A nurse at an Iowa hospital pleaded not guilty to criminal charges that she deliberately overdosed patients with medications. She was charged with six criminal violations, including two felony counts of obtaining a prescription drug through deceit and four counts of wanton neglect of a dependent adult by a caretaker, which is considered a serious misdemeanor.
According to prosecutors, on Nov. 9, 2022, the nurse was caring for a patient who was to receive hydrocodone once every four hours. She allegedly provided the drug at 11:04 a.m., 12:39 p.m., and 3:47 p.m. The same patient was to be given Tramadol once every six hours, although she allegedly administered the drug at 7:12 a.m., 9:04 a.m., 12:33 p.m., and 1:39 p.m.
In another incident, the nurse had been assigned to a patient requiring hydrocodone every four hours. Instead, she administered two doses within the same timeframe and also provided Zofran, morphine, and Tramadol. Prosecutors argue that this combination of medications, along with the hydrocodone, could have led to further overdose.
A few days before that incident, the nurse allegedly provided 6 milligrams of melatonin to a patient who was prescribed only 3 milligrams at bedtime.
In December 2022, the nurse was assigned to care for a patient being treated for an allergic reaction related to cancer treatment. Frustrated by the patient’s use of the call light, the nurse reportedly administered an unprescribed dose of Benadryl to induce sleep.
On two other occasions the nurse allegedly took, for her own use, Tramadol and hydrocodone prescribed for patients of the hospital.
Compliance Perspective
Issue
Giving medications without a physician’s order and not following ordered times is an example of abuse. Medication mismanagement and abuse can result in criminal charges, professional sanctions, and harm to patients. Nurses who divert medications have developed a number of ways to conceal diversion. Efforts must identify the types of medications most likely to be taken, signs that diversion has taken place, and signs of impairment. Facilities must prioritize patient safety, enforce strict protocols, and hold accountable those who violate ethical standards.
Discussion Points
- Review your policies and procedures for nursing services and following physician orders. Also, review your policies for preventing drug diversion.
- Train appropriate staff on your policies and procedures for following physician orders, and for performing nursing services and other tasks. Ensure that all staff are aware of their obligation to report failure to follow physician orders or any other suspected abuse of a resident using the Hotline or other reporting steps. Document that the training occurred and file the signed documents in each employee’s education file.
- Periodically review medical record documentation to ensure that physician orders are being followed. Also periodically audit to ensure that all controlled substances are accounted for each shift, and that proper documentation of controlled substances has occurred.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
