What Happened

Jackeline Correa-Vázquez, 45, an advanced practice nurse with an anesthesia concentration, was indicted on May 28, 2026 by a federal grand jury in the District of Puerto Rico on eight counts for tampering with fentanyl at hospitals in Puerto Rico.

According to the indictment, Correa-Vázquez removed fentanyl citrate from vials entrusted for patient care and replaced the contents with clear liquid substances to conceal the theft. The substitution method is designed to evade routine counts: the vials remain present and appear full, so inventory appears intact while the actual drug has been removed.

She was arrested on the indictment and later released on a $10,000 bond with electronic monitoring. The eight-count charging structure indicates the conduct was alleged to have involved multiple vials and episodes rather than a single incident. She is presumed innocent unless and until proven guilty, and the case remains pending.

What Went Wrong

The public record does not describe the hospitals' internal controls, so the analysis below is hypothesis based on the method alleged. Vial substitution with clear liquid is a classic anesthesia diversion technique that typically flourishes where:

  • Vials are not visually inspected for tampering at the point of use — a substituted vial looks normal unless the contents are examined.
  • Tamper-evident seals or packaging are absent, or their integrity is not verified at receipt and before administration.
  • Anesthesia controlled substances are not reconciled per case: vials dispensed to the provider are not matched against documented administration, waste and returns.
  • Unused or partially used vials are returned without inspection or witnessed disposal.
  • Anesthesia work areas and storage lack access controls and periodic surveillance, so a provider can manipulate vials outside view.
  • No post-case review comparing documented administration to patient records, so substituted doses were never tied back to actual care.

The substitution pattern is unusually difficult to catch through inventory alone, because the vials stay in place. Detection depends on inspecting the vials themselves, reconciling per-case use, or analyzing use patterns — none of which can happen if the controls stop at counting containers rather than verifying contents.

How It Could Have Been Prevented

  • Inspect every vial for tampering — seal integrity, discoloration, particulates and volume — before drawing medication, and again when vials are returned.
  • Require witnessed waste and witnessed return of all unused anesthesia vials, with documentation that ties each vial to a specific case.
  • Reconcile anesthesia controlled substances per case: dispensed minus administered minus wasted must equal returned, with any discrepancy resolved before the next case.
  • Deploy peer-comparison analytics on anesthesia drug use to flag providers whose usage or wastage deviates from benchmarks.
  • Restrict access to anesthesia storage, secure unattended work areas, and apply random, unannounced audits of vial integrity.

Related Guidance

Sources