An Iowa nurse who stole pain medication from at least 50 new mothers at a Waterloo hospital was sentenced on March 27, 2024, to one year and one day of imprisonment. She must also serve a three-year term of supervised release after the prison term. There is no parole in the federal system.
From no later than January 2022, to at least March 25, 2022, the defendant used her nursing license to gain access to controlled substances in the hospital’s labor and delivery unit. Instead of administering the controlled substances to the women in pain, the defendant diverted the controlled substances to herself for her own illicit drug use. She admitted to stealing narcotics from no less than 50 victims. To cover up her crimes, she used a variety of fraudulent means, including falsely documenting that she had administered pain medication to new mothers when she had not done so. She also admitted to tampering with pain medication—replacing fentanyl inside a vial with saline and diverting the narcotic for her own use.
For example, on March 25, 2022, the defendant was supposed to care for three new mothers and their babies during her shift from 3 a.m. to 3 p.m. Despite documenting the administration of pain medication, she diverted it for her own use. As a result, one of the mothers, who was a c-section patient, said she suffered excruciating pain, and the next nurse delayed providing pain relief due to the defendant’s false records. Additionally, her newborn did not receive formula until the end of the defendant’s shift. Another c-section patient did not speak fluent English, so her husband made multiple complaints to the hospital about her pain but to no avail.
The next day, the defendant was again working the first shift at the hospital. The hospital gave her a drug test, and she tested positive for opiates (oxycodone and hydromorphone) and marijuana. Another nurse then found an open fentanyl vial, an open ephedrine vial, and an epidural bag in another new mother’s room. The hospital’s records revealed that the defendant had removed these three items under the new mother’s name despite the fact there were no such orders for her. The fentanyl vial had puncture marks on the top and bottom stopper surfaces, and laboratory results later revealed that nearly all the fentanyl in the vial had been replaced with saline.
The defendant also admitted that she routinely drank alcohol and used marijuana while working at the Waterloo hospital. In order to pass a drug test at the hospital, she injected another person’s urine into her bladder. In September 2021, after receiving reports that the defendant was disappearing from her shift for extended periods of time, the hospital’s director referred her to an employee assistance program. On September 9, 2021, however, she took a leave of absence from the hospital for about three months after she was arrested for drunk driving. Her blood alcohol level at the time of her arrest was no less than .274.
In July 2022, the defendant entered into a settlement agreement with the Iowa Board of Nursing under which she agreed to voluntarily surrender her nursing license for one year. As a part of her plea agreement, she has now forfeited her nursing license to the United States.
Compliance Perspective
Issue
Experts estimate that 10–15 percent of our nation’s population struggles with impairment from alcohol or drug dependency. Nurses, as part of this statistic, are distinct due to their ability to access drugs in the workplace. Because as many as one in ten nurses could be affected by a substance use disorder, it is critical that each facility implements a proactive diversion-prevention program. The consequences of failure to do this include a negative impact on residents’ quality of care, legal and ethical concerns, and potential for high scope and severity citations once a diversion problem is uncovered. 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.
Discussion Points
- Review your policies and procedures on preventing, identifying, and responding to drug diversion. Update as needed.
- Train appropriate staff on actions that can be taken to prevent, identify, and respond to any suspicion of drug diversion. Provide education on the impact of drug diversion on residents as a form of abuse and neglect, staff responsibility to report concerns immediately, and the consequences of theft of controlled substances. Document that the trainings occurred, and place the signed document in each employee’s education file. Med-Net Academy offers all clients three PowerPoint training programs in our new category of Substance Use. Visit MNA to access all three. Additionally, in the Fraud, Waste, and Abuse Category of MNA, a program titled Drug Diversion: What Every Facility Needs to Know is available for viewing by all clients.
- Periodically audit to ensure that all controlled substances are accounted for on each shift, and that proper documentation of controlled substances has occurred. Your consultant pharmacist can be included in this effort.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
