampered drugs found on Wake ambulances, but questions remain

Eastern Wake EMS, a Wendell-based nonprofit, is a contractor for Wake County EMS that provides services in the eastern part of the county.

On May 31, a paramedic at Eastern Wake EMS discovered what appeared to be tampered vials in the vehicle’s stock. After further inspection, five vials of morphine and three vials of fentanyl were found with suspicious damage, including what looked like puncture holes in the tops.

"It's something we take extremely seriously," says Jeff Hammerstein, assistant chief of Wake EMS, adding that the discovery of tampered vials is an immediate red flag. "If, upon inspection, you see that, it’s a stop-the-bus moment."

Supervisors started going through security video and employee key cards used to access EMS facilities to see who was possibly responsible.

"If we notice evidence of tampering, obviously we need to know where it’s coming from, who could potentially be involved," Hammerstein said.

Based on video and key card data, the investigation quickly spread. Two ambulances were discovered at Wendell Fire Station No. 2 with tampered vials. Another ambulance in Knightdale also had suspicious looking medicine vials. Finally, an ambulance in Raleigh also had vials with similar concerns.

In total, more than 30 morphine and fentanyl vials showed evidence someone was stealing the narcotics and replacing them with another liquid.

All signs pointed to Eastern Wake EMS technician Jason Dean. Security video obtained by WRAL Investigates shows Dean accessing an EMS warehouse multiple times, including three times in one day.

Internal investigatory reports called Dean’s movements “suspicious.” Among other things, the videos show Dean slowly closing doors behind him, peaking around corners and walking quickly in and out of the facility. External cameras showed Dean entering and leaving the building three times on May 30, driving his truck to the back of the parking lot for a short time, then returning.

During the course of the investigation, Wendell police, Knightdale police, Raleigh police, the Wake County Sheriff’s Office and the City-County Bureau of Identification were contacted. Less than 50 days after the discovery of the first tainted vial, Dean was charged with misdemeanor larceny and misdemeanor obtaining controlled substances based on evidence from Wendell police.

Thirteen days later, he pleaded guilty to the larceny and a misdemeanor related to dangerous drugs. He was given probation and forced to surrender his EMT license. No charges were brought forth based on evidence collected in other jurisdictions.

"For somebody who has no prior record, no prior convictions, that’s a pretty standard sentence," Wake County District Attorney Lorrin Freeman said, adding that, for many drug offenders, the priority isn’t necessarily prison, but treatment, which was also part of Dean’s sentence.

When asked why Dean faced only two charges despite evidence of more than 30 tampered vials, Freeman said drug diversion cases can be tricky.

"When it comes to trying to prove whether these drugs have been tampered with and putting together a case of how that’s happened, in order to prosecute in court, that can be challenging," she said.

WRAL Investigates also questioned why none of the vials was tested to see what, if any, foreign substance was used to replace the stolen narcotics.

Freeman said neither the State Crime Lab nor the local crime lab has the ability to do that sort of testing, but she acknowledged it may have been worthwhile.

"I think, in this case, there was an opportunity to pursue that perhaps further," she said.

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While not speaking directly about he Dean case, Hammerstein speculated on what could be in the vials.

"We know that, through the course of diversion in health care, it’s not uncommon for people to pull medication and refill with something like normal saline," he said.

Because there was no evidence any patients were actually harmed, Dean’s case didn’t warrant more serious charges, Freeman said.

"[I]t was a matter of whether pain medicine that they were administered, was it effective or not?” she said.

Internal reports show another ambulance tech who worked with Dean was asked whether it appeared narcotics failed to have the expected effect on patients. He recalled two cases where fentanyl failed to provide the expected amount of pain relief. Wake EMS didn't reach out to patients who were treated by Dean to see if they had unexpected or unpleasant results. The agency also said it didn’t receive any complaints about care.

Dean initially said he would talk to WRAL Investigates about his case, but he wanted to speak with his attorney first. Despite calls and texts to Dean after that conversation, WRAL Investigates never heard back.

"Our job is to detect it and stop it,” Hammerstein said to explain Wake County EMS' role in ending drug diversion.

The agency continues to develop new ways to track medicine and has protocols in place to make sure any unused narcotics are disposed and that disposal is witnessed, he said. The form that’s filled out to confirm two people were present when drugs were flushed takes more than a signature, it takes a thumb print.

EMTs are no different than other professions with access to drugs, especially during the opioid epidemic, Hammerstein said.

"We know we are risk for it just like everyone else, without a doubt. So, we’ve got to take care of each other before we take care of everyone else," he said.