June 2022
The following are several drug diversion news stories that have captured our industry’s attention.
Health system reaches multi-million settlement in drug diversion case
What’s the hospital’s price for drug diversion? Sovah Health, a Virginia-based health system, has agreed to pay $4.36 million penalty and be subject to a four-year compliance an oversight from the federal government. The health system violated the Controlled Substances Act from 2017 to 2020. They allegedly saw one employee divert 11,000 Schedule II controlled substances and found another employee tampering with fentanyl vials before replacing them with saline solution. As part of the settlement, Sovah Health has committed to installing cameras at ADCs, reporting losses regularly, and conduct a full physical inventory of all controlled substances more frequently.
Stolen, lost fentanyl prompts license suspensions at New Hampshire hospital
The New Hampshire state boards suspended the licenses of the chief medical officer and two pharmacy executives at Cheshire Medical Center in Keene, N.H. The licensing board found that the Chief Nursing Officer was “negligent and/or careless” for failing to report more than seven gallons of fentanyl solution as unaccounted for. The Pharmacy Director’s license was also suspended because he played an integral role in the diversion and was responsible for reconciling the controlled substance report.
Substance use the main cause of physician license actions: study
A recent study published in the Journal of the American Medical Association (JAMA) found that more than three-fourths of actions taken against physician licenses were related to substance abuse. Researchers looked at data from the National Practitioner Data Bank to understand different factors for license actions, including psychological and physical impairment. The study also found that these physicians were also more likely to accrue further actions over the course of their careers and were more likely to receive indefinite penalties for them.
UPMC Passavant nurse charged for taking patients’ drugs
The Pennsylvania Attorney General’s office has charged Crystal L. Miller with one felony count and one misdemeanor for taking patients’ drugs for personal use. A fellow nurse reported blood and used syringes on a staff bathroom floor and found Miller “lethargic” to the point of falling off a chair. Following an internal investigation, she admitted to taking patients’ wasted narcotics and circumvent policy by showing observing nurses a syringe containing saline.
Veterans’ hospital worker in NJ sentenced for theft of $8.2M in HIV meds
Lisa M. Hoffman, a former pharmacy technician at a VA hospital in New Jersey, was sentenced to five years in federal prison for her involvement in the theft of over $8 million in HIV medications from the hospital. She had used her position to place large orders on behalf of the hospital before stealing the drugs. Hospital surveillance footage eventually captured her putting the substances in her bag, leading to her guilty plea and ensuing sentence. She must pay over $8 million in restitution and forfeit an additional $450,000.
Cook County has confirmed a record number of fatal overdoses last year
The second largest county in the nation confirmed a record 1,920 fatal overdoses in 2021, according to the county medical examiner’s office. The number represents a four percent increase over the first year of the pandemic. The report also found that around 54 percent of overdose victims were Black, even though only 24 percent of the county is Black. Cook County has requested, and received, further aid from the federal government in response to an uptick in fentanyl-related deaths.
Nurse admits stealing patient’s drugs, citing stress from COVID-19 deaths
The Iowa Board of Nursing suspended the license of nurse Kelsey Baxter after she admitted to stealing a nursing home resident’s painkillers. Baxter worked at a Waterloo retirement community from 2009 to 2021, but was spotted by a colleague while taking a pill from a resident in April 2021. After being fired and admitting to substance abuse while at work, she stated that the stress of seeing over a dozen patients die from COVID-19 contributed to her use of painkillers, cocaine, and other drugs.
The Blackfeet Nation’s plight underscores the fentanyl crisis on reservations
The opioid crisis has affected Americans in all 50 states, but a UCLA study concluded that the overdose death rate among Indigenous people was the highest of all racial groups in the first year of the pandemic. Leaders from Blackfeet Nation declared a fentanyl overdose state of emergency in March of this year to outline the seriousness of the situation. Although the communities suffer from underfunding, the tribe created a task force to develop more drug addiction resources for the reservation, including training more people on how to use naloxone to reverse opioid overdoses.
San Diego County prompts outreach to parents as accidental fentanyl deaths spike
San Diego County (Calif.) officials held a virtual town hall meeting June 8 to warn the public about the dangers of fentanyl. Officials declared a “Talk to your kids about fentanyl” week during the meeting, in which attendees were taught how to look for signs of overdose, how to treat an overdose with naloxone, and how to have a conversation about drugs with teens. Since 2016, the number of fentanyl-related deaths have risen by 2,300 percent in the county.
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Stopping drug diversion is an enterprise-wide effort
Christine Versichele, B.S.N., M.S.P.
When a drug diversion event becomes a headline, the focus often turns onto nurses. Whether it is replacing painkillers in an IV with saline solution or misrepresenting medication administered while charting, diverting nurses will be named culprits and be held accountable for their crime. The actions of a few bad actors can sometimes put the blame of drug diversion squarely on the shoulders of the nursing staff within a hospital floor.
But Christine Versichele, BSN, MSP thinks the responsibility of monitoring and stopping drug diversion should fall on the shoulders of everyone in the hospital, not just nurses. As a former intensive care unit (ICU) nurse, Versichele understands the pitfalls healthcare workers face while on the floor. She has seen what drug diversion can do to a nurse’s career.
“When my roommate and I graduated from nursing school, we went our separate ways,” says Versichele. “Years later, when we reconnected, I found out she was no longer a nurse. She lost her license after diverting medications from the floor. I never thought it would happen to someone as close to me.”
Versichele mentions that drug diversion can happen anywhere on the floor, and as such, everyone within a hospital space needs to proactively look for its signs. Whether in the hospital pharmacy, the anesthesiology department, or even the custodial staff, everyone should be trained to look for signs of it happening. Some individuals may have reservations about adding a monitoring plan or program, but Versichele thinks they need to accept the help to avoid future problems.
“A California hospital once tried to implement a solution within several departments,” recalls Versichele. “Almost everyone was on board with the solution, but the anesthesia department felt like it was a personal attack on the staff. They had to understand that this was not about pointing fingers; this was about trying to improve clinical practice at their institution.”
Refusing to have a comprehensive diversion plan in place in a hospital due to fears of facing blame is negligent at best and criminal at worst, she says.
“There was a case of a diverting nurse in Utah who was eventually caught and placed on probation,” says Versichele. “As soon as her probation ended, she moved to the next county, got a job at a hospital there, and started diverting all over again before she was caught.”
“There are no boundaries when someone wants to divert. If a strong program is not in place at a facility, the institution, and especially patients, are at risk.”
Teaching staff about the dangers of drug diversion, and what they can do to stop it, must begin early, says Versichele – even as early as in school. Her experience on the floor has convinced her husband, an associate clinical professor, to add diversion cases to his doctoral courses. She adds that as soon as health care graduates come into the workplace, they need to be integrated into programs at their practicing institutions where they understand what it is, the harm it may cause, and what steps can be taken to prevent it. Crucially, they need to be told that this is a never-ending effort.
“Drug diversion events are not one-time events,” says Versichele. “Just because a diverter is caught once doesn’t mean others will stop.”
Healthcare workers who have addiction issues will just find a different way to take these substances or leave the facility and set up elsewhere – just to harm patients all over again, adds Versichele. Rather than putting the blame of drug diversion squarely on the shoulders of nursing staff, facilities can take a proactive approach by having a robust prevention program in place.
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