San Jose fire hid drug tampering, patient exposure

San Jose firefighters raised internal alarms in 2023 about addictive painkillers that went missing from their paramedic drug inventories, and gave morphine from tampered vials to patients with traumatic injuries, according to email records obtained by San José Spotlight.

The emails indicate Fire Chief Robert Sapien and city leaders knew about a firefighter drug theft crisis more than a year before disclosing it to the public last month, following the April 16 arrest of Fire Capt. Mark Moalem on suspicion of stealing opioids. City officials announced Moalem’s arrest — and their belief that as many as 17 stations were impacted — without disclosing the patient exposure incidents in the 2023 emails.

The communications between fire captains, deputy chiefs and drug inventory supervisors span the months of November and December 2023. San José Spotlight obtained the emails last week and chose to redact names and certain email time stamps to protect sources.

Sapien acknowledged the tampering incidents described in the emails, which show firefighters noticed problems with the containers of narcotics they needed to administer to patients.

“The DEA and SJPD were notified, but the investigation did not yield evidence of a suspect. Although a suspect could not be identified, action was taken to address this issue,” Sapien told San José Spotlight.

Mayor Matt Mahan didn’t directly address the emails when asked about them, but vowed “accountability” for Moalem’s alleged actions.

“Our first responders swear to serve and protect, and we have someone who allegedly did the opposite. This is unacceptable and there will be accountability,” Mahan told San José Spotlight. “In parallel, we need to make sure this never happens again, which is why I strongly support new investments to better restrict access to and monitor use of controlled substances within the fire department.”

Patient exposure 

The 2023 emails show Moalem was part of these internal discussions about missing medications and patient exposure — and even raised leadership’s attention to the first reported incident.

That incident occurred on Nov. 28, 2023. An email from a Med 30 captain to a deputy chief reported an issue with a morphine sulfate vial — logged as “MS #1839” — during an incident involving a patient with a traumatic hip injury. The firefighter paramedic noticed he was only able to draw up half of the medication in what should have been a full vial of 10 milligrams. He still gave the patient the vial’s remaining fluid.

The vial had a loose top, according to the email, along with an unusual crease mark. The paramedic later said the membrane of the vial “had a different feel when punctured.” But there were no other signs of tampering, and everyone agreed the vial was simply defective.

Then the issue happened again the next month — same drug, different patient.

“I received a phone call from [a firefighter] at Engine 7 today, 12/20/23. He had a call where he had to administer Morphine. When drawing it up he noticed there was only 5 mg in the vial (MS-1682) instead of the full 10 mg,” reads a Dec. 20, 2023 email from another Med 30 captain to a deputy fire chief. “I was made aware that E7 had a similar episode on 11/28/23 in which [another Med 30 captain] investigated and they determined two vials were also defective (MS-1839 and MS-1842).”

The Med 30 captain reported inspecting a narcotics box and finding another vial “also below full when compared to the others in the box.”

Multiple emails in December 2023 reported drug vials missing entirely.

“The EMS Division has been made aware of several instances of Department Paramedics entering the wrong control number for administration of controlled substances,” reads a Dec. 7 email from a deputy chief to personnel. “EMS Field Coordinators are also reporting an increase in occurrences where daily inventory and equipment checks through Operative IQ are not being performed and missing/incorrect vials are being entered into the system.”

Sapien said he took immediate action.

“Additional security measures were put in place to secure the controlled substance supply in fire stations and on apparatuses,”  he told San José Spotlight.

Fiery decision

A few months before receiving those 2023 email warnings, Sapien got approval from the San Jose City Council to cut the department’s drug oversight program known as Med 30, which helped report these discrepancies. But the cut didn’t take effect until July 2024, at which time the program’s duties were reassigned across a wider range of personnel. 

Sapien has since come under fire from the union representing his rank-and-file firefighters.

Jerry May, president of San Jose Fire Fighters Local 230, didn’t respond to requests for comment about the emails. But he has publicly criticized Sapien’s decision to cut Med 30 as “jeopardizing public safety” and said the drug thefts tie back to this decision. He repeatedly called on city leaders to reverse course at budget presentations before the crisis became public.
Sapien denies the notion and accused the union of using it for negotiation leverage.

“I would like to be very clear: eliminating Med 30 did not result in decreased oversight. In fact, controlled substance inventory is now managed by the Emergency Medical Services Continuous Quality Improvement Fire Captain, which is the same fire captain that was formerly assigned to Med 30 and whose expertise provides consistency and continuity in this area,” Sapien told San José Spotlight. “There was a potential tampering issue in 2023 that was raised by a paramedic. It is important to note that this event occurred despite Med 30 existing at the time and was not discovered by Med 30, but rather by a paramedic on the fire engine.”

He added the former Med 30 captains had oversight of the department’s overall inventories, but didn’t control the drugs once assigned to each fire station.

District 7 Councilmember Bien Doan, a 27-year firefighter, said the eliminated program “saved lives.”

“I’ve been a strong advocate for its permanent funding because it plays a vital role in protecting public safety, increasing accountability and ensuring our fire department delivers the highest standard of service to our residents,” Doan told San José Spotlight.

Contact Brandon Pho at [email protected] or @brandonphooo on X.