James Poole, 37, a former emergency medical technician at Mercy Medical Center, pleaded guilty in federal court to stealing fentanyl and hydromorphone from dozens of vials used by ambulances in Carthage and Mount Vernon, Missouri, and replacing the drugs with saline or water solution. On Jan. 23, 2020, paramedics with Mercy Medical Center in Carthage, Mo., noticed what appeared to be puncture marks on a fentanyl vial that was being used to administer the pain-killing medication to a patient. Paramedics then reported a second incident in which they drew fentanyl from a vial, into a syringe, and observed that there was not enough fluid in the vial to administer a dose to the patient. The remaining narcotics in the ambulances and the office stock were examined by officials at Mercy Carthage EMS, who observed that the fentanyl and hydromorphone on the ambulances and in the office stock appeared to have visible signs of tampering. The Mount Vernon Mercy EMS facility supplies were also examined since the facility is a sister ambulance location to the Carthage facility, with the same paramedics working at both locations. Officials observed signs of tampering for one fentanyl vial that were similar to those observed at the Carthage facility.
On the same day, officials with Mercy Medical Center in Springfield, Mo., contacted the Federal Drug Administration-Office of Criminal Investigations. Mercy Medical Center officials reported that 26 fentanyl and 43 hydromorphone vials appeared to have physical signs of tampering. Officials with Mercy Medical Center had the vials that were identified as being tampered with tested, and lab reports revealed that the vials had some of their original contents replaced with either saline or water solution. Supervisors and other personnel were drug tested on the date the tampering was discovered, and Poole tested positive for norfentanyl, an analog of fentanyl.
