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Texas EMS Director's License Suspended for Giving Wife Fentanyl

BLANCO, Texas -- The director of the nonprofit Blanco (Texas) Volunteer Ambulance Corps said at a public meeting in February that he brought his wife the potent narcotic painkiller Fentanyl from the corps' inventory about 237 times over 15 months for her migraine headaches.

At the meeting of ambulance corps members and Blanco County residents last month, corps Director Mark McMain said he didn't believe that he had done anything wrong, said David Hotz , a member of the ambulance corps' board of directors who is serving as the corps' spokesman. Each time they administer controlled substances to patients, the corps' emergency medical workers must fill out a form, and McMain did so, Hotz said.

"He didn't understand that what he was doing was wrong," Hotz said of McMain's actions. "He does now."

McMain will meet with state officials on Wednesday in an informal conference on his license suspension. McMain's lawyer, Nelson Skinner of San Antonio, declined to comment on the case.

Court and state records don't say how much of the drug McMain is accused of taking. EMS services usually purchase Fentanyl in 150 microgram vials, which cost about $2 each. McMain, 47, faces a criminal investigation by the Drug Enforcement Administration and an emergency suspension of his paramedic license by the Texas Department of State Health Services. State officials declined to say whether McMain had been or would be asked to take a drug test, citing the ongoing investigation.

The state health department also intends to revoke the license of the Blanco Volunteer Ambulance Corps, which provides emergency medical services to the southern half of Blanco County, and the license of corps paramedic Evelyn "Suzy" Armstead , who is accused of co-signing the narcotic control forms McMain filled out.

Administering narcotics without direction from a doctor violates state and federal laws. And an EMS medical director, the doctor who oversees how emergency workers administer drugs and care for patients, could be expected to question a paramedic giving a family member drugs nearly every other day without direction, said Dr. Steven Ellerbe , a member of the Governor's EMS and Trauma Advisory Council.

"I believe that if one of my medics was making a routine response (to a relative's home and administering narcotics), I would have thought that that would have flagged my attention," Ellerbe said.

Ellerbe, who serves as medical director for four emergency medical services, said he reviews each service's log of controlled substance usage when he reorders narcotics, or he reviews each "run report" during which a controlled substance is used.

Dr. Larry Miller , the medical director for the Blanco ambulance service and four other emergency medical services, did not return a call seeking comment Monday. But Miller told the Blanco County News that the state health department asked him to audit the corps' morphine and Fentanyl supplies in January. Though Miller's audit accounted for all the corps' Fentanyl, Hotz said McMain did not bill his wife for the Fentanyl.

According to the DEA, the percentage of state and local drug cases involving Fentanyl have increased significantly over the past seven years, rising from 37 in 2001 to 1,412 cases in 2008.

Thomas Hinojosa , assistant special agent in charge for the DEA's San Antonio office, declined to comment on the McMain investigation but said that people involved in situations where "larger quantities of drugs are involved" can be charged with possession of a controlled substance with intent to distribute; penalties range from 180 days to life in jail.

mbloom@statesman.com; (512) 392-8750

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