A Missouri nurse pleaded guilty in federal court on December 16, 2024, to illegally obtaining fentanyl from a hospital for his personal use.
The defendant, a certified registered nurse anesthetist at a hospital in Osage Beach, was responsible for preparing medications used in daily medical procedures. He admitted to stealing fentanyl from the hospital’s automated dispensing cabinets in the operating rooms between July 1 and August 21, 2023. Specifically, he fraudulently obtained a vial of fentanyl intended for medical procedures by scanning it to generate a label, which he then affixed to a syringe he had filled with saline. This concealed the true contents of the syringe and allowed him to divert the fentanyl for his personal use.
On August 16, 2023, a pharmacy technician discovered a vial of midazolam and a syringe labeled “hydromorphone” left in a drawer used for storing medications for procedures. The technician alerted the hospital’s director of pharmacy, prompting a review of security footage.
Surveillance footage showed the defendant removing a vial of fentanyl and placing it in his pocket. He then applied a fentanyl label to a syringe filled with saline. The footage also captured him removing a carpuject of hydromorphone and placing it in his shirt pocket, along with another syringe labeled “hydromorphone.” Further review of the hospital’s security footage revealed similar incidents over the preceding two weeks.
The defendant admitted that he diverted either fentanyl or hydromorphone almost daily until his confrontation in August 2023. He confessed to storing the drugs in his backpack and self-administering them at home. In addition to fraudulently labeling syringes, he also admitted to withdrawing more medication than needed for procedures. In some cases, where only one vial of fentanyl was required, he would pull two vials, using one for the procedure and diverting the second for personal use.
Moreover, the defendant falsified patient records, documenting that patients received doses of medication that they did not actually receive. He made these false entries to cover up the medication he had diverted.
Under federal law, the defendant faces up to four years in federal prison without parole.
Compliance Perspective
Issue
Failure to prevent the diversion of residents’ prescribed controlled medications by staff who sell or use the drugs for personal gain may be considered abuse, neglect, misappropriation, and fraud, in violation of both state and federal regulations. Staff who divert medications often develop various methods to conceal their actions. To address this, facilities should implement a proactive diversion-prevention program that identifies the medications most likely to be diverted, signs that diversion has occurred, and indicators of staff impairment.
Discussion Points
- Regularly review your policies and procedures on preventing, identifying, and responding to drug diversion. Ensure they are up to date and aligned with current regulations and best practices.
- Provide training for all appropriate staff on how to prevent, identify, and respond to suspected drug diversion. This should include education on the impact of drug diversion on residents as a form of abuse and neglect, the responsibility to report concerns immediately, and the legal consequences of theft involving controlled substances. Document all training sessions, and ensure signed records are placed in each employee’s education file. Med-Net Academy offers three PowerPoint training programs in our Substance Use category; visit MNA to access these resources.
- Conduct regular audits to ensure all controlled substances are properly accounted for on each shift, and that documentation of these substances is accurate and complete. Involve your consultant pharmacist in these audits to ensure compliance and proper oversight.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*
