Jeff Davis County EMS director enters into settlement with Department of State Health Services following notice of violation

The interior of a Jeff Davis County ambulance in 2022. Staff photo by Mary Cantrell.

FORT DAVIS — Jeff Davis County EMS Director Peggy Fonseca has entered into a settlement agreement with the Texas Department of State Health Services (DSHS) regarding a notice of violation (NOV) she received in August for failing to follow protocol when responding to a person in cardiac arrest. 

According to the NOV, when responding to a call for a person in cardiac arrest in May, Fonseca assessed the patient, who “was determined to be apneic and pulseless,” but subsequently “failed to perform lifesaving interventions” as required by Jeff Davis County EMS and medical director protocols. 

An initial letter dated June 5 addressed to Jeff Davis County Ambulance detailed that a complaint had been filed with DSHS regarding Fonseca’s “withholding [of] resuscitative measures.” That letter prompted the service to send statements and documentation relating to protocol to DSHS.

After receiving the NOV in August, Fonseca requested an informal conference on the matter — her opportunity to present facts, according to a DSHS spokesperson — which took place October 18. While it is possible that the NOV could have been withdrawn after that conference, the department maintained Fonseca was in violation of failing to provide lifesaving interventions.

According to the settlement agreement, which Fonseca signed on October 29, DSHS did withdraw its initial proposal to suspend both Fonseca’s EMT-paramedic and instructor certifications for 90 days and opted instead for a lesser disciplinary action. 

“Based on the information, documentation, and overall good faith efforts demonstrated by [Fonseca] to come into compliance, it was determined a settlement of these matters would be in the best interests of the parties,” the document states.

In lieu of a 90-day suspension on both of her certifications, the department mandated Fonseca complete three one-hour continuing education courses — in documentation, patient assessment and geriatrics — by December 1. A DSHS spokesperson confirmed Fonseca has completed the required courses and was issued a formal “reprimand.” 

Fonseca will be required to provide a copy of the settlement agreement to all current and future employers for which she acts as EMS personnel for the next twelve months. The final disciplinary action will be posted to the National Practitioner Data Bank, National EMS Compact database and DSHS website, states the settlement agreement. 

If Fonseca does not comply with the settlement agreement, DSHS will pursue the original 90-day certification suspensions and raise the matter with the State Office of Administrative Hearings.

Fonseca remained in her role as EMS director while the legal proceedings with DSHS played out. When reached for comment about the settlement agreement, County Judge Curtis Evans reaffirmed that Fonseca is excelling in her role and helping the county move forward with a number of healthcare initiatives, namely professionalizing the previously volunteer-run EMS service.

“Peggy’s doing a great job for us,” said Evans. “She is moving us forward into a paid service.” 

Fonseca said she was eager to discuss the settlement agreement with county leaders in a forthcoming meeting but declined to comment further. She said, due to delays, the matter had not yet been put forth during executive session in commissioners court — a time for the court to convene privately on personnel and legal matters. 

Commissioner Royce Laskoskie, who previously voiced “grave concerns” about Fonseca receiving the notice of violation and said he believed the court wasn’t taking it seriously, declined to comment on the settlement agreement.