Press Release: “The Paramedic Heretic” Exposes Curious Conundrums within EMS

The author was not even out of medical school before he witnessed his first doctor commit murder. It would not be his last – Lord, no – but he can recall that night as vividly as though it happened last week. Few medics forget their first physician homicide.



heretic-cover-1When Patrick McDonald began rescue training in the 1970s, he was among the first paramedics in the nation, filled with the zeal to save lives in ways not imagined even a decade before. More than 20,000 911 calls later however, pride in his profession has eroded. So he turned to his three-decades of note-taking to scribe an imminently readable, jaw-dropping assessment of the power struggles within the cloistered world of rescue – a battle that sometimes has fatal consequences. He also defines what he calls the “Immutable Laws” that reign supreme in the business of saving lives.

McDonald, having experienced the trenches of rescue for more than 30 years, offers story after story in which rules and policy corrupt paramedic efficiency. He details some success stories, but reveals dozens of cases where the consequences of protocol short-circuit rescue efforts. In one fascinating case the author himself nearly lost his medical license because he authorized a non-EMS helicopter to fly out critically injured Girl Scouts in a Palm Springs bus tragedy – until the famous Sonny Bono (who had been on the disaster scene) saved the day.

“The Paramedic Heretic” – a first-person account of San Diego’s PSA Flight #182 tragedy

“The Pedigree of a Paramedic Heretic: Immutable Laws and Ethical Illusions” reveals that time after time, saving lives is not rescue priority. Instead, following policies, ensuring team safety and avoiding lawsuits all trump patients’ lives. “Heretic” also points out numerous medical myths, such as ambulance sirens saving lives (they don’t); the “Golden Hour” of patient care (one doctor’s silly fantasy); and the futility, in many cases, of CPR. Some of the biggest problem areas, McDonald writes, are mistakes made in prescriptions; wholly unnecessary surgeries and flawed medical records.

That paramedics remain mute in the presence of incompetent or criminal physicians, for fear of losing their jobs, is a maddening reality. Saving lives, in the end, has become far more about capitalism and power struggles, than heroism.

Author K. Patrick McDonald knows of what he writes. He was appointed the first EMS supervisor for San Diego city and created one of the country’s first Special Trauma & Rescue teams. McDonald, a graduate of University of California, San Diego School of Medicine original advanced field medicine program, co-wrote the National Pool & Waterpark Lifeguard Training Manual. He has served as a consultant to the U.S. Secret Service and Super Bowl XLIX in Phoenix

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NYC Doctor and Wife Leap to Their Deaths in Suicide Pact

In downtown New York City a doctor and his wife jumped to their deaths from a Midtown high-rise early this morning. They each carried what is referred to by investigators as a ‘letter of intent’ that indicated they had serious financial problems, according to an NYPD spokeswoman.


Doctor and wife’s bodies lay covered in the street early this morning in New York City. (photo by Seth Gottfried)

Doctor Glenn Scarpelli, age 53, and his wife Patricia Colant, age 50, apparently leaped from their 9th floor clinic, located in a 14-story business building at 33 Street and Madison Avenue. They are believed to have jumped from a window about 5:45 a.m.

“We had a wonderful life,” one of the notes said. It went on to reference to a, “financial spiral.”

Dr. Glen Scarpelli and his wife, Patricia, jumped to their deaths from a rooftop on 33rd St. on Friday.

Doctor Glenn Scarpelli

The couple worked together at Scarpelli’s chiropractic clinic, known as the Madison Wellness Center, where for a time former New York Yankees manager Joe Torre was a patient.

The ugly deaths in the street left the couple’s neighbors stunned. They were known to frequent neighborhood restaurants and bodegas and were well-liked. “He was the happiest guy you’d ever want to meet,” said Robert Bisaccia, who worked for an architectural firm in the same building.

The staff at Beckett’s Bar & Grill  was emotionally crushed by the news, the owner said sadly.

“He was a family man,” said a neighbor. “He always talked about his son and his daughter. I can’t comprehend why they did this.”

The boy is 19 and the daughter is 20. They are both college students.

The NYPD Head of Detectives, Robert Boyce, said the motives for the double suicide are not yet clear. “We just don’t know right now,” Boyce said.

NTC High-rise

The Madison Avenue Wellness center was located on the 9th floor. (photo by Marcus Santos)







Nevada Immigrant Doctor Jorge Burgos Assaults 7 Patients; Get 7 Days in Jail. Ole!

(We are indebted to Charles Weston, DoctorWatchdog, for advising us of this case)

Yesterday in the city of Las Vegas a freaky physician was sentenced to a jaw-dropping 7 days in jail, after sexually assaulting 7 different women during medical exams at his clinic. And no, we’re not kidding.


Dr Jorge Burgos

“Are you going to get me in trouble for doing that?” (Doctor Jorge Burgos, to patient he had just assaulted in a Las Vegas exam room)


The punishment – if any normal person can call it that – for Doctor Jorge Burgos, means this lab coat lunatic will serve a whopping 1 day behind bars, for each of the attacks, in return for his confession of Gross Lewdness Involving Patients. 

“You are ordered to reflect, each day, about what you did to each of these women.” (Clark County District Judge Richard Scotti) 

Well, damn it, that oughta teach him. 

After the sentencing, Crane Pomerantz – and that would be the daffy doc’s lawyer – asked the judge if his medical miscreant client could serve his 7 days on weekends. Yeah, he really did. After all, his 168-hours behind bars shouldn’t have to be served all in a row. That might interfere with his appointment schedule. As is typical when it comes to weenie legal “punishment” of MDs meted out by the courts, the judge agreed. The last thing the judge would want to do is inconvenience a sexual predator.

“This event, this series of events, have caused Doctor Burgos great shame.” (Attorney Crane Pomerantz)

News flash: The idiot’s idiot behavior embarrassed him when people found out. Who knew?

The doctor, who was first arrested September 21 of last year, was handcuffed and taken away once again in October when more victims came forward . But his first known chimp-on-chocolate behavior was actually reported by a woman as far back as 2011. But no charges were filed and of course the nutcase continued on his merry way.

“You must take a 4-hour online course on “victim empathy” and attend therapy sessions.” (Judge Richard Scotti)

Well just grab your giggling guppies. That oughta teach him.

Bawdy Burgos, who has actually lived to be 50 without being throttled by a spouse of his victims,  was originally charged on 16 counts of Gross Lewdness. All but 3 charges were dropped when he agreed to confess.

According to the court record, at least 6 other women patients reported to Las Vegas Police that “the doctor kissed, groped and touched them inappropriately” while he supposedly performed physical exams at his clinic. 

One woman described an encounter when Burgos lifted her blouse, opened her bra and started kissing her breasts.  Complaints by other victims were similar in nature.

After this wholly ridiculous, slap on the poopy-butt sentencing, the doctor hugged his family and smiled for the cameras. He’ll be back to undressing patients on Monday morning. 

The Nevada State Board of Medical Examiners website shows this medical moron as “a physician in good standing.”

Bad-boy Burgos’ clinic happens to be located at 1815 E Lake Mead Blvd, Suite 314, in North Las Vegas, Nevada 89030. If you or your family are in need of a doctor, you might want to make a note.

Our Observation:

Bad-boy Burgos is an excellent example of what is known in the halls of medicine as a Third World Assassin. He immigrated here from the Dominican Republic after attending the  University Nacional P H Urena in  Santa Domingo in the 1990s. Like many foreign-born MDs, he has found the U.S. system easy pickings for his perversions. In a sane society, this urban gorilla in a lab coat would have been deported immediately. Instead, he’ll lay low for a while and then his sexual exploits will be back in the news again.

Oh, you can count on it.

Here’s another peek at this rarely discussed problem of physician predators:






California State Agency Names Surgeons with Highest Patient Death Rate

“This is the first time California has ever reported the surgical mortality results for individual doctors. It will help patients choose better surgeons and a better hospitals, and will provide an incentive to improve quality care.” (Dr. David Carlisle, Director, Office of Statewide Health Planning and Development)  

As of this month, California residents can now learn the names of both hospitals and surgeons that score higher or lower, when it comes to cardiac bypass death rates. 


The Office of Statewide Health Planning & Development, which compiles statistics, now publishes coronary bypass death rates for 300 cardiac surgeons working at 120 hospitals. That’s the good news. The bad news is the most recent information covers surgeries performed in 2003-2004. In other words, the information is 14 years old.

The study was ordered by the California state legislature in 2003 and cost just under $2,000,000. It revealed that while 95% of California heart surgeons scored at, or about the expected, mortality average of 3% patient deaths, some performed considerably better, and some measurably worse.  As an example, Doctor Alexander Giritsky at La Jolla Scripps Memorial, was one of only 4 surgeons with the lowest heart bypass mortality rates. Not one of his 126 surgical patients died.

On the other end of the scale,  Doctor Jeffrey M. Rosenburg and Doctor Leland B. Housman were among the 12 physicians with the highest patient death rates. Rosenburg operated on 12 patients – 3 of whom died. Housman performed surgeries at Scripps Mercy in San Diego. Rosenburg operated at Palomar Medical Center Escondido. Housman operated on 140 patients – 9 of whom died during the reporting period.

By contrast, at Arcadia Methodist Hospital, a surgeon named Ismael Nuno tallied just under a 90% patient death rate.

About 400 patients each week undergo bypass surgery in California. Called a “cabbage” behind closed doors, the CABG procedure normally involves taking a blood vessel from the chest or leg and using it to create a new route for blood flow within the heart. 50% of these procedures are done on emergency patients.

It is important to note that dire surgical outcomes ought not be laid solely at the feet of the physicians. Some surgeons are quick to point out – and rightfully so – that their statistics are skewed from the start, because they are treating extremely sick patients to begin with, whose chances of surviving – especially in an emergency – are poor at best. Doctor Housman said it very well. “They died mainly because I accepted a mix of people who were older and sicker than most other surgeons are willing to take.”

Here’s another look:


Clinical Cooties: They Only Kill 100 People a Day, So Who Really Cares?

So which nifty little item commonly used in healthcare is most likely to carry nasty boogies from one sick patient to another?


Trust us: Sloppy medical professional hygiene sickens 1,000 patients each day, and kills 10% of them. Go ahead. You do the math.

Why, the stethoscope, of course. Ask practically anybody in a lab coat (which incidentally also carries ten tons of cooties) and you’ll get the quick answer that – just like grubby doctor hands – stethoscopes can – and do – transmit millions of invisible critters, all over the hospital, every damned minute of the day.

So according to a recent study, how many doctors do you suppose bother to clean their stethoscopes between patients?


Not a one. And that fact was determined to be true even after educational intervention was instituted, about how essential stethoscope hygiene actually is, in preventing infections.

Doctor Covering His Ears Over White Background

“I’m too busy to listen to facts!”

So a big fat “zero” number of doctors bother to wipe their stethoscopes with antiseptic pads between patient encounters, according to a study published in this month’s issue of the American Journal of Infection Control.

The investigation team – staffed by MDs from Yale University School of Medicine and the V/A in West Haven Connecticut – reported they already suspected the results would be poor.

But they were outright stunned to discover NO doctors were disinfecting their stethoscopes. After all, the Centers for Disease Control  guidelines mandate that reusable medical equipment must undergo disinfection between patients. That’s called a law with no teeth.

So physicians resist obeying the rules. Who knew?

The rotten study findings were especially confounding to the organizers, because second-year med students are taught early on, the importance of compliance, as one step of several that evaluate history & physical performance competency.

“Stethoscopes are used repeatedly throughout the work shift and become contaminated after patient contact. They must be treated as potential germ transmitters. Failing to disinfect stethoscopes can constitute a serious patient safety issue similar to ignoring hand hygiene.” (APIC President Linda Greene, RN)

A recent Swiss study found that stethoscopes were capable of transmitting lethally resistant bacteria, including methicillin-resistant Staphylococcus aureus (MRSA). Pathogens cultured from stethoscopes include Staphylococcus aureus, Pseudomonas aeruginosa, Clostridium difficile and vancomycin-resistant enterococci. 

The doctors underwent a quality improvement project in which they were supposed to follow standard hygiene, using alcohol swabs or disinfectant wipes, at a teaching hospital. Most of them washed their hands. No one bothered with stethoscope cleanliness.

At the mid-point in the study, the investigators stepped in and reiterated the importance of stethoscope hygiene between patient encounters. They underscored the safe practices expectation, that the physicians follow proper protocols. It didn’t matter what they were taught, the doctors in a real-time, real-patient environment, simply refused to clean their stethoscopes. 


Hand hygiene rates were lower than anticipated, 58% initially and 63% post-intervention, which was not statistically significant. Stethoscope hygiene never occurred during the 128 initial and 41 post intervention observations (see Table 1)

Table 1       Stethoscope and hand hygiene before and after the multimodal intervention
  Before   (performed) After (performed) P value
Hand Hygiene 73/126    (58%) 29/46      (63%) 0.55
Stethoscope Hygiene 0/128      (0%) 0/41        (0%)

The authors ended the study by stating that the project demonstrates routine education may not be the answer to the problem of stubborn doctors, and stronger efforts may be necessary to change the careless culture and careless habits.

To which we at Medical Miscreants say, “No shit, Sherlock.”

Doctor Carmen Puliafito and USC: The ‘White Coat Conspiracy of Silence’ Comes Across Loud and Clear

“In one now-discovered video, Puliafito uses a butane torch to heat a large glass pipe outfitted for methamphetamine use. He inhales and then unleashes a thick plume of white smoke. Seated next to him on a sofa, a young woman smokes heroin from a piece of heated foil.” (L.A. Times investigation report)


Up until last year Doctor Carmen Puliafito was the dean extraordinaire of Keck School of Medicine, at the University of Southern California in Los Angeles. He served the school as an administrator, a respected physician and a stunningly successful fundraiser.

Dr Carmen PuliafitoWhen he abruptly resigned in March, 2016, he told everyone he had made the decision to look into other interesting challenges – specifically, to take a key position with a drug company called Ophthotech, which was creating new medications for eye conditions.

He was praised by the university’s president for his work in helping elevate Keck to among the finest medical schools in the nation. He was lauded in the school paper – The Daily Trojan – and raved about on local news.

Sarah Warren (3)

Sarah Warren overdosed while partying with the esteemed doctor (photo by L.A. Times)

But . . . but, did any of these Puliafito cheerleaders bother to mention that the man’s resignation happened 3 weeks after a 21-year-old woman overdosed, when he was in the same Pasadena hotel room?

Don’t be ridiculous. Transparency is not a common protein to be found in modern healthcare DNA. There are reasons the Wizard draws curtains.

Now, USC’s super-hero dean, age 66, was neither charged nor arrested at the time, in spite of the fact that he was found in a hotel room with an unconscious prostitute and a cache of illegal drugs. But when an unknown caller who was familiar with the incident contacted the USC president’s office – the party-hearty doc decided to resign. 

On the night in question investigators discovered methamphetamine in the Pasadena hotel room. Puliafito was considered by Pasadena police to be simply a witness to the near-lethal overdose. That decision was highly questionable in itself.

“My girlfriend here had a bunch of drinks and she’s sleeping,” the doctor told the 911 dispatcher. Asked whether the woman had taken anything else, he replied, “I think just the alcohol.”

Detectives looking into the case interviewed enough friends and acquaintances to find out that – as busy as the doctor-dean-fundraiser was – he seemed to have plenty of time to party with a circle of drug pushers and users – at least some of whom reported that Puliafito used drugs himself whenever a party broke out. It was beginning to appear that Keck’s dean of medicine was leading a curious doublelife.

Investigators learned of numerous failures in medical ethics as well as potential crimes. There is evidence that Puliafito – an eye specialist – wrote prescriptions for breathing inhalers for at least 2 of his party pals, evidently to calm their symptoms after smoking meth. And police soon knew that on the night of the overdose, the doctor lied to the 911 operator by reporting the unconscious woman was “just drunk.” A blood test performed at the ER later proved that she was,“obviously under the influence of narcotics,” and the doctor certainly knew it.

In spite of the squalid details, Puliafito’s secret partying ways expose embarrassing questions for USC Medical School. What did university administration know about the squirrelly doc’s miscreancy, and how long did they know it? Why was he allowed to remain on staff after the incident at the hotel? In June of last year, 3 months after Puliafito’s sudden departure, he was honored by various USC administrators, including President C.L. Max Nikias and Puliafitio’s immediate boss Michael Quick, who chose to remain silent for more than a year when investigators came calling.

Now, it is true that USC is a private university. But it does collect millions in public funding for its medical research, and as such, we believe it owes the public just a bit more transparency. As dean, Puliafito supervised hundreds of medical students and many professors. The likelihood that he was deeply involved in repeated criminal and ethical misbehavior reflects just a tad poorly on the values and leadership of the university as a whole, does it not?


“The med students are just crushed by this. Totally shamed.” (One second-year resident who asked not to be named)

But, as is almost always the case when it comes to medical operandi, the White Coat Conspiracy of Silence kicked into high gear, until they had little choice but to finally speak up. They were hoping it would all blow over quickly. After all, the American citizenry – in love as they are with their silly little text-tools – possess a remarkably brief attention span. But here’s a news flash for USC President Max Nikias:

What you are experiencing now is the tip of an iceberg. And some of us are absolutely paying attention.

Here’s another look at this seriously squalid case:

What’s a Creative Way to Lose Some Weight? Why, Start Tossing Out Some Unneeded Body Parts

So let us guess: you believe with all your heart that your own personal body just happens to be a God-given concoction of cosmically critical parts, am I right? Got a bunch of stuff inside you that you just can’t do without?


Next time people tell you they don’t believe in evolution, ask them why they happen to have all the spinal linkage needed for a tail

Well . . . not exactly. The truth is freakier than that. Your body – just like the bodies of your neighbors and your kin and your frenemies and even your boss – is far more like a creepy episode of “Storage Wars.” Oh, sure, there’re a few rather key components tucked away in your corpus, but the reality is that you – and everybody else found wandering at the mall – happen to be chockfull of all sorts of random stuff you don’t even need. And what really gaggles the goose is that some of those internal items can do you far more harm than good.

Today is Sunday, so this is a terrific day to face the fact that you are a walking, talking concatenation of unproductive, non-functional, unceremonious junk. So it’s time to take stock. And if perchance you’re considering lightening up the ‘ol scales, why, here are a whole ton of quirky body parts you can toss out right now:

Body Hair:


Back in our cave-days we had no nifty electric heaters nor snuggly yoga pants, so we were all sheltered by a thick layer of fur to protect us from the elements. Now, modern day conveniences have completely outflanked the need for hirsuteness. Even your eyebrows and nose follicles offer little more than marginal protection. So let’s get shaving. And let’s do it before the inevitable scourge of time turns your personal fur into very strange patchwork.

Nifty Navels:

Of course it’s true your umbilical chord once connected your prenatal self to the blood vessels of your mom, while you were temporarily living inside the world’s tiniest mobile home. But that curious tummy-divot after birth serves no biological purpose whatsoever. On its best days, it acts as a curious little lint collector. But you can learn to live very well without it . . . and the lint that goes with it.

Oh! And if you happen to be geographically challenged, the navel marks the center of your body on pretty much all of us. And that’s the basis for all navigation.



What? You never noticed you have a pair of plica semilunaris? They too, are vestigial remnants of the nictitating membrane,  organs that are fully functional in some other species of mammals


Vestigial Teeth:

Your annoying extra pair of molars are leftovers from a time when we gnawed on bones and needed teeth that could crush. Then, over eons, our our early farmers learned how to grow pizza and fried chicken – but nobody bothered to tell our teeth they should just stop growing. Nowadays, the only purpose of our molars is to completely ruin your day with pain, and allow dentists to afford golf club memberships.


It is totally true that you need at least one kidney to stay alive, but that second one is just along for the ride. A kidney is indeed an amazing little organ, from filtering waste products to keeping your blood pressure on an even keel, among other skills. But even the folks over at the National Kidney Foundation will quietly admit you can live just fine with either one. You surely don’t need both.  99% of us are renally redundant.

Your Appendix:

APPENDIXThe human appendix is another curious bit of slack-dangling flesh. Its only known value is to occasionally become infected, burst into flames and force you to crave an out-of-body experience. The very best thing you can say about your appendix is that it provides your abdomen with its very own ticking time-bomb. You may gleefully consider your appendix a sleeping tummy-terrorist.

Little Toes:

Now, most of your pedal protuberances are keen on keeping you balanced. But the runt of the litter? Why, it’s just a freaky little troublemaker, in search of nighttime furniture.

Ear Muscles:

Ear MusclesThey say about 12 people in 100 can wiggle their ears, but aside from impressing drinkers at a party, there’s no modern-day purpose for such highbrow hijinks. Moving your ears around won’t help you hear a Smart Car coming at you, even a little bit. But back in the day, wow. Those fleshy radar dishes twirled around and saved lives.

Male Nipples:

Well guys, nature just didn’t quite know how to erase your pesky papilli after it rolled out the gender dice and they turned up, “not female.” So it simply pretended not to notice, and hoped you wouldn’t notice them, either. But it’s kinda hard not to, since the invention of bathroom mirrors. While nipples on females are a never-ending source of fascination, the end-game of the male thelarche structure is to just sort of pose in tandem and look weird. Some twits actually dangle piercings from them like Christmas ornaments, likely because they don’t quite know what else to do with them. Which – come to think of it – is likely yet another glitch in our shared double helix.


So in the end, if you’re truly serious about losing some weight, now you know what to do. Don’t be an organ-hoarder. Clean house. It’ll only hurt a for a little while. And trust us: you’ll have not the slightest trouble finding a doctor mercenary enough to chop off, slice up, gouge out or amputate, any ‘ol part of your body you want. After all, they’ve mastered the art of the bank account biopsy, so removal of your little parts presents no medical challenge at all. We’re here to help, don’t you know.