Administrative charges following a medical procedure reportedly conducted without proper certification.
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Administrative charges following a medical procedure reportedly conducted without proper certification.

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Ottawa County commissioner, two firefighters face misconduct charges

WILLISTON, Ohio — An Ottawa County commissioner — in his outside role as a battalion fire chief — and two other Allen-Clay Joint Fire District firefighters face administrative charges following a medical procedure reportedly conducted without proper certification.

Misconduct-in-office charges were filed against county commissioner and Allen-Clay battalion chief Mark Stahl, emergency medical technician Justin Frank, and paramedic Cara Orra.

Mr. Stahl and Ms. Orra face an additional misfeasance charge, and Mr. Frank a malfeasance charge, according to records obtained by The Blade.

A commissioned investigation alleges Mr. Frank performed an invasive medical procedure last summer for a patient believed to be suffering cardiac arrest, exceeding Mr. Frank’s medical authorization.

The review found Mr. Stahl “permitted” the act while on scene and that Ms. Orra completed a false emergency medical service report.

The patient, 81, died later that day. No official suggests wrongdoing led to his death.

“We’re all entitled to our day to clear our name, and I look forward to having that day with the Allen-Clay Joint Fire District,” Mr. Stahl said.

The three firefighters arrived shortly after 1 p.m. Aug. 19 at the Williston residence of Donald Berger. During the call, Mr. Frank established intraosseous access to Mr. Berger — meaning drilling or punching through the patient’s bone cortex to insert a hollow needle into the cavity, according to the federal Agency for Healthcare Research and Quality.

Mr. Berger died that afternoon at Mercy Health St. Charles Hospital because of kidney failure and Parkinson’s disease.

Mr. Frank, through his attorney, said Mr. Stahl ordered him to perform the procedure. It is a claim Mr. Stahl denies.

Attorney Matthew Bryant of Toledo said Mr. Frank followed chain of command.

“This patient was in serious condition. They couldn’t revive him. Mr. Frank was directed to ‘drill him’ — drill the patient — and he did that,” Mr. Bryant said, referring to a term for the intraosseous placement.

There are provisions for life-and-death situations that allow such acts, even though basic-level EMTs like Mr. Frank are not permitted to do so, Mr. Bryant said. He added Mr. Frank performed it correctly.

In a statement, Mr. Frank said he swore as an emergency medical technician to serve at the best of his ability. This includes following superior officers’ orders, he said.

“On that call, I followed my chief’s order and performed a procedure that the medic on duty could not perform,” Mr. Frank said. “No one else could perform the [intraosseous procedure], and under the circumstances, this was the only way that the patient could possibly be saved. We chose to err on the side of life.”

Mr. Stahl said he did not direct Mr. Frank to perform the procedure and was not made aware it occurred. He cited an earlier Northwest Ohio EMS Consortium review of his involvement. It determined the case would be resolved with a letter in Mr. Stahl’s file.

“Despite having no concrete evidence of any medically related wrong-doing on your behalf, your participation and failure to report the incident are cause for some concern,” according to the group’s summary report.

Mr. Stahl has been a member of the fire district for 21 years. His county commissioner web page lists credentials as fire instructor, firefighter level II, and EMT intermediate.

In a statement to The Blade, Mr. Berger’s wife, Margaret, said paramedics arrived promptly.

“To me, they were very professional and very courteous, and I had no problems with any procedure they did or who did it. I am also a firm believer that when it’s your time, God calls you home,” she said.

The fire district board appointed David Comstock, an attorney based in Youngstown, to conduct the review. He was tasked with investigating potential misconduct and presenting his findings to the board of trustees.

“Regardless of Frank’s well-intentioned actions, the performance of the IO insertion was and is against the clear prohibition of the local medical protocol orders and the Ohio Administrative Code,” Mr. Comstock wrote. “An EMT should have been aware of these limitations, and I believe that Frank was aware, to some degree, when he refused to sign the medic sheet at the completion of the run.”

Mr. Comstock wrote Mr. Stahl “permitted an employee to exceed his authorized scope of practice in violation of the Ohio Revised and Administrative Codes.”

According to Mr. Comstock, Mr. Stahl committed nonfeasance by failing to administratively address the issue and properly report the incident.

The investigation further claims Ms. Orra completed a false report and failed to report Mr. Frank’s actions as required.

“Your conduct further constitutes a violation of the fire district’s rules of conduct. Specifically, your conduct violates the rule requiring employees to obey the law,” Mr. Comstock wrote.

Ms. Orra and Mr. Frank both completed a temporary de-credentialing from the EMS consortium and administrative leave.

Ms. Orra did not return interview requests left with her fire station and email address. District Chief Mike Musolf declined to comment through a spokesman.

These alleged violations constitute serious charges because medical licenses exist for different acts and skill levels, said Sharona Hoffman of Case Western Reserve University. She is a professor of both law and bioethics as well as co-director of the Law-Medicine Center.

“We have licenses. We have certifications. And they are supposed to describe the scope of your practice. It is inappropriate to do procedures that are outside of your scope of practice,” Ms. Hoffman said.

Beyond strict authorization, Ms. Hoffman said laws exist regarding public-health emergencies and for good Samaritans during matters of life and death. An exemption for anyone with an emergency, for example, would not exist because first responder certifications would not mean anything, she said.

Mark Finamore, a Warren, Ohio-based attorney representing the fire department, declined comment on evidence before the hearing. The charges on their face are obviously serious, he said.

There is no indication from investigators that the firefighters’ actions contributed to Mr. Berger’s death, he said. 

Administrative charges pending against Mr. Stahl, Mr. Frank, and Ms. Orra will next proceed to an upcoming unscheduled board meeting, during which they will have opportunities to dispute the case. A “true” finding to any of these charges can result in punishments that include a letter of reprimand, unpaid suspension, and termination.

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