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Bailey: EMS ‘putting the public at risk,’ medical director said in resigning

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Steve Bailey

When there are two versions of a resignation — one the bosses want you to see, another they don’t — it’s clear which one you want. That’s especially true if it’s the medical director of your local ambulance service, a doctor overseeing, quite literally, matters of life and death.

It’s taken awhile, but today we offer you the untold story of why Dr. David M. French walked away from the troubled Charleston County EMS system.

Ten years ago the county’s ambulance system was named the nation’s best, but the past few years have been “especially challenging,” as Dr. French put it in the resignation letter his bosses didn’t want you to see.

The list is long: High turnover, staff shortages and poor morale. Slow response times. There were a couple of gruesome, unnecessary deaths, followed by investigations and costly lawsuits. More lawsuits over the use of ketamine, a drug used and misused to subdue troublesome suspects.

Then, in November 2020, Dr. French resigned as medical director — in the midst of a deadly pandemic and an opioid crisis no less. Challenging indeed.

At the time, Dr. French explained his resignation to the troops in a one-paragraph email with the cheery subject line “Thank you.”

“I wanted to take a moment to thank all of you for your hard work during my tenure as the medical director of the Charleston County EMS. It has been quite a ride! Unfortunately, it is becoming increasingly evident that I am the wrong physician to lead this agency in the direction that it is wanting to go. Therefore I am stepping down from this position. I wish you all the best in the future.”

French declined to elaborate at the time, but as Don Lundy, the county’s former EMS director, wrote in his own commentary on this page, it’s an “ominous sign” when your medical director resigns. Now we know.

The same day French sent out his resignation email, he sent a second letter to David Abrams, the county EMS director. That two-page rocket, finally unearthed through an open-records request, makes clear that French thought top management was “putting the public at risk.” He didn’t want any part of it.

“Despite my best efforts, I feel this agency is headed in the wrong direction,” he began. “Over four years CCEMS has drifted aimlessly without a purpose or a plan. There has never been a mission or a vision.”

French cited ongoing challenges in staffing and retention and the basics of answering 911 calls in a reasonable time.

“By all measures, our performance is worse today than it has been over the last few years, but we have never regrouped to try to understand why,” he wrote.

He blasted management’s “haphazard” and “mind-boggling decisions” on everything from training to operating ambulances with only EMTs rather than higher-skilled paramedics to “stalled” mental health programs. The agency failed to respond adequately to COVID and the opioid crisis, he said.

“Instead of identifying specific problems, our approach has been to lower our standards,” he wrote.

It’s a searing indictment from someone who was at the very heart of the county’s emergency response system. A Charleston County spokeswoman said the county doesn’t comment on personnel matters. Dr. French, who now works at Trident Medical Center and is on the Medical University of South Carolina faculty, didn’t respond to my phone call or email.

His letter didn’t mention Nathaniel Rhodes or Jamie Britt, who died 13 months apart in cases botched by paramedics and the cops.

In 2018, Rhodes, 58, died after being taken to jail for a blood-alcohol test rather than to a hospital following a car crash that left him with broken ribs and a lacerated liver. Jail video from Rhodes’ arrest showed paramedics joking as he moaned in pain. The city of Charleston and Charleston County paid the family $550,000 in a settlement.

A year later, Britt, 50, died after a paramedic gave him a shot of Ketamine while he was hogtied and shackled. Britt, drunk and combative, had been arrested by Mount  Pleasant police, who then called in the paramedics to take him to the hospital. The death was ruled a homicide, and the town of Mount Pleasant paid the Britt family $3 million. A separate lawsuit is pending against the county and two paramedics.

While no one will talk about it, there is evidence that Dr. French led by leaving. Five months after he resigned, County Council approved $2.8 million to add 44 new positions and buy and refurbish ambulances. “We all realize that we have a problem, and we need to fix this,” one council member said.

Some things don’t change. As of this writing, EMS was down 40 employees, a 17% vacancy rate, and it's seeking to recruit paramedics and EMTs from Australia. Top management — which Dr. French said “has never been unified behind a common purpose” — remains mostly unchanged, too.

The questions need to go well beyond David Abrams and his team. What of their bosses, County Council members? What did they know, and why didn’t they tell us?

We and our families, after all, depend on these paramedics and EMTs in the most frightening moments of our lives. Why are we just now finding out about all of this?

Steve Bailey can be reached at

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