According to federal prosecutors, a pharmacy technician at a hospital system in Pikeville, Kentucky diverted more than 60,000 doses of oxycodone, hydrocodone and methadone from the hospital's narcotics vault and automated dispensing cabinets from January 2016 through early September 2018. Prosecutors said the hospital's failure to maintain accurate and complete inventories and dispensing records was what allowed the diversion to continue for that long.

The technician and her husband pleaded guilty in 2020 to a conspiracy to distribute the drugs. She was sentenced to 41 months in prison and he was sentenced to 38 months. The hospital told local media that no patients were deprived of medication or harmed as a result of the diversion.

The hospital self-reported the diversion and cooperated with a Drug Enforcement Administration investigation. It later agreed to pay a $4.4 million civil penalty for the recordkeeping failures. The settlement does not determine any liability. The DEA's Louisville division chief said the size of the penalty reflected the seriousness of the situation.

Alongside the penalty, the hospital entered a three-year memorandum of agreement with the DEA that includes inspection, reporting and training requirements. The hospital said it had taken multiple steps and invested in new technology to better detect and prevent medication diversion in its facility.