There's a Fine Line Between Secondary Assessments and Sexual Assault


Every so often, I hear of or read a story that makes me wonder if it is true or not. The most recent of these was an article in the Cleveland, OH, newspaper,

The Plain Dealer

. The headline read, "Veteran Cleveland paramedic set for trial on sex charges." The article spoke of the indictment of a paramedic who worked for the Cleveland EMS system after he was accused of sexually assaulting two patients six months apart. The paramedic was charged with, and will stand trial, for rape and gross sexual imposition.

In the most recent case, a man living at a residential drug-treatment center accused the paramedic of fondling his genitals for several minutes while he was strapped to a stretcher in the back of the ambulance. In the earlier case, a homeless man accused the paramedic of fondling him and performing oral sex on him in the ambulance. According to the newspaper report, the paramedic indicated he had given the man a full-body exam, but did not touch him inappropriately. Further, the accused paramedic's partner had constant visual contact on the man and observed nothing abnormal, but did witness the homeless man fondling himself at the hospital.

As I read and hear of such stories, I always wonder whether to take the word of a man living in a drug-treatment center and a homeless man or the word of a veteran paramedic with 20-plus years of experience. Should it matter whether the accusers are homeless or under treatment for substance abuse? Do they have just as much credibility as an individual who has worked for over 20 years as a paramedic in an urban system? All I know is that a 20-year veteran paramedic may go to jail, but even if he is cleared of the charges in the trial, he will never get his reputation back.

I saw this happen to a paramedic in St. Louis. It is almost the same scenario as the Cleveland story. A female who lived at a drug-treatment center had a seizure. Later, at the hospital, she made the accusation that the paramedic touched her genital area inappropriately as she was lying on the stretcher while being transported to the hospital. Now, I knew this paramedic and maybe I am a bad judge of character, but he was married and did not give the impression that he was a predator who preyed on the helpless. Nonetheless, the police were called and he was arrested. Later, he went to trial and was convicted, even though the patient had falsely made the same complaints about others in the past and that she supposedly experienced the paramedic touching her inappropriately while she was in a postictal (altered consciousness or confused) state after the seizure. I always thought the paramedic had a terrible attorney or that the jury members were not bright enough to understand everything. The paramedic served time in prison and, to this day, is still trying to clear his name. He recently called me to ask if I would help him do that. I had no problem helping him, since I think he got a raw deal. These situations and stories can be repeated. Just change the names and the cities.

It probably happens more often than we realize. I did a quick Internet search using the term "paramedic sexual assault." I found plenty of situations in which paramedics were charged with sexual assault, including one case in which a paramedic was accused of sexually assaulting a small boy who was being transported. In most of these cases, the faces of the paramedics were also plastered in newspapers.

I am sure there are some in the fire and EMS profession that have committed immoral and illegal acts against patients. And I am sure there are some that have been accused, found guilty, lost their financial ability to provide for themselves and their families, and also lost their good reputations.

A paramedic who is alone in the rear compartment of an ambulance with a patient can turn from hero to villain real quick, based on the comments of a patient turned accuser. There is a fine line between secondary assessments and being accused of sexual assault. In some cases, it may be necessary to do a head-to-toe survey, especially in unconscious patients. When doing the head-to-toe survey, a patient may not understand why they are being touched in certain areas. It is imperative to communicate to the patient, if conscious, what you are doing. Also, it is usually unnecessary to do any type of genital exam unless there is an injury, an imminent birth or a possible miscarriage.

I would hate to see us get to the point where we need witnesses to each secondary survey or a camera mounted in the back of the ambulance, but many services are using dash cameras to protect themselves during vehicle accidents. Continue to do your job, but be wary of those who file false reports — and if you are a predator in this profession, do us a favor, resign and get professional help.

GARY LUDWIG, MS, EMT-P, a Firehouse® contributing editor, is a deputy fire chief with the Memphis, TN, Fire Department. He has 30 years of fire-rescue service experience. Ludwig is chairman of the EMS Section for the International Association of Fire Chiefs (IAFC), has a master's degree in business and management, and is a licensed paramedic. He is a frequent speaker at EMS and fire conferences nationally and internationally, and can be reached through his website at