State regulators suspended Northfield EMS Chief and Orange EMS Capt. Mark Fortier’s paramedic license over his alleged failure to properly assess a 2-week-old infant during a house call and for refusing the child transportation in an ambulance, according to state investigatory reports obtained by the Recorder.

Fortier’s license suspension took effect on Feb. 2, according to the state Department of Public Health, which handles news media inquiries for the Office of Emergency Medical Services. At this time, Fortier is unable to work with the Orange department, where he serves as a captain, according to Orange Fire Chief James Young. However, he retains his title as Northfield’s EMS chief, where he can serve in a managerial role but cannot staff an ambulance.

Fortier declined to comment for this report and has filed an appeal of his license suspension.

The incident that prompted the suspension occurred in New Salem on Jan. 4, according to the state’s Complaint Investigation Report. A mother called for an ambulance after her baby became “lethargic” and “limp in her arms,” she said during an interview with the state DPH. The mother reportedly told dispatchers that her child “keeps choking and not breathing. He acts like he is going to pass out and stops breathing.” The mother described her 2-week-old child as having “some blue color to his lips” and said he was born with some “lung problems.”

About 12:57 a.m., the Orange Fire Department sent an ambulance staffed by Fortier and EMT-Basic Joe Larson. First responders from the New Salem Fire Department also responded.

In his interview with the state DPH, Fortier reportedly said the New Salem first responders told him that “the kid was fine and there are no issues.” Fortier told the state DPH that while he didn’t conduct a physical assessment of the child, the baby showed no signs of “abnormal” breathing, didn’t feel feverish and his skin color appeared normal.

“The kid was crying ... looked normal and appeared to interact normally,” Fortier is quoted as saying in the state report. “No concerns jumped out at me.”

In DPH’s interview with the child’s mother, she said that while the baby was “crying more steadily” when first responders arrived, she felt he “still did not seem to be acting right” and requested he be transported to Baystate Franklin Medical Center’s emergency room to ensure he’d be well cared for if another episode occurred while traveling to Greenfield.

Fortier reportedly said in his interview that the pediatric restraint device on the ambulance is good for infants 10 pounds or greater, and the child “did not look to weigh 10 pounds.” Therefore, Fortier thought it was safer for the mother to drive her baby to the hospital by herself, with the child secured in his car seat. Fortier told state regulators investigating the case that if the baby had appeared sicker, he would’ve taken the child in an ambulance.

An EMT is supposed to use an appropriately sized five-point harness that’s secured to the ambulance stretcher per manufacturers’ recommendations, according to the state report. If the child weighs under 10 pounds, accommodations have to be made such as applying extra padding around the child or using more straps to secure the infant’s car seat to the stretcher.

The DPH told Fortier, a certified paramedic for 13 years, during his interview that “when EMTs are faced with transporting patients who are small infants, it is common practice to find the safest way to accommodate their size using their own car seat or the pediatric restraint device on the ambulance.”

The mother, who drove the infant to Baystate Franklin Medical Center herself, stated in her interview with DPH that she “was scared driving to the hospital” and “stopped every few minutes on the side of the road to check” on the baby. Upon arrival at the hospital, the staff tested the baby for several illnesses and found him to be positive for COVID-19. The medical staff then wanted the baby to be transferred by ambulance to Baystate Medical Center in Springfield.

“I was not going to let them put my baby in an ambulance,” she said during her interview with the state DPH. “An EMT just told me it was not safe.”

After several hours, the mother left the hospital with her baby against the advice of a doctor. According to DPH’s report, she “has been caring for her baby at home and has not had any further incidents.”

After these interviews, the DPH determined Fortier “failed to assess, treat and transport to the hospital [emergency department] a pediatric patient for whom 911 was called, in violation of the EMS system regulations and Statewide Treatment Protocols,” the state documents read. This was determined by the department after not having a signed refusal of treatment and transport by a parent of the child, which violates protocol 105 CMR 170.355.

The DPH also claims Fortier “defaulted on his duties as the paramedic member of the dispatched ambulance crew by failing to perform a thorough, paramedic-level assessment” of the child and “failing to use options for the transport of an infant patient with which his ambulance was equipped.”

“The commissioner finds that the conduct described herein endangers the public health and safety, and that immediate suspension is necessary to prevent endangering the public health and safety,” the report states.

Record of previous complaints

According to state documents, complaints filed against Fortier date back to Dec. 11, 2012, when the DPH received a complaint stating that Northfield EMS — which at the time was an ambulance service licensed at the ALS-Intermediate level — carried on its ambulance a “Zoll E series” cardiac monitor that was programmed to operate as if the ambulance service was licensed at the ALS-Paramedic level. The complaint stated that Fortier, a certified paramedic, used the cardiac monitor on a patient even though he was only allowed to work to the EMT-Intermediate level and was not allowed to exceed the service’s level of licensure while working for it.

Additionally, the DPH stated that Fortier documented an incomplete care report for the patient that didn’t mention the use of the cardiac monitor and “lacked” details on patient assessment findings. In this instance, the DPH accepted Northfield EMS’ plan of correction, which included removing the cardiac monitor from its ambulances and improving the service’s patient care report procedures.

On June 15, 2017, the DPH investigated a report from the Orange Fire Department’s contracted quality assurance reviewer. The DPH said Fortier had violated the Statewide Treatment Protocols by failing to immobilize a patient who had suffered a traumatic injury after falling and had a potential humerus fracture. The DPH issued Fortier a Letter of Clinical Deficiency/Order to Correct Violations, and he was required to complete remedial training.

Another incident report from the Orange Fire Department was received on Jan. 8, 2018, stating that in treating a patient for chest pain, Fortier intended to administer fentanyl for pain but instead administered Ativan. When the error was found, Fortier notified the receiving hospital and wrote an incident report for his department’s chief and EMS coordinator. The service reported that Fortier advised he was confused by a recent review of narcotic meds at another service he worked for and said he was experiencing “abnormal fatigue” due to lack of sleep at the time of the early-morning call. The DPH accepted the Fire Department’s handling of the situation, which involved providing remedial training for Fortier.

Fortier’s most recent investigation by the DPH was on Nov. 9, 2022, after a complaint was received stating Orange EMTs “failed to transport a chest pain patient with a history of a previous heart attack to an appropriate hospital with cardiac catheterization and percutaneous coronary intervention (PCI) capabilities.” The DPH said Fortier violated Statewide Treatment Protocols by “failing to perform a complete and accurate patient assessment” and did not document a complete and accurate patient care report. Ultimately, the DPH issued Fortier a Letter of Clinical Deficiency/Order to Correct Violations, and he was required to complete remedial training.

Appeal underway

Fortier said during an interview in early March that his paramedic license suspension is being appealed at the state level. According to DPH spokesperson Ann Scales, Fortier’s hearing has been scheduled for May 22.

Fortier has declined to comment further on the incident prompting the suspension or the contents of the state documents.

Although Fortier is unable to work in Orange, where Young said seven paramedics are on staff, Northfield Selectboard Chairperson Alex Meisner said in an interview in early March that the board, during a Feb. 20 executive session, voted unanimously to keep Fortier as Northfield EMS chief.

According to the DPH, “There is nothing in the EMS regulations that precludes a non-EMT from leading an ambulance service.” However, “a paramedic whose certification has been suspended cannot staff an ambulance.” It is “up to the licensed ambulance service to determine” if Fortier “is able to remain as manager,” according to the state agency.

“He’s still remaining as [Northfield EMS] chief after careful and thorough consideration,” Meisner said of Fortier at the time, mentioning that the situation more directly relates to Fortier’s work in Orange. “We’re going to back our chief.”

Asked if the Selectboard had documents from the DPH’s investigation regarding Fortier during its February executive session, Meisner declined to comment.