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HUDSON VALLEY REGIONAL EMERGENCY

MEDICAL ADVISORY COMMITTEE

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MINUTES OF MEETING, held at the offices

of Hudson Valley Regional EMS, 33 Airport Center

Drive, New Windsor, New York, on Monday,

September 18, 2017, at 9:30 a.m.

Yvette Arnold,

Court Reporter

ROCKLAND & ORANGE REPORTING

2 Congers Road

New City, New York 10956

(845) 634-4200



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1 A P P E A R A N C E S :

2 DR. PAMELA MURPHY,

3 Committee Chair

4 DR. MARK PAPISH, Medical Director

5 DR. ARSHAD,

6 Evaluation Subcommittee

7 WILLIAM HUGHES, EMT HVREMSCO Executive Director

8 JEFFREY CRUTCHER,

9 QI Coordinator

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11GOOD SAMARITAN HOSPITAL

12 DR. DENNIS MAO,

13 Director

14HEALTH ALLIANCE OF THE HUDSON VALLEY

15 DR. GUTMAN,

16 Physician Representative

17NORTHERN DUTCHESS HOSPITAL

18 DR. WILSON,

19 Director

20ORANGE REGIONAL MEDICAL CENTER

21 DR. VOHRA,

22 Director

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1 PUTNAM HOSPITAL CENTER

2 DR. BUTTERFASS, Director

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4 MID HUDSON REGIONAL HOSPITAL OF WMC

5 DR. PAPISH, Director

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7 VASSAR BROTHERS MEDICAL CENTER

8 DR. ARSHAD, Physician Representative

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1 A P P E A R A N C E S :

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3 DAVID VIOLANTE MIKE BENENATI

4 ISRAEL KNOBLOCH MATT NOLAN

5 TIM MURPHY JOE SOLDA

6 DAVID GRASS MICHAEL MURPHY

7 ANDY LAMARCA JOHN MAHONEY

8 TIM MURPHY BOB SZLI

9 SHARON FRAZIER

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2 DR. MURPHY: Good morning, everybody.

3 Thank you for coming.

4 So this morning -- I filled out the

5 sheet for you for roll call -- we have the

6 minutes that were distributed from our

7 June 5th meeting -- it seems so far away.

8 And if anybody has any additions, deletions,

9 or corrections, let me know.

10 Otherwise, I'll ask for a motion of

11 acceptance.

12 DR. MAO: Motion.

13 DR. MURPHY: And second?

14 DR. GUTMAN: Second.

15 DR. MURPHY: Thank you. So since we

16 were off all summer and today is still

17 September -- September 18th, I would like to

18 take a moment just for September 11th

19 remembrance. We had amazing remembrance

20 ceremonies around the State and across the

21 country actually, a lot of other states were

22 involved and did amazing programs to, you

23 know, remember everybody from 9/11. So I

24 would like to just take a moment of silence.

25 (A moment of silence was observed.)



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2 DR. MURPHY: Thank you very much.

3 Anyone that would like to comment or

4 make any announcements?

5 Thank you.

6 We have a ton of old business to get

7 through today and a bunch of new things going

8 on around the region.

9 First, we will start with the

10 collaborative protocols rollout update.

11 Michael?

12 MR. BENENATI: The protocol committee

13 took the summer off as well so we have --

14 then we have a conflict with the meeting for

15 next week because of the SEMSCO meeting. So

16 we will resume in October and pickup with the

17 policy and procedure manual from the New York

18 State BLS protocol perspective -- which I'm

19 also on that -- and is moving forward at the

20 State level. And we should be hearing more

21 about that and the status of that next week,

22 but it will look exactly like the

23 collaborative protocols, same format except

24 designed for BLS providers --

25 DR. MURPHY: And also the policy



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2 material you sent out I reviewed, it looked

3 really good.

4 MR. BENENATI: So we need to talk about

5 that, clean that up a little bit, there is

6 another, you know, hole that Jeff found. So

7 that's what we are working on, there is not

8 sweeping changes, just stuff we need to

9 cleanup a bit.

10 DR. MURPHY: It's really also an

11 reorganization and to put certain things in

12 that manual. So we'll submit it to everyone

13 on the committee once protocol is finished,

14 but the first pass looked really good. And

15 organizationally wise taking out the stuff

16 that doesn't need to be in the

17 collaboratives, but belongs to our region

18 that we will keep separate.

19 Narcan update. Bill?

20 MR. HUGHES: Well, we have it available.

21 We had some shortages and it was hard to get,

22 but now we have a substantial amount in the

23 office and we have been using it. Jeff will

24 give you an idea how many --

25 DR. MURPHY: You have the usages and



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2 stuff?

3 MR. CRUTCHER: We have the usages. We

4 are running probably 40 percent over last

5 year's totals. So far this year we have

6 distributed just over a thousand doses, last

7 year we didn't make it to a thousand doses.

8 We have seen it slow down a little bit in the

9 past couple of weeks, but summer use was

10 pretty much as we anticipated, high usage.

11 We do have four agencies that are

12 applying for Narcan -- you want to take care

13 of that now?

14 DR. MURPHY: Well, we can. We can do it

15 here or under new business -- but why don't

16 we do it now, that's fine.

17 MR. CRUTCHER: Lenape VAC is applying,

18 New Hamburg, Pine Bush and Upper Delaware.

19 DR. MURPHY: And Pine Bush VAC?

20 MR. CRUTCHER: Yes.

21 DR. MURPHY: That's great three -- four

22 more. During that time that the resources

23 were low what did they tell you to do? They

24 just said we just have to hold on?

25 MR. CRUTCHER: Pretty much.



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2 MR. HUGHES: But we did -- we belong to

3 a coalition group that they were able to go

4 out to different places and get us a supply.

5 So over the Labor Day weekend we had none

6 available for us here to distribute so they

7 went and I believe Dutchess County was one of

8 the counties that really clipped in and gave

9 us a bunch to have available. So although

10 the agency didn't have anything for us, the

11 coalition group did come through and get some

12 for us too so we could distribute it to the

13 agencies that needed it for that weekend.

14 DR. MURPHY: All right, thanks.

15 Hospital diversion. Do you have

16 anything more on that, right now?

17 DR. PAPISH: Not since we were last

18 here --

19 DR. MURPHY: Any other issues?

20 MR. BENENATI: We were going to rollout

21 that manual and stuff, did that occur?

22 MR. HUGHES: No. Because the way we

23 left it -- at the last meeting we had a very

24 long discussion about it and the way we left

25 it was we weren't sure as to whether we



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2 should go to the CEO or emergency room and

3 where do we need to send that letter? So we

4 did have it, we didn't rollout the manual at

5 all so we are kind of -- still kind of just

6 --

7 DR. PAPISH: So why don't we just send

8 out the letter to everybody, like to the CEOs

9 -- our current -- when we send out the

10 advisory to REMAC it goes to CEO and

11 everybody.

12 DR. MURPHY: Yeah. I think it applies

13 to everybody. I agree with Dr. Papish that

14 the CEO has to definitely be on there because

15 they are the last straw for diversion. But I

16 think everybody on the front line needs to

17 know and everybody needs to announce at

18 department meetings and that this is where we

19 stand. So I think it's important for

20 everybody.

21 DR. PAPISH: Yeah.

22 MR. HUGHES: Okay.

23 DR. PAPISH: So should we do that as the

24 next step in this endeavor?

25 DR. MURPHY: Yeah. When does Karen come



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2 back?

3 MR. HUGHES: We will get it done.

4 DR. MURPHY: I'm teasing.

5 Psychiatric patients and disposition

6 issues. I've had nothing else come to our

7 attention or our committee.

8 Anybody have any issues?

9 Boy, you guys are making this easy this

10 morning.

11 BLS protocols. Mike, you already spoke

12 a bit about that. I don't think there is

13 anything else more on that. The only thing

14 is, it's going to be a long process, right?

15 It's not going --

16 MR. BENENATI: We will find that out

17 next week. I know Dr. Daily has been in

18 frequent contact with Lee Burns and I don't

19 see this process going very slow. I mean, it

20 seems to be on a fast track by what I've seen

21 and been participating in so I think we will

22 hear something next week and that will give

23 us a good indication. His goal was to have

24 it out before the end of the year so we will

25 see, obviously it will depend on



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2 representation across the State so we will

3 know more next week.

4 DR. MURPHY: And I think that now one of

5 the things that happens is, you know, you

6 have to abide by everything, the kind of the

7 fences they have up, but he is moving it

8 along.

9 MR. BENENATI: Right, it seems to be

10 moving.

11 DR. MURPHY: Okay. Evaluation

12 subcommittee report -- no -- no service

13 upgrade, sorry.

14 Arshad --

15 MR. HUGHES: We have two.

16 DR. MURPHY: We did? No, those are the

17 programs --

18 DR. ARSHAD: Quiet summer, thankfully.

19 DR. MURPHY: I don't think there were

20 any cases.

21 DR. ARSHAD: Just a reminder to

22 everyone, we exist. If there are any cases

23 that warrant attention, or some additional

24 eyes, or you just want feedback for the

25 providers, we are happy to review any case



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2 you think merits the attention of the region.

3 DR. MURPHY: Helicopter committee. Dr.

4 Berkowitz is not here.

5 MR. HUGHES: They have their Westchester

6 meeting today also.

7 DR. MURPHY: So that might be where they

8 are.

9 MR. HUGHES: No. They sent an e-mail

10 saying they would not be here, but there was

11 no change in helicopter --

12 DR. MURPHY: All right, QI. Jeff?

13 Oh, I skipped over RTAC -- sorry.

14 MR. CRUTCHER: New York State is still

15 talking about releasing the Elite Bridge

16 soon, it's the same conversation we have had

17 for the last 18 months. The additions to the

18 data dictionary that are New York State

19 specific were pushed out to the vendors about

20 30 days ago and push back to the State came

21 about 29 days ago. So they are still trying

22 to figure out what they are going to do with

23 some of the things that Mike Taylor wanted

24 added.

25 DR. MURPHY: Okay, so it's still a work



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2 in progress.

3 MR. CRUTCHER: Yes.

4 DR. MURPHY: Kind of like our whole

5 meeting this morning. Protocol committee?

6 MR. BENENATI: Post summer, you know --

7 DR. MURPHY: But usually we have some

8 things we have to do, usually September

9 meetings are a little bit more.

10 MR. BENENATI: Nothing else from the

11 protocol committee at this point.

12 DR. MURPHY: Holy moly, we are flying.

13 Under new business, so did everybody get

14 these up front?

15 MR. HUGHES: No.

16 DR. MURPHY: So we have to talk about

17 the meetings for 2018. And what I'll do --

18 you know, the next one here is November 6th,

19 but for 2018 the one conflict we see -- we

20 have January 8th, March 5th, June 4th, but to

21 have it even out to be that specific Monday

22 it falls on September 10th, which is Rosh

23 Hashana so I think we have to change that one

24 meeting and then the next one being

25 November 5th. So everybody look at their



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2 schedules over the next week or so and try

3 and get back to the office where you think we

4 should go. Because Labor Day is in the

5 beginning of the month we probably have to

6 move it back to the 17th like we did this

7 month. We can't go too far because we will

8 run into SEMAC again because generally there

9 is a September meeting, which happens next

10 week.

11 So I've got nothing to report on SEMAC

12 either.

13 MR. BENENATI: Just a quick -- as I

14 looked at my calendar the Operation Lifeline

15 has really taken up speed in the region.

16 And, you know, it maybe good to get some

17 representation from them involved in the

18 group. I know there has been a lot of action

19 that aspect --

20 DR. MURPHY: Lifeline meaning the guys

21 that fall --

22 MR. BENENATI: The America Heart

23 Association initiative --

24 DR. MURPHY: Mission Lifeline --

25 MR. BENENATI: -- maybe we should make



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2 sure they get invited to this, it's a good

3 format. I believe there is a meeting later

4 this week, a teleconference meeting.

5 DR. MURPHY: We could send an e-mail to

6 that lady -- I can't think of her name right

7 now -- but she was the one that headed that

8 thing up at West Point.

9 MR. BENENATI: Maybe that would be

10 something smart to do, Bill?

11 MR. HUGHES: Okay.

12 DR. MURPHY: Forward that e-mail to him,

13 that's the woman who directs all the

14 scheduling with them.

15 A few announcements, few new business.

16 Putnam Hospital and Northern Dutchess

17 Hospital under Health Quest have -- have

18 submitted an application to New York State to

19 provide cardiac cath lab and become PCI

20 center for both, and we have both Dr.

21 Butterfass and Dr. Wilson here if anybody has

22 any questions, but they are putting forth an

23 application to New York State to become a PCI

24 center.

25 Anything you guys need to add?



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2 DR. WILSON: It's true -- you want to

3 add --

4 DR. PAPISH: What was the rationale?

5 DR. WILSON: For not only PCI, but

6 elective cases and Health Quest to provide

7 that type of service line that extends up

8 north in the Hudson Valley --

9 DR. MURPHY: So we will have the guys

10 from Vassar and then go up?

11 DR. WILSON: Yes. And we will have a

12 call team and we have established a protocol.

13 And we also have an educational rollout for

14 EMS with physician directors if this were to

15 be approved, but we are in the very beginning

16 stages of the process, there is a good chance

17 we might not even get approved. So we are at

18 that stage, due diligence, make sure we get

19 it in the minutes.

20 DR. MURPHY: I think it's good everybody

21 is aware what is coming down the pike, so

22 it's all good then.

23 I was approached by the Ulster County

24 Department of Health, who had put forth a

25 plan with their local officials in the Ulster



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2 County EMS or EMO, Emergency Management

3 Office, they submitted a grant and were

4 awarded Cyanokits and a whole operational

5 plan was setup. So they sent it to us for us

6 to -- just to announce, they initially wanted

7 us to sign off on it. I said, we don't need

8 to. We have the protocol and they will

9 follow the protocol. Initially they had a

10 couple things that were different and we

11 pointed out that they have to follow the

12 protocol. But it's a very elaborate plan

13 that they have set up between all the fire

14 coordinators, emergency management personnel

15 and all the fire officers in the area and any

16 kind of high volume agencies to provide and

17 carry Cyanokits. So just an FYI there and

18 kudos to them. It's a great program, they

19 really set it up well. And I told them we

20 don't really need to sign off on that, it's

21 more informational.

22 MR. MAHONEY: Dr. Murphy, since they

23 came up with that it ended up across Dutchess

24 County desk, which came to my attention.

25 Some of the concerns that we have are, who is



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2 responsible for that medication? If I'm a

3 paramedic on the ambulance and I've never

4 seen that medication before and I show up on

5 the scene and a fireman comes up and hands me

6 medication and I have no idea what it is and

7 tells me I'm supposed to be administering it,

8 I have no idea. I'm not going to do it. And

9 when they file the complaint saying we had a

10 patient that needed this medication and the

11 paramedic refused to administer, what is

12 going to happen to that paramedic?

13 DR. MURPHY: Well, it's part of our

14 protocols, included in the fire inhalation --

15 the smoke inhalation protocol so people

16 should probably have an educational processes

17 on it if you're not comfortable with it

18 through your medical director because it is

19 something that is out there. Granted most

20 fire companies carry it, not a lot of EMS

21 agencies that have it. However --

22 MR. MAHONEY: Only two in my county and

23 both of them have paramedics with them so --

24 DR. MURPHY: Yeah, that's what most of

25 the fire companies do, except that it's



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2 changing in someplaces. But it is under our

3 protocol so it's something we expect people

4 that if they feel comfortable with it, again,

5 it's not something you are going to do

6 something outside of your comfort level, but

7 it's covered by our protocols.

8 MR. MAHONEY: Okay, but now are those

9 going to be temperature controlled

10 compartments that the fire departments have

11 the medication in?

12 DR. MURPHY: They have to, that's their

13 responsibility if they are going to carry it.

14 They are not governed by -- you know -- us.

15 They are really governed by what they have

16 there in the auspices if they are going to

17 take it from the protocols it's under the

18 formulary, otherwise it's not going to work.

19 MR. HUGHES: Their operational plan does

20 say it will be temperature controlled --

21 DR. MURPHY: However, I don't boss them,

22 I don't regulate them, but they have to

23 follow the protocol --

24 MR. MAHONEY: So we don't have an issue

25 of medication that is out of control of a



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2 paramedic being administered by a paramedic,

3 this medication is not in the paramedic

4 control. They will never see it until the

5 moment it needs to be administered.

6 DR. MURPHY: Well, the paramedic has to

7 feel comfortable administering just like

8 anybody else with any other medication they

9 have, if they're not, they say that.

10 MR. MAHONEY: That's if they have the

11 medication, the paramedics aren't going to

12 have it, that's why I'm concerned. This is

13 going to be scattered throughout an area and

14 the paramedics have no control until the

15 firemen comes over and says, you need to have

16 this. I'll use Dutchess as an example, we

17 follow what Ulster is doing and I have a call

18 in the middle of the county, which is a

19 volunteer fire department, with a volunteer

20 ambulance, depending on time of day and

21 everything else it could be a totally

22 different agency that they normally are used

23 to dealing with in response to the call.

24 Paramedics showing up have no idea who these

25 people are and getting told you need to go



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2 give this to somebody and having no idea

3 where that medication has been for the last

4 18 months.

5 DR. MURPHY: True. I think that if

6 somebody hands you something out of the med

7 box you still don't know.

8 DR. PAPISH: When is the last time you

9 traced every bottle of epinephrine --

10 MR. MAHONEY: But it's in my drug box

11 and I checked it that morning. I know it's

12 not brown, or at an accident scene freezing

13 for the next four hours.

14 MR. VIOLANTE: So maybe we can just

15 throw some education out there. Paramedics

16 have to check expiration dates of meditation,

17 if they are comfortable, great, if not,

18 great.

19 DR. MURPHY: And I think just like

20 anything, we put the protocols out there to

21 guide people, to help people, but I can't

22 force anybody's hand to do anything.

23 However, a Cyanokit is an intact entity, it's

24 not going to be -- hopefully broken open so

25 they are handed an intact kit. Two, like



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2 Michael is saying, there is an expiration

3 date on it. And I believe it has a

4 temperature sensitive colored thing, no?

5 MR. BENENATI: No, I don't think so.

6 There is a range, but I'm not aware of them.

7 DR. MURPHY: So that's just what we are

8 going to have to go with. I think that it is

9 lifesaving. It's like, how do we know when a

10 family member walks up with a bottle of

11 Narcan or nasal aspiration device where it's

12 been and what has it's been doing? But if we

13 can save somebody's life, we will. However,

14 if somebody is uncomfortable I can't force

15 their hand to do anything. They have to be

16 able to do what they feel is right and feel

17 comfortable with. But since it's in the

18 protocols I expect people to kind of have an

19 idea what it is as a paramedic.

20 I think in emergency medicine I don't do

21 every single procedure every day, but I

22 pretty much feel comfortable what walks

23 through the door I'll try and handle as best

24 I can.

25 DR. PAPISH: I think the default of



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2 calling medical control is a fallback that is

3 very easy, a fireman handed me this orange

4 box, I'm not so familiar, this is what I

5 have.

6 MR. LAMARCA: With REMAC advisory since

7 this is, you know, a new program just a REMAC

8 authorizes any paramedic to administer, you

9 know, Cyanokit provided by a fire department

10 that is in the program.

11 DR. MURPHY: Yes.

12 MR. LAMARCA: So REMAC gives them

13 permission to use it as long as it's intact

14 and it's covered by their protocols.

15 DR. MURPHY: As long as everybody is

16 following the protocols --

17 (Everyone is speaking at once.)

18 DR. MURPHY: -- that's pretty much what

19 I said to Ulster too, they have to make sure

20 they follow the protocol. Michael?

21 MR. MURPHY: I'm chair of the EMS

22 committee and fire committee. And the design

23 of this is that it was fiscally improbable to

24 put Cyanokits on every ambulance and since

25 hydrogen cyanide and smoke inhalation is



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2 prevalent in the fire service, the idea was

3 to have the fire department have the kit with

4 them. Therefore, when the EMS unit responds,

5 be it standby unit, or all of sudden develops

6 an issue with the firefighter, et cetera,

7 that Cyanokit is available. The idea is not

8 that a fireman is going to hand it to you and

9 say you need to give this, or give it to this

10 guy. It is the idea that the paramedic will

11 make an assessment of the smoke inhalation

12 individual and if in their belief under the

13 circumstances there is a high probability

14 that cyanide could be involved, the Cyanokit

15 would be readily available to them because it

16 would be on the fire apparatus.

17 DR. MURPHY: And it's in concert too,

18 because I think there is nobody better than a

19 fire person to tell me what is burning and

20 what is the risk of the gas right there and

21 the flammable substances that were there. I

22 mean, that's the other thing where I think

23 that it makes sense that fire --

24 MR. MURPHY: -- and that interaction

25 between the fire ground safety officer and



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2 EMS unit.

3 DR. ARSHAD: I hear what everybody is

4 saying and I certainly see and view this as

5 an opportunity not only to save potential

6 firefighters that maybe down, but it's an

7 excellent educational opportunity for EMS

8 providers as well.

9 But, firstly, congratulations to Ulster

10 County for going out and securing that grant

11 because this is an excellent medication we

12 should have for our firefighters --

13 DR. MURPHY: It's a good title for a pod

14 cast.

15 DR. ARSHAD: -- so, John, I also

16 appreciate your concerns --

17 DR. WILSON: No.

18 DR. ARSHAD: -- specially in regards to

19 preparation the Cyanokit for delivery or

20 administration, it's not a straightforward

21 process that's just drawing a medication out

22 of a vial and administering. I do appreciate

23 there is some concern from the EMS

24 perspective, I've never actually trained on

25 this, I'm not sure. Am I supposed to use D5



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2 water or normal saline? Can I use lactated

3 ringers to do 250 cc reconstitution? So for

4 fire providers or rather fire services that

5 normally respond to large alarm structural

6 fires and there is EMS unit or agency tasked

7 doing the firefighter rehabilitation should

8 it be necessary, I think it's a great

9 opportunity to reach out and say, an

10 extension or part of the fire rehab process

11 we may have extreme cases where either carbon

12 monoxide or hydroxycobalamin are involved and

13 endangering the life of a firefighter. It's

14 a very high stress situation and ideally we

15 would want that medication to be administered

16 as quickly as possible. So I definitely

17 encourage Ulster County to reach out to EMS

18 services in their backyard who may

19 potentially respond to a firefighter down or

20 on more regular basis provide firefighter

21 rehabilitation services to help as best

22 practice for the administration should we

23 need it in a critical situation.

24 MR. BENENATI: I spoke with both the

25 Director of Emergency Management and EMS



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2 coordinator after the packet of information

3 came out. I provided them with some training

4 tools as well as implementation tools, like a

5 cheat sheet that we use, as well as what our

6 kits look like and how they are built. And

7 so, you know, I certainly understand, you

8 know, John's concern looking at this. And I

9 think that the other point that we made to

10 Ulster County as well is that it's the

11 region's responsibility to ensure that it is

12 protocol driven. We approve the protocols

13 for a paramedic to administer. It's

14 approved. It's already approved. We don't

15 do the regulatory side of this, that's the

16 responsibility of the Bureau. And so they

17 have been encouraged to make sure they

18 communicate with the Bureau on those topics

19 to make sure everything is within the

20 regulatory guidelines. And so that's where

21 we left it with them, I sent them a bunch of

22 material.

23 MR. HUGHES: I have received a letter

24 from Lee Burns that she is aware of it and

25 she supports them in doing this, so the



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2 Bureau is aware of it.

3 DR. MURPHY: Yeah, that was attached --

4 MR. BENENATI: There are some logistical

5 challenges that they have, they are aware of

6 those logistical challenges, like temperature

7 control.

8 DR. MURPHY: Thank you, Michael.

9 Any other questions or concerns?

10 Thank you, John.

11 So SEMAC is next week, I don't know --

12 Arshad? Anybody has anything they want to

13 talk about?

14 This is like the quickest meeting we are

15 ever going to have.

16 MR. BENENATI: Next time will be long --

17 DR. MURPHY: I have no Pad, EpiPen,

18 Albuterol, or glucometer to -- well, you did

19 the people that are applying --

20 MR. CRUTCHER: Um, um.

21 DR. MURPHY: I do have a bunch of

22 announcements, we were busy with that.

23 MR. HUGHES: Can I do one more before

24 you go?

25 DR. MURPHY: Yeah.



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2 MR. HUGHES: I'm not sure if we

3 mentioned this, but the check and inject, BLS

4 epi inject program is available to all BLS

5 providers now so you might see BLS providers

6 doing the injection of epi, so everybody is

7 aware of it.

8 DR. MURPHY: I think we did it the last

9 time, we talked about they finally got

10 approved and we announced it, Lee's letter --

11 MR. HUGHES: I wanted to make sure

12 everybody is aware they could be seeing

13 patients.

14 DR. MURPHY: Under Department of Health

15 notifications we have -- the first one is

16 Jeffery Ruminisky (phonetic) from Holland,

17 New York. He's been suspended for one year

18 and assessed a civil penalty of $2,000.00 for

19 violations of Part 800.

20 Again, we have for the same violation,

21 David Manachevrov (phonetic), out of

22 Brooklyn, New York. He has -- his

23 certification has been revoked as of August.

24 Matthew Argona (phonetic) out of Buffalo, New

25 York, suspended for two years and assessed a



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2 civil penalty of $1,000.00 for violations

3 under Article -- Part 800.

4 And, lastly, Woodhaven Richmond Hill

5 Volunteer Ambulance Corp out of Ozone Park,

6 New York had their certification revoked

7 effective August 16th for violations of the

8 Public Health Law Part 800 and that was

9 effective August 16, 2017. And that's under

10 notifications.

11 That brings us to open forum? Oh, my

12 goodness.

13 Anything anyone wants to talk about?

14 Any issues? Things that have come to your

15 attention?

16 Wow. This is going to be a record

17 meeting, 35 minutes.

18 Anything else? Motion to adjourn?

19 MR. BENENATI: If anybody cares to see

20 what the BLS protocols look like, I have a

21 copy after --

22 DR. WILSON: Motion.

23 DR. ARSHAD: Second.

24 DR. WILSON: But I do want to look at

25 them.



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2 MR. BENENATI: You are welcome to come

3 and take a peek if you want to see it.

4 DR. MURPHY: Thanks, everybody.

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6 THE FOREGOING IS CERTIFIED to be a true

7 and correct transcription of the original

8 Stenographic minutes to the best of my ability.

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11 ___________________________ Yvette Arnold

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Documents

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