A registered nurse from Cape Girardeau, Missouri, pleaded guilty in federal court to one felony count of obtaining a controlled substance by fraud, admitting she fraudulently obtained fentanyl for her own use. Federal prosecutors in the Eastern District of Missouri described diversion at two different hospitals, separated by a firing and a state nursing board investigation.
In early 2020, pharmacy staff at a St. Louis-area hospital flagged the nurse for withdrawing two to three times more fentanyl than her peers. According to the government's sentencing memorandum, she had been taking fentanyl from the hospital's medication storage and dispensing cabinets. She was drug tested in February 2020 because of the aberrant fentanyl usage, multiple discrepancies in her documentation and her inability to account for the drug. She tested positive and was fired.
The Missouri Board of Nursing opened an investigation and interviewed her. Prosecutors said she told the board she had taken medication from the hospital on multiple occasions and acknowledged the risk to patient safety. Because she reported being in addiction treatment, and the treatment center confirmed her participation, she did not lose her nursing license. In October 2021 she was hired into another hospital's intensive care unit. In January 2022 that hospital suspended and drug tested her after she documented giving a patient 27 doses of 25 micrograms of fentanyl within 15 minutes, far outside hospital policy. This time the test was negative, but the hospital fired her anyway because its dispensing cabinet records indicated she frequently retained partially used vials in violation of policy. She was also accused of trying to disguise records to hide what drugs were taken.
After her guilty plea, she was sentenced to four years of probation. The case illustrates how pharmacy-side comparisons of withdrawal volumes against peers and review of dispensing cabinet records surfaced the diversion at both hospitals, and how a licensee who kept her license during treatment was able to move to a new employer and divert again.