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What's The Prognosis? 

As The Gunsmoke Clears, Dr. Richard Carmona Considers His Options.

HIGH-FLYING SWAT Doc Richard Carmona is grounded until next month, out of action after the Pima County Board of Supervisors refused to approve a new contract because of trouble securing insurance coverage.

Supervisors, including his staunch ally Republican Ray Carroll, voted to delay Carmona's new contract for medical and law enforcement work for the sheriff's department until November 2, when they hope questions about insurance are answered.

The contract, replacing one that expired when Carmona was forced to resign as head of the county health care system, is only worth up to $5,000 a year and was supposed to be routine. It calls for Carmona, a deputy for 14 years, to provide medical duties as well as retain his role on the SWAT team and as a deputy.

Trouble arose late last week in getting insurance coverage for the medical duty portion of the contract, according to County Administrator Chuck Huckelberry and the county's risk manager, Dave Parker.

Cost of insurance could be far higher than the contract itself.

"I don't think it's anything personal about Carmona," Carroll says. "I think it is solely due to the insurance issue. If the cost is prohibitive, we may have to redefine the duties."

Sheriff's officials were working on September 14 to get approval for Carmona's new contract.

That is the same day that Carl Lafitte grew so alarmed by his son's increasingly deteriorating mental state that he drove him to Kino Community Hospital for psychiatric care.

It also was on September 14, in the downtown offices of county administration five miles away from Kino, that a severance check for $75,000 and letter were mailed to Carmona. A trauma surgeon, Carmona had overseen Kino for four years and the entire county health system for two until he lost an internecine battle with the Board of Supervisors and the county health care commission and was forced out in July.

Jean Pierre Lafitte had been a patient at Kino before, and his dad believed his son would be evaluated and again admitted to one of Kino's 51 beds reserved for psychiatric patients. His lawyer believed the same.

But Jean Lafitte, plagued by acute mental illness throughout his 27 years, was instead released after about a day. Shortly after the release, Jean Pierre Lafitte tells friends he wants to kill himself.

And two days later -- Saturday, September 18 -- Carl Lafitte, 53, was savagely murdered at his southwest-side mobile home. Sheriff's investigators now consider Jean Lafitte the likely killer.

Later that day, Lafitte was driving a Toyota pickup and rear-ended a car driven by Henrietta Gomez at about 5:45 p.m. on East Grant Road and North Campbell Avenue. An armed Lafitte grabbed Gomez when she approached to discuss the collision. He slammed her head on the truck but turned her loose.

Carmona was on his way for a quick dinner with his daughter before working his medical job at the UA-Stanford football game at Arizona Stadium a mile and a half away. Later that night Carmona was to catch a plane to attend a SWAT conference in Virginia.

Carmona stopped his county-issued Chevy Lumina to render aid and approached Lafitte, who was seated in the truck. Bystanders shouted warnings that Lafitte had a gun. Carmona returned to his car, dove in, backed it up, radioed for backup and got his county-issued .45-caliber semi-automatic.

"I looked at him very carefully," Carmona says. "I identified myself as a peace officer. I told him over and over to put down his weapon, that I was a peace officer, that there had been an accident and that there was no need for this. I was literally begging him. I knew he could hear me. He was intent in his look. He was staring at me very clearly."

Lafitte appeared to begin to put his gun down, but instead raised it and fired, grazing Carmona's balding head. Carmona returned seven shots. Three hit Lafitte. Two struck Lafitte's truck and another round hit the windshield of a car driven by Wendy Hernandez, a former special magistrate at City Court.

Carmona went to nearby University Medical Center for evaluation and then was back to the scene. Michael Piccarreta, the Tucson lawyer who represents members of the Tucson Police Officers Association and the Sheriff's Deputies Association, was just being seated for dinner with his wife and two other couples at Presidio Grill when he got the call. He hustled to the scene as well and says Carmona's actions were "heroic."

Piccarreta joined those pointing to the ultimate tragedy: the state's mental health system that utterly failed the Lafittes.

But he says Carmona was fully justified.

"Bullets fired by the mentally ill hurt just as much as bullets fired by those who are sane," Piccarreta says.

Piccarreta, who got called out to another shooting around midnight on September 18, says it is "of no legal significance" that Carmona's contract with the sheriff's deparment had lapsed.

"Dr. Carmona could have done what he did if he owned a bookstore, was a trauma surgeon or was a chef," Piccarreta says.

Sheriff Clarence Dupnik agrees.

"He stopped to render aid as a doctor," Dupnik says. "He's a unique person. I don't think many people or many doctors would have even stopped.

"That's not a problem at all," Dupnik says of the contract. "I'd be shocked if somebody sued and would think the county would defend him."

The former contract and new one both contain a provision that says Carmona will be covered by the county's insurance program only for "activities and actions which are within the scope of duties...and which occurred during the term of this agreement."

Dupnik says the contract pays Carmona, who made $189,000 a year as the county health czar, "almost nothing."

"We missed the boat on the contract," Carmona says about the lapse when he was forced to resign from his health systems position. "None of us thought ahead."

For Carmona, the shootout created a new wave of publicity, including some pain from a headline in The Arizona Daily Star the next day: "Carmona kills armed man in traffic dispute."

Even his critics managed some forms of praise.

Supervisor Raul Grijalva, a Democrat, implored Carmona to not resign before switching gears to join his close friend and ally from the health commission, Sylvia Campoy, to force Carmona out.

"It appears to be a singular act of bravery on his part, potentially saving several people's lives," Grijalva told the Star.

Dick Jaskiewicz, a nurse at the jail and a veteran of decades of the county's bruising political battles, is no fan of Carmona's. But he saluted him and says Grijalva's remark was snide and offensive.

"Rich did the right thing. Absolutely. It'd taken me just one shot, but Rich showed courage. He's got guts. Just like that time he dropped out of that helicopter to rescue someone. No one can take that away from him. If, as Grijalva says, it was a 'singular act of bravery,' well that's a million times more than what Grijalva's ever shown."

The shooting has touched off a new round of Carmona: The Movie -- or Carmona: The TV Series -- complete with the reset of the life of Richard Henry Carmona: Born in Manhattan to Raoul and Lucy Carmona on November 22, 1949; a high school drop-out, a sergeant in the Army special forces in Vietnam, discharged January 1, 1974; nurse and paramedic in California; a top graduate from the University of California at San Francisco Medical School; director of trauma services at Tucson Medical Center until 1993, when a nasty internal battle left him out at TMC but with a $3.9 million settlement from TMC and a doctor.

On the SWAT team, Carmona was injured, a shot in the foot or leg, from friendly fire in 1988. But he received a medal of valor four years later for his action rappelling out of a helicopter to rescue a survivor of a MedEvac helicopter crash.

He will be up for another medal of valor -- the only deputy to have two. That touched off a brief controversy when there was no talk of similar honors for the other deputies who were forced to shoot armed and dangerous people recently.

Dupnik put that issue to rest, saying all would be honored.

Carmona credits bystanders for warning him about Lafitte's gun, but says "people watched as if they were watching a video game or television. I think we have become so desensitized. It was very surreal. Here we're at peace time, not war, at Grant and Campbell in Tucson."

Carmona, who lectures and runs a clinic at the UA, says he still is evaluating permanent positions. He refuted speculation that a job as chief medical officer at the jail was designed for him. He says he helped Dupnik's staff draw up specifications and an advertisement for a new position, which will pay up to $126,640 a year. Two leading candidates are a retired military doctor and another from the state Department of Corrections.

The shooting also has fueled the drive by some deputies and jail guards to compel Carmona to run for sheriff next year. Several guards and deputies talk openly about creating an exploratory committee for such a campaign. None of the required campaign statements have been filed.

Carmona, a registered independent who has been married for 28 years and the father of four, says he has no desire to ever challenge Dupnik, a Democrat in his fifth full term.

"Clarence Dupnik is one of my best friends," Carmona says. "I look at him as a mentor. He has afforded me many opportunities. I would never do anything against him. There is no better law enforcement official in the state. I truly admire him. He has my unyielding and undivided support."

Still, Carmona says he would consider running for sheriff when Dupnik chooses to retire and with Dupnik's blessing.

"I don't have the power to bless anyone," says Dupnik, who considers Carmona a friend. "He's bright, a hard worker and someone who got a bad rap" for the financial crisis, much of which was underway before he took over the county health system. "He was the political fall guy."

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