First Choice Surgical Center, an ambulatory surgical center located in Cedar Rapids, Iowa, has agreed to pay $125,000 to the United States to resolve allegations that it violated civil provisions of the Controlled Substances Act. First Choice Surgical Center is the surgical center affiliated with Fox Eye Laser & Cosmetic Institute, PC, a practice performing laser vision correction and cataract surgery. The settlement resolves allegations that First Choice failed to maintain complete and accurate records concerning the controlled substances it purchased and dispensed and failed to provide effective controls and procedures to guard against theft and diversion of controlled substances. In August 2019, other employees of First Choice discovered that Sabrina Thalblum, a registered nurse at First Choice, had been tampering with vials of fentanyl. The fentanyl was kept at First Choice for patient use during out-patient surgical procedures. A criminal investigation revealed that Thalblum stole the fentanyl for her own use. Thalblum withdrew fentanyl from the vials, reinjected saline into the vials, and returned the vials, which now contained less than declared values of fentanyl, to storage at First Choice. In January 2021, Thalblum pled guilty in federal court in Cedar Rapids, Iowa, to charges related to the theft and, in January 2022, was sentenced to five years-probation.
A related civil investigation identified at least 130 separate occasions in which the record-keeping requirements of the Controlled Substances Act were allegedly violated by First Choice. The DEA’s investigation found that First Choice employees “batch signed” records indicating they had witnessed the wasting of fentanyl remaining after surgery when it was not First Choice’s practice to ensure those employees had witnessed the wasting. Additionally, First Choice failed to make a timely report to DEA after it learned of the fentanyl theft.
