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Playing with fire



Who could blame Don Ammerman for wanting to get to the bottom of things? After all, the allegations he set out to investigate on a Friday afternoon last August were alarming. They were revealed when Orlando firefighters alleged in a lawsuit that for 25 years doctors at a city-run clinic withheld the results of blood tests from firemen who later contracted lung, heart and liver diseases.

Ammerman, the District 1 City Council member representing south-central Orlando, had heard that a city employee who might hold a key to the complaint was eager to speak with him. That person was Mark Munsey, who had worked for nine years in the city's Risk Management office, which acts as the city's in-house insurance agency. Ammerman and the firefighters suspected that Risk Management pressured clinic doctors into withholding test results in order to save money.

The two city officials sat outside the Panera Bread restaurant on Michigan Avenue, talking for more than an hour. Ammerman recalled that Munsey, who heads the 12-member Risk Management office, was solemn and nervous. He wanted to tell the commissioner he had nothing to do with an alleged cover-up but was concerned he'd become "the fall guy" when firefighters eventually uncovered wrongdoing. Munsey was willing to provide firefighters with inside information they could use against the city, Ammerman says. Although Munsey didn't name any specific documents, "he was trying to leverage and negotiate," Ammerman explains. "He gave a tidbit, as if to be an indicator of how much he would provide. I had to press him to get it. I had to press him for specifics."

Perhaps most damning, Munsey also revealed that his computer, a Compaq Deskpro, had been taken from his desk at City Hall. The presumption was that city officials were removing files to cover up wrongdoing. "I wish I could have taken a photo of his face," says Ammerman. "He said it with a note of worry."

Ammerman sat on that information for five months. But on Jan. 23, the day after the commissioner went public with his version of the meeting, Munsey wrote a two-page memo contradicting almost every point Ammerman made. The one exception: Munsey allowed that he was indeed nervous. He wrote that Ammerman requested the meeting without disclosing its purpose and that Munsey was de-briefed as soon as he returned to his office. "Given the unusual circumstances, most people would be nervous," Munsey wrote. "Regarding the removal of my computer, this is absolutely untrue and I never indicated such to any person."

Once the allegations of a cover-up surfaced, Mayor Glenda Hood called on the Florida Department of Law Enforcement (FDLE) to investigate. While the result is unlikely to quiet the rumor mill, it will indicate which side is more believable. This high-stakes battle, with its endless contradictory claims, has clearly reached a point of no return. Someone is telling the truth. And someone is not.

"The evidence in the FDLE report will impact the credibility of the accusers," says District 3 Commissioner Vicki Vargo who, like Ammerman, is running for reelection next month with the backing of the firefighter union. "If the FDLE says nothing ever happened with Mark Munsey's computer, what does that tell us?"

It might tell us that Ammerman isn't ready to be mayor of Orlando, an office he says he's 90 percent certain he'll run for in 2004. Political observers say that Ammerman is using the firefighters as a wedge to help distinguish himself should Hood abandon her pledge to step down after three terms and run again. Yet Ammerman says he has no agenda. "Only people at City Hall are saying things like that," he says. Further, in this election season, Ammerman has so far been untouchable in his self-described role as the firefighters' "third-party advocate," even though he faces two formidable opponents in his re-election bid: attorney Phil Diamond and freelance writer Tom Levine.

Diamond especially is a concern for Ammerman. The latter has often sparred with Mayor Hood, who doesn't take such things lightly. Ammerman says he knows of at least four people who the mayor tried to recruit to run against him; moreover, Hood's daughter and son-in-law are on the host committee for a Diamond fundraiser later this month.

In a candidate forum Feb. 8, the firefighters' lawsuit never came up. Ammerman doesn't think it will. "It's not an election issue," he says.

Diamond agrees, though he questions why Ammerman waited so long to divulge the results of his meeting with Munsey. Diamond says the files in the firefighters' suit contain affadavits from city employees saying there has been no City Hall conspiracy. "An affadavit to the contrary from a sitting city commissioner could have had an impact on the case," he says.

Firefighters, meanwhile, are squarely behind Ammerman. They don't feel he has stolen the spotlight away from their ill colleagues. "Don Ammerman had the balls to get out there and get pink in the face about this and let people know that somebody's up to no good," says J.J. Alexander, a firefighter who lives two doors down from Ammerman. "He's a brother as far as we're concerned. He's lived through the same things we've lived through. He can identify with us."

For all his hero status now, Don Ammerman wasn't the union's choice when he first ran for election in 1992. Former Fire Chief Gene Reynolds also was in the race, so firefighters backed him. After Reynolds lost in the general election, the union shifted its support to Ammerman, whose father, Robert, was a full-time Columbus, Ohio, fireman for nearly 30 years.

"Never once has he told anyone that he's the son of a firefighter," says Steve Clelland, a fireman and president of the Orlando local. "He's kept that quiet. He has deep feelings about this. He feels an obligation."

The ruddy-faced Ammerman has evolved into the council's senior statesman, mostly because he is its best public speaker. A 55-year-old populist Republican, Ammerman has amassed a small fortune as a corporate-industrial real-estate specialist, though he isn't ostentatious and has a folksy sense of humor. On a shelf in his City Hall office -- just above an Orlando firefighter helmet -- he keeps a framed copy of Will Rogers' famous quip, "I hope I never get all the government I pay for."

Of late, Ammerman's votes on the council haven't raised many eyebrows. But he did invite hecklers with a quote last fall in an Orlando Sentinel series that raised questions about the city's sale of the former Navy base. In one of the articles, Ammerman claimed ignorance that the site was sold cheaply to Chicago billionaires for redevelopment. "The total picture was never shared," he told the Sentinel. Commissioners, who are each allotted one city employee to work for them, commonly complain that Hood's office provides only one side of an issue in order to get a project approved. Nevertheless, Ammerman gave his opponents an opening. At the Feb. 8 forum, Diamond hammered the commissioner for his lack of knowledge, linking it to the latest Washington scandal: "He has the memory of an Enron executive," Diamond said.

Ammerman also seemed to extend himself too far on the firefighter issue when, in October, he asked that commissioners terminate two city employees he said had acted unethically. The employees, Steve Valis and Jay Goldrick, allegedly had conspired to remove records from patient files and had "rushed" to the courthouse to have a case dismissed after firefighter Larry Crumbley missed a doctor's appointment. In fact, Valis and Goldrick never had access or control of patient records. And the city documented that Goldrick, a former Air Force officer, responded to Crumbley's condition in a responsible manner. Indeed, when Crumbley didn't show for his September appointment, city attorneys actually filed a motion to compel Crumbley to go to the doctor.

Even so, Ammerman remains unrepentent. "My regret is that [other commissioners] didn't take the time to have the same experiences I did," he says.

Commissioner Patty Sheehan, who is fond of calling Ammerman "Ammo," apologized to Goldrick and Valis. She says they never should have been singled out publicly -- especially Goldrick, who is in a relatively low-level position as a senior claims adjuster. "If you're going to pick on someone, pick on a department head," she says. "But I think it's inappropriate to use the media to punish or persecute someone."

Even with that mark against him, commissioners generally give Ammerman latitude on the issue. And his instincts have been on target from the beginning to push the Hood administration into an independent investigation. In August, Ammerman called for an inquiry by a team headed by Tom Feeney, the Oviedo lawmaker who is speaker of the Florida House of Representatives. Hood said any investigation should be done in-house, which immediately drew suspicion since she was named as a defendant in the suit. Despite two major presentations at the city council by attorneys and doctors, firefighters still say an independent investigation of the clinic and Risk Management has yet to be done.

"Glenda never wants to look at bad information," says Ammerman. "She doesn't handle it well. This is a tough matter that has public-opinion consequences regarding the government's treatment of employees. It needs leadership required to right past wrongs."

Ammerman says that a week before he went public with his meeting with Munsey, he tried to tell Hood there was "a real cancer" in Risk Management that needed to be cleaned up. He says she became defensive and refused to listen. "If it's from me, her attitude is, how can this be real? How can this possibly be?"

Hood is not the only one asking. Ammerman is wading into a controversy that has an ever-shifting bottom, one with a hazy motive.

Why would doctors risk their credibility and livelihoods by systematically refusing to reveal blood tests? They -- not administrators -- risk their reputations and financial well-being by withholding information. "According to the medical code of ethics, physicians quite clearly have to tell their patients what is wrong," says Jessica Berg, assistant professor of law and biomedical ethics at Case Western Reserve University in Cleveland. "There is never a good reason not to tell a patient about negative results."

The facts in the case are that 13 firefighters filed a lawsuit on July 30, 2001, alleging that the city's clinic, located on South Parramore Avenue, failed to disclose abnormal test results. On Aug. 1, 2001, their attorneys amended the complaint to bring the total to 27 firefighters, plus two police officers. On Oct. 25, 2001, Circuit Judge George A. Sprinkel IV dismissed the case, saying that the firefighters' claims addressed not civil wrongdoing but medical malpractice.

Beyond these facts, almost everything else is -- and has been -- open to interpretation.

The firefighters' attorneys had devised an unusual strategy by not treating the claims as malpractice. Rather, they argued that the actions of the Orlando clinic were similar to those in a 2000 Florida Supreme Court ruling, which allowed employees to sue an employer if it could be proved that injury or death was "substantially certain" to occur from an employer's actions. In that case, however, an Alachua County company, PCR Inc., had failed to tell two employees killed in an explosion that the chemicals they were mixing were extremely combustible. (Unlike the Orlando case, there was no medical testimony to consider in the PCR case.) The firefighters' attorneys have appealed Sprinkel's decision.

"Sometimes attorneys have to take chances and test the law," says Geoffrey Bichler, a firefighter attorney. "We knew the case was the first of its kind. We knew we were going out on a limb. But we felt strongly about the moral issues involved."

Firefighters have been quick to point out that Judge Sprinkel's order did not mean the merit of their case was invalid. Indeed, Sprinkel twice addressed the firefighters, saying his ruling shouldn't end their pursuit of justice. "It doesn't mean the court is unsympathetic to the situation involved, just like anybody else would be," the judge said.

Yet conspiracy theorists will be disappointed that details of a plot against firefighters were never presented coherently. In particular, Sprinkel said firefighters had failed to link wrongdoing to the seven city administrators -- including Hood -- named in the suit. Their complaint did not identify to what extent city officials were complicit in the operation of the clinic. "You haven't said which defendant did what," Sprinkel said.

Indeed, even before Sprinkel dismissed the case, one of the defendants, assistant city attorney Jody Litchford, filed a motion forcing firefighter attorneys to produce evidence that she was guilty of misdeeds. Instead of answering her, attorneys dismissed her from the case.

That lack of evidence lends credence to the city's view that the case is a farce. The city has emphasized that the lawsuit wasn't even served when firefighters in wheelchairs and gas masks began appearing on the evening news. In court documents, city attorneys claimed that the lawsuit was an "unlawful shakedown," "facially invalid" and that firefighter attorneys "are not pursuing it seriously." Rather, firefighter attorneys were using "media manipulation" to "exert undue media and political pressure" on city administrators. City attorneys further describe the action as a "strike suit" -- one used as leverage to obtain a favorable or inflated settlement.

The city official who has the most to lose is Dr. Juan Boudet, who ran the clinic for 14 of the 25 years in dispute. Boudet retired from the clinic in 1999 when its management was taken over by the Orlando Regional Health System. He is now 81 years old and has a heart condition that will require surgery this month.

Boudet has been reluctant to speak to the media on advice from his attorney. But he did tell Orlando Weekly that, unequivocally, city officials never interfered with the diagnosis of a patient. "If the city did that, I would have resigned my job," he says. "How could I accept not continuing this or that treatment on a patient? That is ridiculous."

But he acknowledges that it's hard to recall specifics for a clinic that treated upwards of 100 patients a day. "You're asking me to do the impossible," he says. "You're asking me what happened in 1995, 1996. How the hell do I know what happened? Let me see the record and I can tell you the best I can. These [patients] were human beings. To not treat this man, not tell a patient he has Hepatitis C -- absolutely incredible. ... I'm telling you, one man to another, I would never permit it."

And Boudet brings up a point that firefighters are hard-pressed to answer: If the clinic treated tens of thousands of patients each year -- and conducted blood tests on police officers as well as those in the transportation department who worked with chemicals -- why haven't more city employees come forward with problems? Why were firefighters the only ones chosen by the city to be treated inhumanely?

To help cut through the accusations, the city hired Dr. Thomas Byron Thames to investigate firefighter records. Thames would seem to be a logical, impartial choice: He has been an Orlando doctor since 1958 and has run clinics similar to the city's. He has been on the board of directors of the American Academy of Family Physicians as well as past president of the Florida Medical Association. He has been named director or chief medical consultant for Walt Disney World, Sea World, the Sentinel, United Parcel Service, Orlando Utilities Commission and Darden Restaurants. Most important, Thames has a son, Randy, who is a captain on the Orlando Police Department. (Two police officers were included in the firefighter suit.)

Thames reviewed all 29 cases involved in the suit and concluded that the clinic was guilty of no wrongdoing; at the Jan. 28 council meeting, he illustrated those findings with seven individual cases. Among those was A.C. Walker -- brother of Orlando Fire Chief Charlie Walker -- who claims he was never told of elevated liver enzymes in his blood test. A.C. Walker now has Stage 3 hepatitis C. But Thames says the clinic did try to reach Walker, as indicated by test results that were marked "[copied] to patient" in 1990 and 1992. Subsequent test results in 1994 were not forwarded to the patient because the later test revealed normal enzyme levels, says Thames.

In another example, James Morton claims he wasn't told of elevated liver enzymes until 2000; Thames says Morton's records were marked "to patient" three years in a row -- 1996, 1997 and 1998. Alba Hall claims he was never notified of abnormal lung tests until 1998; Thames says tests in 1992, 1993 and 1995 showed no significant abnormalities -- in other words, until then there was nothing for doctors to report.

To confuse matters, the fire union's contracts with the city from November 1978 to January 1988 didn't require mandatory blood tests, helping to explain why results weren't available in some files, said Thames. Remarking on the city's normal notification procedure, he added, "In my clinic and many others, it would have been done just like this."

Ammerman, however, remained unconvinced by the presentation. "I cannot believe that someone would willingly accept ill-health reports and do nothing about it," he said.

Firefighters were also skeptical, saying Thames was paid by city leaders to achieve their agenda. "He was not about to come in there and say, Ã?You messed up. You should be suing them,'" says Clelland, the union president. "It was a two-hour show by a physician paid by the city. I could produce the same show if given the opportunity."

Ammerman and firefighters prefer what they claim is the view of Dr. Tony Rizzo, an Orlando Regional Health System doctor who began working at the clinic after ORHS took control in 1999. According to Ammerman and firefighters, Rizzo knows that the clinic had problems. "Dr. Rizzo was finding things in the medical records," Ammerman says. "He was going toe to toe with people in Risk Management."

But at a presentation to council in November, City Attorney Scott Gabrielson told commissioners that Rizzo had given the clinic's record-keeping a clean bill of health. "He was not aware of any major problems with missing records," Gabrielson said. "He did note that employees may not have appeared for his or her physical." Rizzo is a colonel in the Air Force Reserve, and his unit was called up during the current military buildup. According to an Air Force spokesperson, Rizzo declined an interview request with the Weekly.

The bottom line: Even among the firefighters' apparent allies, there hasn't been convincing evidence the clinic was operating maliciously. "There has to be some trail," says Commissioner Vargo. "There has been none to tie the concerns of overreaching [administrators] to the lack of medical treatment of firefighters."

That leaves the FDLE investigation. But already firefighters are saying they've been tipped that Munsey's computer might not have been the one removed, as the FDLE report may ultimately reveal.

Munsey, meanwhile, still has some explaining to do. Ammerman wasn't the only source Munsey made contact with in August. He also spoke with District 2 Commissioner Betty Wyman and two firefighter union representatives, as well as firefighter attorney Geoffrey Bichler.

Some of the things Munsey told Steve Clelland were similar to what Ammerman reported. "First of all, [Munsey] told me he didn't have anything to do with destroying files," says Clelland, the union president. "He was grateful he wasn't named in the lawsuit. He couldn't give exact records but gave an indication what to look for. He was going to be the fall guy and didn't want to lose his job. He couldn't give us evidence because he didn't want to jeopardize his employment. We understand that. Christ, we're a union."

Clelland says he submitted several public-information requests based on what Munsey told him. But the documents he received are hardly damning evidence. One is a 1989 workers' compensation study that says, among other things, that the clinic should become part of the city's injury-management program as a cost-reduction measure. A 1994 Management Services Study indicated that doctors were spending too much time involved in administrative chores. "Many of the questions that arise do not deal directly on how to treat the patient and with what medical resources, but instead on, do we treat the patient (Risk Management/Third Party Administrator areas of concern)," the report said. "To this degree, some expertise lays with the current civilian administrator who assists in helping achieve answers so that the doctors may practice their profession."

Those statements are not quite a smoking gun. But Ammerman is convinced firefighters will eventually find one. "I don't feel like I'm out on a limb," he says, "because I know what the truth is."


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