As the prosecution put it to a jury in midafternoon today, James Melady raped R.M. when he was the lone paramedic tending to her as she was passed out in the back of an ambulance. He set up his phone’s video camera, exposed his patient’s breasts, then penetrated her sexually, with his fingers.
As the defense put it, Melady, a former Flagler County Fire Rescue paramedic, was “doing his job.” He was looking for a cause for the woman’s unconsciousness. She had not responded to Narcan, the neutralizing agent typically administered to individuals who have overdosed. He did a pelvic exam, wrote that in his medical report, and handed over the report to a physician at the hospital.
Assistant State Attorney Melissa Clark and defense attorney Charles Fletcher briefly presented their cases to the jury of five women and three men they’d selected in a workmanlike session that took most of the day, from a pool of 50 jurors. The alleged incident took place in 2021. It was not uncovered–by chance–until last year.
Melady, 38, resigned in June 2024 when he was under internal investigation over a separate matter: he faces allegations of fraud, using another patient’s credit card. He’d had a checkered record as an employee. He faces up to 35 years in prison if convicted of the rape and video voyeurism charge to be decided in this trial, and 55 years when the other charges are included. He faces yet more unrelated charges, including voyeurism, in Volusia County.
Fletcher told Circuit Judge Dawn Nichols, who is presiding over the trial, that his client intends to testify. He will be the only defense witness. Denied bond, he’s been at the Flagler County jail for the past 15 months.
The case has hurt the image of Flagler County’s fire services, and county government was informed that the former patient intends to sue. The county referred the case as “horrific sexual assault allegations” and announced new safety protocols after Melady’s arrest on Sept. 12, 2024, among them the mandatory presence of two paramedics in the back of an ambulance when tending to a patient.
Melady, sitting by his attorney and wearing a shirt and tie (no jacket), faced the jury during selection and appeared involved in the choices, taking notes and conferring with Fletcher. Like Clark, Fletcher is a non-nonsense, get-to-the-point attorney: no small talk, no ice-breaking jokes, no attempts to schmooze the jury. Both attorneys are unhesitating, self-assured, blunt and clear-spoken. Clark’s opening was six minutes long, Fletcher’s two minutes.
Clark described how on Oct. 17, 2021, RM was passed out from an alcohol overdose as she was being transported by ambulance to a local hospital. Three years later, when Melady was living with his girlfriend, the girlfriend had become suspicious of him, suspecting infidelity. She examined his laptop. She discovered the video of her boyfriend in the ambulance, in full Fire Rescue gear, and the unresponsive woman. The former girlfriend will testify, Clark told the jury, that “she found the video disturbing, so she decided to record that video as it’s playing on the defendant’s laptop using her cell phone.” Law enforcement got the video, and began investigating.
“You will get to see the video for yourself,” Clark said. “You’re going to see the defendant make sure she’s unresponsive. You’ll watch him try and open her eyes and do what’s called a sternum rub, which will have some folks explaining what that is. And after confirming that she’s unresponsive, as you watch the video, you’ll see at one point, he lifts up her shirt, exposing her naked breast to the camera. And then later, he pulls up her sweatpants, exposing her naked genitalia to the video. And then eventually, he pulls her pants down and begins to manipulate her genital area with his fingers, and it’s at that point that he penetrated her vagina with his fingers.”
To the defense, which revealed its strategy in a pre-trial hearing reported here last September, everything Melady did was medically necessary.
“Mr. Melady put everything he did in the report that he filled out right as he did it,” Fletcher told the jury, including the reference to “an examination of the pelvic area,” where he found no abnormalities, though there’s apparently no mention in the report of the abnormality in Melady’s behavior: the video he’d recorded. Flagler County Fire Chief Michael Tucker said it is not and has never been either standard procedure or allowable procedure to record patient care in the back of an ambulance.
“He put it on a laptop camera because he was worried that somebody might accuse him of something,” the defense attorney told the jury. Time goes by. Melady allegedly forgot about that day. “When the officers talk to him,” Fletcher says, “unfortunately, he’s on Ambien and forgets things that he says right after he says them. He doesn’t remember this. He makes up a whole story about him and his girlfriend. He doesn’t even remember. It was not a significant time in his life. Nothing significant about that.” Ambien is a prescription sedative that helps people sleep.
Fletcher described Melady’s training, including training he got in the military “while he was in Afghanistan serving in the Navy.” Melady was a corpsman. No one knew what was making RM unresponsive. The Narcan hadn’t worked. “He thought there might be a continuing source of those narcotics, and he did a pelvic exam, and it’s right there on the form that he filled out on October 17, 2021,” Fletcher told the jury, before quoting the law: “You’ll hear this sentence, an act done for a bona fide medical purpose is not sexual battery.”
That’s what this case and this verdict will com down to. The jury will have to decide whether what Melady did was medically necessary. The jury will not hear peripheral cases of voyeurism or fraud–just the incident in the ambulance.
The prosecution’s witnesses include Jesse Hunter, the paramedic who was Melady’s partner, who will testify to the standard of care, which does not include pelvic exams. It will also hear a board-certified emergency room physician “talk to you about whether or not he believes that to be a proper medical procedure, whether or not it was medically necessary,” Clark told the jury.
It was not, he will testify, except in rare and specific instances, echoing medical literature on the subject.
The pelvic exam drew national and international attention in 2018, the year of Melady’s hire date at Flagler County Fire Rescue, when more than 150 women testified that their Olympic doctor, Larry Nassar had routinely abused them by performing pelvic exams, or “treatments,” under the guise of medical necessity. There were no references to Nassar’s case today, though the prosecution made one unexpected reference to a once well-known rape victim, and the defense took a swipe at the media.
Jury selection had been a preview of the two attorneys’ strategy. Clark asked jurors whether they would hold it against the victim that she drank, and at one point made a reference to the notorious 1989 Central Park jogger who was raped, disfigured and left for dead by unknown assailants. Clark rhetorically asked the jury whether it was “not the best idea” for a woman to jog in Central Park at 2 a.m. (Trisha Mili had been jogging, as she routinely did, before 9 p.m., though the time or place was not the issue.) “Does that make her less of a victim?” Clark asked the jury. No, came the collective answer. The prosecutor was ensuring that jurors would not hold RM’s behavior before she was assaulted against her.
Fletcher, for his part, asked a juror whether he believed everything he reads in the paper, or on the internet, handing the juror the softball he needed to hear the juror what it back with “absolutely not,” as the juror went on to describe the internet as “basically ground zero for misinformation.”
Testimony begins at 8:30 Tuesday in Courtroom 401 at the Flagler County courthouse.
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