Audit finds secure storage and disposal but recommends policy, system upgrades for Las Vegas Fire Rescue controlled substances

Joe Throneberry, the city auditor’s senior forensic auditor, presented the Audit Office’s review of Las Vegas Fire Rescue’s controlled substance inventory management on July 21, 2025. The review found controlled substances were stored securely and expired medicines were disposed of and documented, but identified four areas for improvement, including inconsistent policy versions, limitations of the ImageTrend case management configuration, procurement reconciliation gaps and reliance on manual logbooks.

The audit matters because controlled substances such as fentanyl, ketamine and midazolam (Versed) are used in emergency care but carry risks of diversion; robust controls and reliable tracking reduce the risk to patients and the city. Throneberry said the audit evaluated alignment with Drug Enforcement Administration requirements, guidance from the Southern Nevada Health District and City of Las Vegas policy CM601.

Throneberry told committee members the audit team observed secure disposal processes during field work on Feb. 11, 2025, and verified documentation on DEA Form 222 for returns and disposals. The report noted 211 vials of midazolam (Versed), 79 vials of ketamine and 47 vials of fentanyl were segregated as expired and documented for disposal. The audit found no inventory-count discrepancies during testing.

The audit’s four findings and recommendations included: 1) consolidate and formalize policy approvals—three versions of policy FR 510.31 were located in different approval states and one outdated version remained posted on SharePoint; 2) evaluate ImageTrend enhancements to enable real-time controlled-substance tracking, automated reconciliation, waste-witness verification and stronger authentication and role‑based access controls; 3) strengthen procurement reconciliation processes between Oracle purchase records, logbooks, DEA forms and physical receipts to reduce invoice/delivery irregularities; and 4) evaluate an automated cradle‑to‑grave inventory management system in a cost‑benefit analysis to reduce human-error risk.

Fernando Gray, Fire Chief, responded that Fire Rescue appreciated the audit and is open to exploring technology solutions. Committee members asked how witness verification and PINs would be monitored and what interim protections exist while system upgrades are planned; Throneberry explained ImageTrend’s existing drop‑down name fields and recommended notifications for listed witnesses to improve auditability. Chief Gray said manual process enhancements were implemented and the office is evaluating technology options to meet operational needs.

A motion to accept the audit report passed after committee vote.

The audit report recommended collaboration among Fire Rescue management, the city IT department and ImageTrend vendor representatives to evaluate feasibility, timelines and implementation requirements. The audit noted Fire Rescue already took corrective steps on posting the revised policy.

Looking ahead, the audit recommends the city consider phased technical controls (notification of witnesses, stronger authentication, exception alerts) and an evaluation of electronic safe or biometric-integrated solutions as part of any procurement. The committee did not take additional action beyond accepting the report.