Document:

EX-4.1

AMENDMENT NO. 1 TO

AMENDED AND RESTATED RIGHTS AGREEMENT

This Amendment No. 1, effective as of January 20, 2009 (the “Amendment”), amends the
Amended and Restated Rights Agreement, dated December 2, 2008 (the “Rights Agreement”), by
and between La Jolla Pharmaceutical Company, a Delaware corporation (the “Corporation”) and
American Stock Transfer & Trust Company, LLC, a New York limited liability trust company (the
“Rights Agent”). Capitalized terms used herein but not defined herein shall have their
defined meanings set forth in the Rights Agreement.

WHEREAS, on January 4, 2009, the Corporation entered into a Securities Purchase Agreement (the
“Securities Purchase Agreement”) with BioMarin Pharmaceutical, Inc., a Delaware corporation
(“BioMarin”);

WHEREAS, pursuant to the Securities Purchase Agreement, the Corporation is issuing on the date
herewith 339,104 shares of Series B-1 Convertible Preferred Stock, par value $0.01 and may, as
contemplated in the Securities Purchase Agreement, issue to BioMarin up to 226,068 shares of Series
B-2 Convertible Preferred Stock, par value $0.01 and 678,205 shares of Series B-3 Convertible
Preferred Stock, par value $0.01 (the Series B-1, B-2 and B-3 Convertible Preferred Stock being
collectively referred to as the “Series B Preferred Stock”);

WHEREAS, BioMarin has certain preemptive rights under the Securities Purchase Agreement to
purchase Common Stock of the Company and other securities or rights convertible into, or entitling
the holder to receive directly or indirectly, additional shares of Common Stock (the
“Preemptive Shares”); and

WHEREAS, the Corporation and the Rights Agent are entering into this Amendment to permit
BioMarin to acquire the Series B Preferred Stock, any securities issued to BioMarin as a dividend
on the Series B Preferred Stock, the Common Stock issuable upon conversion of the Series B
Preferred Stock and any Preemptive Shares that may be issued to BioMarin as contemplated under the
Securities Purchase Agreement (collectively, the “Partnership Shares”) without thereby
making BioMarin an Acquiring Person or resulting in a Distribution Date.

NOW, THEREFORE, the parties hereby agree as follows:

	 	1.	 	Section 1(a) is hereby deleted in its entirety and the following is inserted in
lieu thereof:

“(a) “Acquiring Person” shall mean any Person (as such term
is hereinafter defined) who or which, together with all Affiliates
(as such term is hereinafter defined) and Associates (as such term
is hereinafter defined) of such Person, shall be the Beneficial
Owner (as such term is hereinafter defined) of 15% or more of the
            shares of Common Stock of the Company then outstanding, but shall
not include (i) the Company, (ii) any Subsidiary (as such term is
hereinafter defined) of the Company, (iii) any employee benefit plan
or compensation arrangement of the Company or any Subsidiary of the
Company or (iv) any Person holding shares of Common Stock of the
Company organized, appointed or established by the Company or any
Subsidiary of the Company for or pursuant to the terms of any such
employee benefit plan or compensation arrangement (the Persons
described in clauses (i) through (iv) above are referred to herein
as “Exempt Persons”); provided, however,
that the term “Acquiring Person” shall not include: (A) BioMarin
Pharmaceutical Inc. and its Affiliates and Associates (collectively,
“BioMarin”), to the extent BioMarin becomes the Beneficial
Owner of 15% or more of the shares of Common Stock of the Company
then outstanding solely due to BioMarin’s Beneficial Ownership of
the Partnership Shares; or (B) any Grandfathered Person, unless such
Grandfathered Person becomes the Beneficial Owner of a percentage of
the shares of Common Stock of the Company then outstanding equal to
or exceeding such Grandfathered Person’s Grandfathered Percentage.
For the avoidance of doubt, if BioMarin becomes or is the Beneficial
Owner of 15% or more of the shares of Common Stock of the Company
then outstanding (including the Partnership Shares) and at such time
BioMarin is deemed to be the Beneficial Owner of any shares of
Common Stock of the Company other than the Partnership Shares, then
BioMarin shall be deemed an Acquiring Person hereunder.

Notwithstanding the foregoing, no Person shall become an “Acquiring
Person” as the result of an acquisition by the Company of Common
Stock of the Company which, by reducing the number of shares
outstanding, increases the proportionate number of shares
Beneficially Owned by such Person to 15% or more (or, in the case of
a Grandfathered Person, the Grandfathered Percentage applicable to
such Grandfathered Person) of the shares of Common Stock of the
Company then outstanding; provided, however, that if
a Person shall become the Beneficial Owner of 15% or more (or, in
the case of a Grandfathered Person, the Grandfathered Percentage
applicable to such Grandfathered Person) of the shares of Common
Stock of the Company then outstanding by reason of share purchases
by the Company and shall, after such share purchases by the Company,
become the Beneficial Owner of any additional shares (other than
pursuant to a stock split, stock dividend or similar transaction) of
Common Stock of the Company and immediately thereafter be the
Beneficial Owner of 15% or more (or, in the case of a Grandfathered
Person, the Grandfathered Percentage applicable to such
Grandfathered Person) of the shares of Common Stock of the Company
then outstanding, then such Person shall be deemed to be an
“Acquiring Person.” In addition, notwithstanding the foregoing, and
notwithstanding anything to the contrary provided in the Agreement
including without limitation in Sections 1(jj), 3(a) or 27, a Person
shall not be an “Acquiring Person” if the Board of Directors of the
Company determines at any time that a Person who would otherwise be
an “Acquiring Person,” has become such without intending to become
an “Acquiring Person,” and such Person divests as promptly as
practicable (or within such period of time as the Board of Directors
of the Company determines is reasonable) a sufficient number of
            shares of Common Stock of the Company (or, for the avoidance of
doubt, with respect to any Derivative Common Shares, terminates the
subject derivative transaction or transactions or disposes of the
subject derivative security or securities) so that such Person would
no longer be an “Acquiring Person,” as defined pursuant to the
foregoing provisions of this Section 1(a).”

	 	2.	 	Section 3(a) is hereby deleted in its entirety and the following is inserted in
lieu thereof:

“From the date hereof until the earlier of (i) the Close of Business
on the tenth calendar day after the Stock Acquisition Date or
(ii) the Close of Business on the tenth Business Day (or such later
calendar day, if any, as the Board of Directors of the Company may
determine in its sole discretion) after the date a tender or
exchange offer by any Person, other than an Exempt Person, is first
published or sent or given within the meaning of Rule 14d-4(a) of
the Exchange Act, or any successor rule, if, upon consummation
thereof, such Person could become, or would be, the Beneficial Owner
of 15% or more (or, in the case of a Grandfathered Person, the
Grandfathered Percentage applicable to such Grandfathered Person) of
the shares of Common Stock of the Company then outstanding
(including any such date which is after the date of this Agreement
and prior to the issuance of the Rights) (the earliest of such dates
being herein referred to as the “Distribution Date”),
(x) the Rights will be evidenced (subject to the provisions of
Section 3(b) hereof) by the certificates for the Common Stock of the
Company registered in the names of the holders of the Common Stock
of the Company (which certificates for Common Stock of the Company
shall be deemed also to be certificates for Rights) and not by
separate certificates, and (y) the Rights will be transferable only
in connection with the transfer of the underlying shares of Common
Stock of the Company. As soon as practicable after the Distribution
Date, the Rights Agent will, at the Company’s expense send, by
first-class, insured, postage prepaid mail, to each record holder of
the Common Stock of the Company as of the Close of Business on the
Distribution Date, at the address of such holder shown on the
records of the Company, one or more certificates, in substantially
the form of Exhibit B hereto (the “Right
Certificates”), evidencing one Right for each share of Common
Stock of the Company so held, subject to adjustment as provided
herein. In the event that an adjustment in the number of Rights per
share of Common Stock of the Company has been made pursuant to
Section 11(o) hereof, the Company may make the necessary and
appropriate rounding adjustments (in accordance with Section 14(a)
hereof) at the time of distribution of the Right Certificates, so
that Right Certificates representing only whole numbers of Rights
are distributed and cash is paid in lieu of any fractional Rights.
As of and after the Close of Business on the Distribution Date, the
Rights will be evidenced solely by such Right Certificates.”

3.  Except as expressly set forth in this Amendment all other terms of the Rights Agreement
shall remain in full force and effect.

4.  This Amendment shall be governed by and construed in accordance with the laws of the State
of Delaware applicable to contracts made and to be performed entirely within such State, without
regard to conflict-of-law principles.

5.  This Amendment may be executed in any number of counterparts and each of such counterparts
shall for all purposes be deemed to be an original, and all such counterparts shall together
constitute but one and the same instrument.

[The remainder of this page has been intentionally left blank; signature page follows.]

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     IN WITNESS WHEREOF, the Corporation and the Rights Agent have executed this Amendment
effective as of the date first above written.

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 
	 
	 	THE CORPORATION:

La Jolla Pharmaceutical Company,
a Delaware corporation
 	 	 
	 
	 	By:  	 	 /s/ Deirdre Gillespie	 	 
	 
	 	 	 	 	 	 
	 
	 	 	 	Deirdre Y. Gillespie, M.D. 	 	 
	 
	 	 	 	President and Chief Executive Officer 	 	 
	 

	 	 	 	 	 	 	 	 	 
	 	 	RIGHTS AGENT:
American Stock Transfer & Trust Company, LLC, a New York limited liability
company
 	 	 
	 	 	By:  	 	/s/ Herbert J. Lemmer	 	 
	 	 	 	 	 	 	 
	 	 	 	 	Name:  	 	Herbert J. Lemmer	 	 
	 	 	 	 	Title:  	 	Vice President	 	 
	 

2EX-10.1

Exhibit 10.1

SEPARATION AGREEMENT AND RELEASE OF CLAIMS

THIS SEPARATION AGREEMENT AND RELEASE (“Agreement”), is made and entered into by and between
DATATRAK International, Inc. (“Company”) and Dr. Jeffrey A. Green (“Employee”) on the dates written
below.

W I T N E S S E T H:

WHEREAS, pursuant to an Employment Agreement between the Company and Employee dated February
5, 2001, as subsequently amended on December 31, 2008 (the “Employment Agreement”), Employee has
been employed by the Company, most recently as its Chief Executive Officer; and

WHEREAS, in connection with a mutually desired management transition, Employee will be
separated from the employment of the Company effective January 21, 2009; and

WHEREAS, the Company and Employee wish to resolve all matters and issues between them arising
from or relating to Employee’s employment by the Company and Employee’s separation from employment
by the Company, and to provide for Employee’s performance of transition consulting services.

NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein,
Employee and the Company hereby agree as follows:

ARTICLE I

CONSIDERATION

Section 1.1. Separation from Employment & Salary Continuation. Employee will be
separated from the employment of the Company effective January 21, 2009 (the “Date of Separation”).
The parties acknowledge and agree that Employee’s separation will be treated as a “Termination by
Employee for Good Reason” under the provisions of Section 8.6 of the Employment Agreement. After
the Effective Date of this Agreement as set forth in Section 4.8 herein, and beginning on the first
regular payday of the Company following the Date of Separation, the Company will continue
Employee’s pay for a period of twenty-four (24) months, thereby extending Employee’s pay through
and including January 20, 2011 (the “Salary Continuation Period”). Any and all payments hereunder
shall be paid at Employee’s rate immediately preceding Employee’s termination, less applicable
payroll taxes and withholdings, payable through the Company’s normal payroll process.

Section 1.2. Paid Time Off. On the first regular payday of the Company following the
Date of Separation, the Company will, in accordance with the Company’s standard policy, pay
Employee for all earned but unused paid time off, less applicable payroll taxes and withholdings,
up to a maximum of 200 hours.

Section 1.3. Benefit Continuation. The Company will provide Employee with the medical
benefits he was receiving prior to the Date of Separation, on the same basis as such benefits were
provided prior to the Date of Separation, through and including January 21, 2009. Thereafter,
Employee shall be entitled to continuation of coverage under the Company’s health/medical insurance
plan pursuant to any rights he may have under the federal Consolidated Omnibus Budget
Reconciliation Act, as amended (“COBRA”), part VI of Subtitle B of Title I of the Employee
Retirement Income Security Act of 1974 (“ERISA”), as amended; Internal Revenue Code §4980(B)(f).
During the period January 21, 2009 through April 20, 2009, in the event that Employee is not
otherwise eligible for health/medical insurance from his then-current employer (if any), the
Company will pay that portion of the COBRA premium that it pays toward the cost of the medical
benefit coverage for active senior executives, with the remainder of the monthly COBRA premium
during that period payable by Employee. Any COBRA coverage beyond April 20, 2009 will be at
Employee’s sole expense.

Section 1.4. Consulting Services.

(a) Consulting Period. Beginning on the Date of Separation, Employee shall serve the
Company in the capacity of Consultant for a twenty-four (24) month period through and including
January 20, 2011, which period may be extended by mutual agreement of the parties (the “Consulting
Period”).

(b) Consulting Services. Throughout the Consulting Period, Employee shall make
himself reasonably available to perform in person, by telephone, or by other means of communication
as deemed appropriate by the Company and Employee, such advisory and consulting services with
respect to matters concerning the business of the Company, including, without limitation, matters
related to customer relationships, strategic initiatives, investor relations and capital raising
activities, as may be reasonably requested from time-to-time by the Company’s then Chief Executive
Officer or other executives as directed by the then Chief Executive Officer; provided, however,
that such services shall not exceed 150 hours per calendar quarter. In determining reasonable
availability, due consideration shall be given to Employee’s other business, employment and
personal commitments.

(c) Consulting Retainer and Expenses. The Company shall, upon the date this
Agreement becomes effective pursuant to Section 4.8 hereof, pay Employee a one-time retainer of
$1,000.00 as additional consideration for his consulting services. Other than as set forth in
Section 1.1 ,Section 1.3 and the retainer described in Section 1.4(c) hereof, Employee shall not be
entitled to receive any further compensation for his consulting services. However, the Company will
compensate Employee for reasonable expenses incurred in connection with the performance of his
consulting services. Within thirty days of the end of each month in which Employee incurs expenses
in his capacity as Consultant, Employee shall submit to the Company an invoice detailing such
expenses, payable within thirty days following receipt by the Company.

(d) Independent Contractor Status. During the Consulting Period, Employee shall be
deemed for all purposes to be an independent contractor and not an “employee.” The parties agree
that the advisory and consulting services with respect to matters concerning the business of the
Company performed by Employee pursuant to this Section 1.4 during the term of this Agreement and
the Consulting Period will be subject to the Indemnification Agreement dated February 29, 1996
between the parties (the “Indemnification Agreement”).

(e) Confidentiality. Any Proprietary Information, as defined in Section 9.2 of the
Employment Agreement, which Employee learns, develops or otherwise obtains during the course of
providing the Consulting Services shall be subject to all confidentiality obligations set forth in
Section 9.2 of the Employment Agreement.

Section 1.5. Stock Options. Notwithstanding anything to the contrary in any of the
Stock Option Agreements between the Company and Employee dated December 9, 1999, June 4, 2002,
December 23, 2003 and December 28, 2004 (collectively, the “Stock Option Agreements”) or any of the
Company’s stock option plans governing such Stock Option Agreements, Employee shall only have the
right to exercise stock options under such Stock Option Agreements for a period of ninety (90) days
following the Date of Separation, subject to the other terms and conditions set forth in such Stock
Option Agreements. Notwithstanding the foregoing, Employee acknowledges that the failure to
exercise any Stock Option Agreement intended to qualify as an Incentive Stock Option (an “ISO”)
under Section 422 of the Internal Revenue Code (the “Code”) within the limited exercise period set
forth in such Stock Option Agreement shall cause such stock option to be disqualified as an ISO and
may, if later exercised, subject Employee to significant negative tax consequences under Section
409A of the Code.

Section 1.6. Adequacy of Consideration. Employee hereby agrees and acknowledges that
the items described in Sections 1.1, 1.2, 1.3, 1.4, and 2.2 of this Agreement are over and above
any entitlements, severance or otherwise, that he may have by reason of his separation from
employment with the Company, and that such payments and amounts constitute adequate consideration
for all of Employee’s covenants and obligations set forth herein, including, but not limited to,
the Release of Claims set forth in Article II of this Agreement.

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ARTICLE II

RELEASE OF CLAIMS

Section 2.1. Employee’s Release. In consideration of the promises and agreements set
forth herein, Employee does hereby for himself and for his heirs, executors, successors and
assigns, release and forever discharge the Company, its parent company(ies), subsidiaries,
divisions, and affiliated businesses, direct or indirect, if any, together with its and their
respective officers, directors, shareholders, management, representatives, agents, employees,
successors, assigns, and attorneys, both known and unknown, in both their personal and agency
capacities (collectively, the “Company Entities”) of and from any and all claims, demands, damages,
actions or causes of action, suits, claims, charges, complaints, contracts, whether oral or
written, express or implied and promises, at law or in equity, of whatsoever kind or nature,
including but not limited to any alleged violation of any state or federal anti-discrimination
statutes or regulations, including but not limited to Title VII of The Civil Rights Act of 1964 as
amended, ERISA, The Americans With Disabilities Act, the Age Discrimination in Employment
Act, the Older Workers Benefit Protection Act, breach of any express or implied contract or
promise, wrongful discharge, violation of public policy, or tort, all demands for attorney’s fees,
back pay, holiday pay, vacation pay, bonus, group insurance, any claims for reinstatement, all
employee benefits and claims for money, out of pocket expenses, any claims for emotional distress,
degradation, humiliation, that Employee might now have or may subsequently have, whether known or
unknown, suspected or unsuspected, by reason of any matter or thing, arising out of or in any way
connected with, directly or indirectly, any acts or omissions of the Company or any of its
directors, officers, shareholders, employees and/or agents arising out of Employee’s employment and
termination from employment which have occurred prior to and throughout the term of this Agreement,
except those matters specifically set forth herein and except for any pension or retirement
benefits which may have vested on Employee’s behalf, if any. Notwithstanding the foregoing,
nothing herein shall be construed to release any claim or obligation arising under this Agreement,
or the obligation of the Company to indemnify or advance expenses pursuant to the Indemnification
Agreement, any director and officer or other insurance coverage of the Company, the general
corporate laws of any applicable jurisdiction, the Company’s articles of incorporation, by-laws,
code of regulations or other charter documents, or any other agreement between the Company and
Employee.

Section 2.2. Release by Company Entities. The Company Entities hereby release and
forever discharge Employee, his heirs, executors, successors, and assigns, from any and all claims,
demands, actions or causes of action, charges, complaints, damages, liabilities or suits at law or
equity, of whatsoever kind or nature, both known or unknown, that the Company Entities have or may
have by reason of any matter or thing arising out of, or in any way connected with, directly or
indirectly, any act, omission, or event that has occurred prior to the Effective Date of this
Agreement. This Release by Company Entities does not apply to the rights and entitlements of the
Company Entities under this Agreement.

Section 2.3. Older Workers Benefit Protection Act (“OWBPA”). Employee recognizes and
understands that, by executing this Agreement, he shall be releasing the Company Entities from any
claims that he now has, may have, or subsequently may have under the Age Discrimination in
Employment Act of 1967, 29 U.S.C. §§621, et seq., as amended, by reason of any
matter or thing arising out of, or in any way connected with, directly or indirectly, any acts or
omissions which have occurred prior to and including the Effective Date of this Agreement. In
other words, Employee will have none of the legal rights against the aforementioned that he would
otherwise have under the Age Discrimination in Employment Act of 1967, 29 U.S.C. §§621, et
seq., as amended, by his signing this Agreement.

Section 2.4. Consideration Period. The Company hereby notifies Employee of his right
to consult with his chosen legal counsel before signing this Agreement. The Company shall afford,
and Employee acknowledges receiving, not less than twenty-one (21) calendar days in which to
consider this Agreement to ensure that Employee’s execution of this Agreement is knowing and
voluntary. In signing below, Employee expressly acknowledges that he has been afforded the
opportunity to take at least twenty-one (21) days to consider this Agreement and that his execution
of same is with full knowledge of the consequences thereof and is of his own free will.

Notwithstanding the fact that the Company has allowed Employee twenty-one (21) days to
consider this Agreement, Employee may elect to execute this Agreement prior to the end of such
21-day period. If Employee elects to execute this Agreement prior to the end of such 21-day
period, then by his signature below, Employee represents that his decision to accept this
shortening of the time was knowing and voluntary and was not induced by fraud, misrepresentation,
or any threat to withdraw or alter the benefits provided by the Company herein, or by the Company
providing different terms to any similarly-situated employee executing this Agreement prior to end
of such 21-day consideration period.

Section 2.5. Revocation Period. Both the Company and Employee agree and recognize
that, for a period of seven (7) calendar days following Employee’s execution of this Agreement,
Employee may revoke this Agreement by providing written notice revoking the same, within this seven
(7) day period, delivered by hand or by certified mail, addressed to Varnesh Sritharan, DATATRAK
International, Inc., 6150 Parkland Boulevard, Suite 100, Mayfield Heights, Ohio 44124, delivered or
postmarked within such seven (7) day period. In the event Employee so revokes this Agreement, each
party will receive only those entitlements and/or benefits that he/it would have received
regardless of this Agreement.

Section 2.6. Acknowledgments. Employee acknowledges that Employee has carefully read
and fully understands all of the provisions of this Agreement, that Employee has not relied on any
representations of the Company or any of its representatives, directors, officers, employees and/or
agents to induce Employee to enter into this Agreement, other than as specifically set forth herein
and that Employee is fully competent to enter into this Agreement and has not been pressured,
coerced or otherwise unduly influenced to enter into this Agreement and that Employee has
voluntarily entered into this Agreement of Employee’s own free will.

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ARTICLE III

OTHER OBLIGATIONS OF EMPLOYEE

Section 3.1. Company Property. On or before January 23, 2009, Employee shall return
the original and all copies of all property belonging to the Company, including, but not limited
to, all confidential and/or proprietary information, keys, business equipment, computer software
and/or hardware, PC and accessories, connectors, holster, Orinco card, printer, projector,
marketing and sales materials (including all bids and related paperwork), customer lists and
contact information, backup tapes, and files, and technical manuals and other information.

Section 3.2. Non-Disparagement. Employee and the Company each agree that they will
not defame, disparage, criticize or otherwise speak of the other party or their products, services,
subsidiaries, divisions, parents, affiliates, successors, predecessors, or current or former
employees, managers, directors, officers or agents in a negative, derogatory or unflattering
manner. Further, Employee and the Company agree that under no circumstances may they disclose or
cause to be disclosed to the media any material, negative or detrimental information relating to
the other party or their products, services, subsidiaries, divisions, affiliates, parents,
successors or current or former officers, directors, employees, managers or agents.

ARTICLE IV

MISCELLANEOUS PROVISIONS

Section 4.1. Entire Agreement. This Agreement contains the entire agreement between
the parties hereto and, with the exceptions of any provision of Section 9 of the Employment
Agreement, the provisions of the Stock Option Agreements, and all provisions of the Indemnification
Agreement, replaces any prior agreements, contracts and/or promises, whether written or oral, with
respect to the subject matters included herein. This Agreement may not be changed orally, but only
in writing, signed by each of the parties hereto.

Section 4.2. Warranty/Representation. Employee and the Company each warrant and
represent that, prior to and including the Effective Date of this Agreement, no claim, demand,
cause of action, or obligation which is subject to this Agreement has been assigned or transferred
to any other person or entity, and no other person or entity has or has had any interest in any
such claims, demands, causes of action or obligations, and that each has the sole right to execute
this Agreement.

Section 4.3. Invalidity. The parties to this Agreement agree that the invalidity or
unenforceability of any one (1) provision or part of this Agreement shall not render any other
provision(s) or part(s) hereof invalid or unenforceable and that such other provision(s) or part(s)
shall remain in full force and effect.

Section 4.4. Resignation as Officer and Director. By way of his execution of this
Agreement, unless further action on his part is necessary or advisable (in which case Employee
hereby agrees to take such action at the Company’s expense), Employee resigns as an officer and
director of the Company and, to the extent applicable, as an officer and/or director of each of its
related/affiliated business entities, including but not limited to DATATRAK, Inc. and DATATRAK
Deutschland GmbH, and further resigns as a trustee of their respective benefit plans.

Section 4.5. No Assignment. This Agreement is personal in nature and shall not be
assigned by Employee. All payments and benefits provided Employee herein shall be made to his
estate in the event of his death prior to his receipt thereof.

Section 4.6. Originals. Two (2) copies of this Agreement shall be executed as
“originals” so that both Employee and the Company may possess an “original” fully executed
document. The parties hereto expressly agree and recognize that each of these fully executed
“originals” shall be binding and enforceable as an original document representing the agreements
set forth herein.

Section 4.7. Governing Law. This Agreement shall be governed under the laws of the
State of Ohio.

Section 4.8. Effective Date. This Agreement shall become effective only upon (a)
execution of this Agreement by Employee after the expiration of the twenty-one (21) day
consideration period described in Section 2.4 of this Agreement, unless such consideration period
is shortened as provided by law; and (b) the expiration of the seven (7) day period for revocation
of this Agreement by Employee described in Section 2.5 of this Agreement.

Section 4.9. Compliance with Code Section 409A. It is the intention and purpose of
the Company that this Agreement shall be, at all relevant times, in compliance with (or exempt
from) Code Section 409A and all other applicable laws, and this Agreement shall be so interpreted
and administered. The Company specifically retains the unilateral right (but not the obligation)
to make, prospectively or retroactively, any amendment to this Agreement or any related document as
it deems necessary or desirable to more fully address issues in connection with compliance with (or
exemption from) Code Section 409A and such other laws. In no event, however, shall this Section
4.9 or any other provisions of this Agreement be construed to require the Company to provide any
gross-up for the tax consequences of any provisions of, or payments under, this Agreement and the
Company shall have no responsibility for tax or legal consequences to Employee (or his beneficiary)
resulting from the terms or operation of this Agreement.

3

CAUTION TO EMPLOYEE: READ BEFORE SIGNING. THIS DOCUMENT CONTAINS A RELEASE OF ALL CLAIMS AGAINST
THE COMPANY ENTITIES PRIOR TO THE EFFECTIVE DATE OF THIS AGREEMENT.

IN WITNESS WHEREOF, Employee and the Company agree as set forth above:

	 	 	 
	DATE OF RECEIPT BY EMPLOYEE:

1/20/09
	 	SIGNATURE OF EMPLOYEE

ACKNOWLEDGING DATE OF

RECEIPT:

	 	 	/s/ Jeffrey A. Green

	 	 	 

	 	 	RECEIPT WITNESSED BY:

	 	 	/s/ Varnesh Sritharan

	 	 	 

	DATE OF EXECUTION BY EMPLOYEE:
	 	AGREED TO AND ACCEPTED BY:

	1/20/09
	 	/s/ Jeffrey A. Green

	 	 	 

	 	 	EXECUTION WITNESSED BY:

	 	 	/s/ Varnesh Sritharan

	 	 	 

	DATE OF EXECUTION BY COMPANY:
	 	AGREED TO AND ACCEPTED BY:

	1/20/09
	 	DATATRAK INTERNATIONAL, INC.

BY: /s/ Laurence P. Birch

	 	 	 

	 	 	TITLE: Chairman of the Board

	 	 	 

	 	 	EXECUTION WITNESSED BY:

	 	 	/s/ Raymond J. Merk

	 	 	 

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