Jenny Kane

jkane@rgj.com

A near-fatal medical incident last year has sparked renewed tension between Burning Man organizers and local authorities, none of whom can seem to agree on medical protocols for this year's event, which begins Sunday.

Burning Man organizers several weeks ago asked Pershing County Sheriff’s Office and Humboldt General Hospital officials to meet and sign an agreement that organizers believe will help to prevent any further medical accidents. The agreement intends to clarify medical personnel's responsibilities and procedures, Burning Man spokesman Jim Graham said.

Humboldt General Hospital officials refused to attend the meeting, which was cancelled, and Pershing County Sheriff Jerry Allen refused to sign the agreement. Allen told the Reno Gazette-Journal that the agreement was a roundabout attempt to prevent him from hiring Humboldt General Hospital paramedics, whom he wishes to hire as special reserve, or temporary, deputies for this year's event.

"We remain unclear as to what protocols those (hospital) medics follow when administering care to patients. We do not have a commitment to standardized ... hand-off of patient care should those (hospital) medics treat a patient," wrote Burning Man executive Harley Dubois in an Aug. 17 email to the Humboldt General Hospital Board of Trustees.

The proposed agreement is the result of years of strife between Burning Man and Humboldt General Hospital, the event's medical provider from 2011 to 2014. The tension came to a head in 2014 after a woman died after falling from an art car and Burning Man severed the $500,000, five-year contract with the Winnemucca-based county hospital a year early.

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In 2015, Burning Man organizers hired an out-of-state medical services provider, CrowdRx, to run its on-site hospital and clinics. Organizers were outraged when CrowdRx employees informed them of an incident on Sept. 6, when a Humboldt General Hospital staff member injected a Burning Man patient with ketamine because she was resisting officers, Dubois wrote in the email to the hospital board. Ketamine is a general anesthetic sometimes used for sedation and pain management.

“The participant subsequently went into respiratory failure twice and nearly died. Burning Man’s medical staff saved her life. Ketamine is a dangerous drug, especially when mixed with alcohol, and the participant – a 110-pound female – had been drinking,” Dubois wrote in an email to the Humboldt General Hospital Board of Trustees.

The hospital employee, emergency medical services Capt. Monique Rose, injected the woman with the drug while serving as a special reserve deputy under Pershing County Sheriff’s Office, according to contracts with the Pershing County Sheriff's Office. Rose, who remains employed at the hospital, declined comment on Tuesday.

After Burning Man medical staff made a complaint to Allen, Allen told Rose that she could not serve as a deputy during the remainder of the event pending any investigation. The Pershing County Sheriff's Office still is investigating the incident, Allen said, noting the office recently received further questions posed that he cannot discuss publicly.

Humboldt General Hospital CEO Jim Parrish said that the hospital would not comment on the matter.

"Humboldt General Hospital was not a part of the Burning Man event in 2015, and to the extent the Pershing County Sheriff’s Department utilized personnel who may otherwise be employed by HGH, these persons were not working as HGH employees while under the direction and control of the Pershing County Sheriff," Parrish said in an email last week.

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Because the patient was in legal custody at the time of the incident, Allen said he believed his deputies were allowed to administer any emergency response they saw fit.

The contracts that Rose and three other Humboldt General Hospital officials signed do not list medical responsibilities. However, Allen said that it was agreed upon verbally that they could medically assist any parties involved in a law enforcement incident.

"That's why they were hired, because they have that special dual training," Allen said.

A month after the incident, Burning Man staff notified the Nevada Department of Health and Human Services, but the department waited eight months before issuing a warning on May 12 to Rose and asked her to take remedial classes to ensure it would never happen again, according to state health department letters obtained by the Reno Gazette-Journal.

Rose's direct supervisor at the time, Jared Oscarson, former deputy chief of emergency medical services at the hospital, also received a warning, according to department letters, though both Rose and Oscarson's letters were rescinded two weeks later. Oscarson, who since has moved to Minnesota, is the son of Nevada Assemblyman James Oscarson, chairman of the Assembly’s Health and Human Services Committee.

Jared Oscarson could not be reached; James Oscarson said that he has no role in Department of Health investigations.

"I don’t know how they conduct one of those, but as far as I know that’s all internal," said James Oscarson, who said he had no knowledge of the Burning Man incident.

The rescinding letters apologized to Rose and Oscarson for any inconveniences and stated that the investigation had taken too long due to "difficulty contacting all parties involved."

"Any corrective measures are irrelevant after such a lapse of time," the letter said.

As a result, no "official record" of the warnings has been made because the health department closed the case and rescinded both warnings, according to department Bureau Chief Chad Westom.

Some members of the Humboldt General Hospital and the Pershing County Commission are concerned about the health department's response, or lack thereof.

“I was blindsided. I was shocked,” Board of Trustees member Richard Cook said, noting that Dubois' email was the first he had heard of the Ketamine incident. “I had no knowledge of any of this. There was rumor, but the reality was a lot more troubling than the rumors.”

The news of the incident and the health department's response also incensed Pershing County Commission Chairman Darin Bloyed, who is hoping that the sheriff's office signs an agreement with Burning Man organizers but also is hoping for further investigation into the Ketamine incident. At the very least, he expects that contracts, which he calls "vague at best," will better detail the boundaries of special reserve deputies hired for the event.

"That creates a huge liability for the county, especially if we don’t know about it," Bloyed said. "That could have been really horrible."

Allen said that he intends to create more detailed contracts for this year's event, specifically addressing the deputies' medical responsibilities and privileges.