PATRICK COUNTY, Va. - An emergency medical technician who was placed on unpaid leave after racist comments surfaced of him comparing black patients to gorillas and claiming to take "immense satisfaction" as he "terrorized" an African-American boy with a needle has been cleared of wrongdoing by the Virginia Department of Health.
The Virginia health department's investigation focused on whether "any alleged violations of Virginia's EMS regulations have occurred," the agency said in a statement. Those regulations stipulate that "EMS personnel may not discriminate ... based on race, gender, religion, age, national origin, medical condition or any other reason."
After a two-month investigation in which fellow employees were interviewed and patient care was investigated, the health department said it "determined that there is no substantial evidence to support any violation of the EMS regulations" and closed the case.
The department began investigating EMT Alex McNabb after anonymous complaints about him spewing racist and anti-Semitic rhetoric on social media. The complaints expressed concerns he could be harming or mistreating patients of color.
McNabb, a part-time EMT in Patrick County, Virginia, has commented frequently on a white supremacist podcast called "The Daily Shoah." McNabb is a frequent co-host of the podcast, whose title mocks the Holocaust.
The comments, which McNabb, 35, later claimed on Twitter to be a "work of fiction" ignited a debate over whether he can render adequate care to vulnerable, minority and Jewish patients.
McNabb's Twitter account has since been suspended, but in December McNabb would not comment directly to CNN beyond indicating in a tweet that he was undergoing a "character assassination attempt."
Using an alter-ego named "Dr. Narcan" on the podcast, McNabb repeatedly called black people "dindus," a slur combining the words "didn't" and "do" -- a reference to black people who claim they are mistreated by the justice system.
In one podcast from October 4, 2016, first reported by the Huffington Post, McNabb tells of an emergency call to what he characterized as a black apartment complex that medics call "Ebola Alley."
Using the Dr. Narcan persona, he refers to a black woman as a "dinduisha" and called her a shaved "Harambe," the name of a famous gorilla.
But McNabb has maintained his words were all part of a fictional story in which he played a fictional character.
In an interview conducted by the Commonwealth of Virginia Department of Health investigators, McNabb was asked if he had "done anything intentionally or unintentionally that can be construed as discriminating in patient care?"
McNabb responded, "Absolutely not. I have been extremely vocal about how this would not every (sic) be something that would happen."
Virginia's Department of Health opened a formal investigation into McNabb's conduct after receiving a complaint in November.
An attorney for McNabb's employer, JEB Stuart Volunteer Rescue Squad, told CNN that McNabb was placed on unpaid leave two days after news reports of his comments surfaced.
"We'll cooperate (with the state)," said Wren Williams, JEB Stuart's attorney. "I've cautioned against firing him outright yet because we don't want to be sued for wrongful termination."
Williams told CNN on Thursday that the company was awaiting an official copy of the Department of Health's report regarding the outcome of its investigation. But it had received a copy of the decision from McNabb.
"I'm sharing this information with the squad leadership and we will be calling a board of director's meeting soon to discuss the outcome of the investigation and the next steps," McNabb said. Williams said McNabb's future will rest with JEB Stuart's board.
The case is testing the longtime protection for extremists whose words may be racist and offensive, but who are still shielded by free speech laws. In this case, McNabb's occupation is front and center.
"This individual should never be involved in patient care at any level," said Lock Boyce, the board of supervisors' chairman of Patrick County. "Not as a physician, a nurse, an EMT. Not anywhere." The rural, overwhelmingly white county in the Blue Ridge Mountains has a contract with McNabb's employers.
"He is making life-or-death medical decisions for residents of a variety of ethnicities, many of which do not fit his criteria for a white ethno-state," said Keegan Hankes, a senior research analyst with the Southern Poverty Law Center. "Whether drawn from his experiences as an EMT or fiction, (McNabb's statements) are tremendous cause for concern."
Though McNabb has said on Twitter that "any resemblance to actual persons ... is purely coincidental," he told his podcast co-hosts in 2016, after describing a diabetic ER patient and a doctor who collects toenails, that "both these stories are real."
Later in the same podcast, in a Dr. Narcan story that McNabb doesn't label as fact or fiction, he speaks of "an unruly, young African-American male child" who needed to have blood drawn.
"So, guess who volunteered to take (his) blood?" McNabb said. "Dr. Narcan enjoyed great, immense satisfaction as he terrorized this youngster with a needle and stabbed him thusly in the arm with a large-gauge IV catheter."
In December, African-Americans in a rural Virginia county expressed worry they were at risk after hearing that an emergency medical technician made racist comments on a white supremacist podcast.
Some residents served by the company McNabb works for were outraged at comments he made.
They expressed themselves in a Patrick County Board of Supervisors meeting not long after McNabb was suspended.
Racist comments by EMT sparked fear in black community
"Just imagine if you were a black person needing medical help and call the rescue ... your chances of dying in that rescue vehicle are greater than if you stay home," Vietnam veteran Charles Thomas said in the board of supervisors meeting after McNabb was suspended without pay. The meeting got heated and was live-streamed by The Enterprise community newspaper in December.
"This is not some backward county where we're a bunch of white supremacists," said Boyce, who says he's heard from many people in the county outraged over the reports.
"We can't sit here and say it's their First Amendment right," he said. "We have to say 'No, this is the way to hell.' "
In December, chairman of supervisors Boyce wanted to force JEB Stuart to fire McNabb immediately by withdrawing county funding until they did. But no other supervisor supported him. They would only agree to make a statement denouncing racism in any form.
The Department of Health says it has to focus on what it regulates and it could find no violations of the one regulation the anonymous complaints applied to.