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When given the choice between offering pain-stricken patients palliative care with morphine and fentanyl injections and diverting the drugs for his own illicit use, a paramedic who worked in Greene and Hawkins counties allegedly opted for personal opioid-induced numbness, according to an indictment returned by a federal grand jury on Tuesday.
The panel indicted Nathan Smith for tampering with a consumer product and obtaining a controlled substance by misrepresentation, fraud, deception or subterfuge.
If convicted, he faces up to 10 years in prison, but defendants who arrive in court without multiple felony convictions are rarely given top-of-the-range sentences.
Smith, 41, was a full-time paramedic with the Greene County Emergency Medical Service from February 2005 until December 2018. He was a part-time paramedic for the Hawkins County EMS from May 2015 until August 2018. He allegedly diverted morphine and fentanyl over a nine-and-a-half-month period beginning in March 2018, according to the indictment.
The defendant allegedly accessed the locked narcotics boxes in ambulances, removed morphine and fentanyl – a synthetic opiod dozens of times stronger than morphine – from the single-dose vials and replaced the drugs with saline solution, or salt water, according to the indictment.
Smith allegedly demonstrated “extreme indifference” to patient welfare, knowing that the powerful painkillers would only be dispensed to “critically ill or injured patients being transported by ambulance for emergency treatment,” the indictment states.
The two count indictment does not say how authorities learned Smith allegedly was substituting salt water for painkillers.
Smith’s initial appearance in U.S. District Court in Greeneville had not been scheduled by press time.
The Tennessee Board of Emergency Medical Services has yet to initiate disciplinary action against Smith.
When criminal charges are pending against a licensed medical professional, health-related boards frequently await the outcome. A job-related felony conviction would mean immediate suspension or revocation of Smith’s state-issued paramedic license.