Of all the sex-abuse suspects whose names Parkland Memorial Hospital has disclosed, only one is known to have lost his caregiver’s license because of the allegations. And he got it back after two months.
The Texas Board of Nursing revoked Cesar Menchaca’s license in September after finding that he fondled a hospitalized jail inmate — a man who was shackled to a bed and was not his patient. The Texas agency that licenses hospitals came to a similar conclusion and cited it as one reason for fining Parkland a record $1 million last summer.
“His actions were not acceptable practice for our clinicians,” the hospital said in a Jan. 22 statement to The Dallas Morning News. “Chief Nursing Officer Mary Eagen demanded his association with Parkland be terminated.”
But Parkland police called the abuse allegation unfounded. A detective reached this conclusion after interviewing Eagen’s subordinates and the patient, according to police records.
“He said the investigation was terminated because I used the word ‘groin’ instead of ‘penis’” when first describing the incident, inmate Rubin Crain told The News. (The newspaper generally doesn’t name alleged sexual abuse victims, but Crain volunteered to be identified.) Police records do show that the detective considered this a key reason for closing the case.
Menchaca did not respond to interview requests. The Parkland contractor that employed him said he was falsely accused.
The 35-year-old man went to work at Parkland in late 2011, as federally installed safety monitors began documenting the public hospital’s many dangers. One was that Parkland had simply failed to hire enough caregivers. The shortage soon worsened, as the monitors’ scrutiny of patient care led to firings and resignations.
Menchaca was part of the crisis-control plan. He worked for a company called Nurses Now International, which brought nurses from Mexico to Dallas for additional training at El Centro College and then placed them in temporary jobs at Texas hospitals.
The nurse came with a resume listing several prior employers in Saltillo, a city about three hours’ drive from the Texas border. He had one glowing letter of reference, although it was eight years old. On his first attempt to get a Texas nursing license, he flunked the exam, doing particularly poorly in areas where authorities have repeatedly faulted Parkland: safety and infection control.
But Menchaca passed on the second try. Parkland put him to work as part of its “float pool,” which dispatches nurses to areas that need extra help.
One of those areas was the seventh floor, where patients with a variety of ailments are treated. One of those patients, beginning last April, was Crain. He had a severe infection stemming from a finger injury.
Like other Dallas County inmates who become Parkland patients, Crain was not only chained to his bed but also under guard by a sheriff’s officer. His long history of criminal convictions includes everything from marijuana possession to robbery.
That history, Crain knows, makes people inclined to doubt him, and he did not seek out news coverage. But numerous government employees — both investigators and witnesses, including a guard — have lent credence to his complaints about Menchaca.
The state nursing board, for example, declared that Menchaca twice “fondled the penis and testicles” of Crain, which “exposed the patient unnecessarily to the risk of mental and physical harm.” It reached this conclusion after the nurse failed to respond to written allegations.
oth molestations occurred in the middle of the night, Crain said, under the pretense that the nurse was checking his lymph nodes and pulses. He recalled that the first time, in late April, he tried to alert his guard — who was sleeping and “told me to go back to sleep.” Crain did nothing further at the time, fearing “no one would believe me.”
A report by two investigators from the Department of State Health Services, the hospital licensing agency, describes what happened during the second incident:
Crain’s regular nurse began a 30-minute break about 2 a.m. on May 3. She asked Menchaca to respond if any of her patients called for help. Menchaca — without being summoned — quickly went to see Crain in Room 716. A different guard was on duty, and she was awake.
Menchaca immediately violated protocol in two ways, guard Delesia Lacy told the DSHS investigators: He did not put on a “contact isolation gown,” which is designed to prevent the spread of infection, and he closed the privacy curtains around the patient’s bed, preventing her from maintaining required visual contact with the inmate.
The nurse “spoke to the patient in medical terms for a minute, and then it became very quiet,” according to Lacy. He “was behind the curtain for 10 to 15 minutes.”
Lacy had “worked at the hospital for several years and never seen a nurse come in at 2 a.m. and do an assessment on an inmate,” the DSHS report added. She “stated she believed something happened. It was just too strange.”
Crain told her after Menchaca left that he’d been molested, and she urged him to speak with his regular nurse. That nurse and a supervisor told DSHS that Menchaca had no business conducting a full physical assessment and that he had not documented anything about it in the medical record.
When state investigators interviewed Menchaca, he “changed the subject frequently and required redirection.” When asked why he didn’t document his exam, he “did not answer the question.”
Menchaca wrote a statement for Parkland police saying that Crain had been suffering from swollen lymph nodes and groin pain. Also, “I verified the status of his handcuffs that might compromise his circulation.”
He told the hospital detective that the medical record lacked documentation “because he usually gives the patient’s nurse a verbal report,” according to a police report. Menchaca claimed he went to Crain’s room without being called “because he does not want to be accused of not taking care of” patients. And he said he pulled the privacy curtain “because the [sheriff’s] officer was female.” There’s no indication in the police report that the suspect explained his failure to use the isolation gown.
Before federal safety monitors were installed at Parkland, the hospital repeatedly broke the law by not reporting abuse allegations to DSHS. Reporting has improved since then, the state agency says, although the hospital took nine days longer than allowed to disclose the Menchaca matter. DSHS, which hasn’t always interviewed alleged victims, then spoke with Crain.
State investigators substantiated the abuse allegation, saying Parkland failed to protect his “physical and emotional health.” But the criminal case was another dead end.
Menchaca was suspended on the day of the incident and fired the next. At the time of termination, Parkland police were “considering a referral to the district attorney,” says a hospital record cited in the DSHS report.
But the Parkland detective soon declared “there was no basis” for a charge of assault — which Texas law defines as including offensive physical contact. Generally speaking, assault is a misdemeanor. It’s a felony if sexual penetration or serious injury occurs, or if the contact causes mental injury to a disabled person.
In justifying his conclusion, the detective cited both Crain’s initial description of the unwanted touching and statements by two nurses. They thought Menchaca shouldn’t have been in Crain’s room, he wrote, “but they said if he was checking” what he claimed he was, then his actions “would be one way to check.”
Menchaca’s employer takes a position similar to that of the police.
“It’s a total fabrication,” Nurses Now vice chairman David Roth said of the abuse complaint. In a September interview with The News, he laughingly mocked as “incredible” the idea that abuse could occur with a jailer nearby.
Menchaca didn’t initially respond to nursing board allegations because they were mailed to his apartment near Parkland after he’d moved out, Roth said. “He’s never had his day in court on that,” said the executive, whose company has offices in Kentucky and Mexico.
Company lawyers have since persuaded the nursing board to reconsider the matter and, at least for now, to restore Menchaca’s license. It isn’t clear when the board will decide his fate.
Menchaca recently admitted to the board that he failed to report his new address. It was in Houston, where Nurses Now sent him to work at Harris Health — another public hospital system.
Nurses Now did not disclose why he was fired in Dallas, Harris Health spokeswoman Melinda Muse said. Harris Health fired him in September, shortly after he lost his nursing license, and has refused to take him back.
Where is Menchaca now? Nurses Now representatives won’t say.