Commissioner JoAnn Birrell said the fate of Brian Frist’s position with the county is a “personnel issue and should be discussed internally in executive session.”
Chairman Tim Lee said although he has not “dug into” the changes needed at the medical examiner’s office, his opinion is the issues can be addressed without removing Frist from office.
“I think his work product is superb, but there are some process issues that need nailed out,” Lee said. “We need to not rush to judgment and think it out.”
The audit was trigged by a complaint from Tom Cheek, who was upset about the way the office handled the death of his son, who died in a 2012 fire. Medical examiners are tasked with investigating and determining the cause of deaths.
According to Cobb spokesman Robert Quigley, the contract between the county and Frist can be terminated by either party with 60 days notice.
The Board of Commissioners is waiting for a recommendation by County Manager David Hankerson, Quigley said.
“Once that review is complete, I think the BOC will have a clearer idea of how to proceed,” Commissioner Bob Ott said.
Lee said he expects to discuss the recommendations with Hankerson and then work with the rest of the board to create a formal response to the internal audit.
“I would expect it will come to a conclusion in 60 days at max,” Lee said.
None of the commissioners hinted which way they are leaning or what will be the deciding factor.
“I am awaiting the recommendation of the county manager, who was charged with reviewing the commissioners’ comments to the audit and proposing a course of action,” said Commissioner Helen Goreham.
While the internal audit did not examine Cheek’s case specifically, findings about the medical examiner’s office only came to light because of the complaint.
The internal audit revealed the duties performed by Cobb’s medical examiner’s office are in accordance with the Georgia Death Investigation Act, which establishes the powers and responsibilities of medical examiners and coroners.
The internal audit gave 27 recommended changes to the medical examiner’s office, including more monitoring and organizational structure.
It suggests the county require periodic reports to the county manager and public safety agency, as well as a possible change in the qualifications needed to be Cobb’s medical examiner.
“I am undecided, as commissioners have commented on the multiple recommendations made from the audit and I need to know the examiner’s consideration of our feedback,” Commissioner Lisa Cupid said.
Frist has been the county medical examiner since 1999 after being an associate medical examiner for 10 years prior.
Cobb is one of only five counties in Georgia that has eliminated its coroner position in favor of hiring a medical examiner, making the switch in 1973.
A coroner is an elected official who must live in the county and is not required to be a physician because they do not perform forensic pathological services. A medical examiner does not have to live in the county to be appointed to the position, but does have to be a physician.
When the medical examiner’s office was created in Cobb, an annual contract of $49,508 was awarded, which was also the department’s budget to pay all other salaries and expenses.
In 1983, the cost increased to $150,000, according to the internal audit. In February 1999, Frist was awarded a contract of $355,000, which increased in fiscal 2008 to $426,615 and in fiscal 2013 to $475,497, which Frist splits with three part-time employees.
Charlotte Clark, who moved from San Bernardino County, Calif., to northeast Cobb in 2012, said she read the internal audit and was shocked at the lack of written reports and clear procedures that are followed.
“I was a nurse, and as such, worked with many doctors of all types of backgrounds,” Clark said. “I learned that you document everything.”
Clark said the issues brought forth in the audit are a matter of public safety. And those are the kind of issues the commissioners are “weak” at addressing, she said.
“Chairman Lee’s popularity due to the Braves’ move to Cobb County seems to give him the power to simply declare that everything is all right, and most of the other commissioners just agree with him,” Clark said. “The BoC seems to be fine with the (medical examiner) that they have. Lives are the cost of this decision.”
According to the internal audit, from 2009 to 2013 there was an average of 1,200 deaths each year in Cobb.
“The average private citizen could not afford a private autopsy by a real (medical examiner), so this also seems elitist,” Clark said.
Despite the high population growth in Cobb since 1985, the amount of cases has stayed just above 1,000 per year, the internal audit said.
“Between the 1985 and the 2010 census numbers, the population has increased by 85 percent, while the number of cases remained relatively flat,” the internal audit said.