A new city audit is calling out the San José Fire Department over how it safeguards paramedic narcotics, after investigators discovered tampered vials and a captain’s arrest. The report follows internal warnings and at least one confirmed patient exposure that prompted criminal charges earlier this year.
Audit finds gaps in inventory controls
The Office of the City Auditor’s report, issued Nov. 24, urges the department to tighten policies on how paramedic drug kits are stored, accessed and tracked, including changing when inventories are checked and limiting who can get into new biometric narcotics safes the department plans to deploy, according to the City Auditor’s report. “Our audit of the main safe inventory in the summer of 2025 revealed no evidence of theft or tampering,” auditors wrote, but they warned the Controlled Substances Program Manager’s responsibilities are not separated enough to guarantee medication security. The report lays out seven recommendations, including routine independent counts, clearer rules for wasting and destroying medications, and stronger oversight of how central supply is managed.
Captain arrested; prosecutors filed charges
San Jose police arrested Fire Capt. Mark Moalem in April, and the Santa Clara County District Attorney later charged him with burglary and drug-related offenses after an investigation found morphine and midazolam vials had been tampered with, according to a news release from the District Attorney’s Office. Prosecutors said evidence recovered in searches included used IV bags, vial caps and needles, and that suspected tampering or thefts may have occurred at as many as 17 of the city’s 34 fire stations. Local outlets reported heavily on the case when the arrest was announced in April; see earlier coverage spanning 17 stations.
Internal warnings, county alarmed
Emails obtained and published by San José Spotlight show firefighters raised alarms in late 2023 about missing or underfilled vials and at least two incidents in which paramedics gave patients morphine that later appeared not to work. After those concerns became public, Santa Clara County’s EMS director wrote to the fire chief that failing to notify the county “substantially compounds this risk to the public” and called for a full review, as detailed by San José Spotlight. That county pressure pushed elected leaders and the department to promise reforms and more oversight.
Union response and a temporary fix
The firefighters’ union has argued that eliminating a paramedic field-supervisor role known as Med 30 weakened drug oversight, and city leaders signed off on a temporary revival of the position with seven months of funding starting in December, at an estimated cost of $748,000, according to budget coverage by Local News Matters. Fire Chief Robert Sapien has defended the earlier reorganization, saying those responsibilities were reassigned and that additional security measures have been or will be put in place to prevent a repeat.
Legal and oversight questions
The auditor’s report lays out the federal, state and county rules that govern controlled substances and recommends steps, such as separating ordering, labeling and recordkeeping duties, that would strengthen compliance, according to the City Auditor’s report. At the same time, prosecutors have filed criminal charges against a captain in the case, and the District Attorney’s office says penalties could follow if the allegations are proved, per the District Attorney’s Office. City officials now face pressure from the county, the auditor and the union to show that whatever reforms they adopt will keep patients from being exposed again.
